An interesting development in mania is impulsive and risky behaviour. This is where melanin concentrating hormone is involved generating this outcome via the hypothalamus and hippocampus circulatory. It shares 39% amino acid identity with somatostatin receptor 1. This indicates that when somatostatin is in demand in a manic episode MCH becomes depleted playing a secondary role to the cyclic peptide. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6820566/?msclkid=96d52c82ce7911ecbeb7ecfd6b9866b3

The more depleted it becomes the more it influences the CNS to partake in risky and impulsive behaviour. The depressive phase of Bipolar 1 displays many symptoms too, including the possibility of suicidal tendencies. Generally there is a low level of activity and little to no energy. Also a sufferer of this condition has trouble focusing or remembering things and has a hard time making decisions. This is hippocampal dysfunction. Glutamate, GABA, acetylcholine, noradrenaline and serotonin are all neurotransmitters that are found in the hippocampus. All of them are affected by the bipolar swings. Dopamine and somatostatin play an
integral part in the memory and cannot be expected to be functional in a depressive mood. With mania it is the opposite. A person feels highly wired and recall can come with exceptional clarity. However, when euphoria is at its highest levels things can become distorted and grandiosity can become a problem. A casualty of this activity is Brain Derived Neurotropic Factor. It performs poorly under these conditions. BDNF is found in the brain and spinal cord. It promotes the survival of neurons and plays an important role in learning and memory.

There are many facets to the bipolar disorder and the complexities of the illness are numerous. The highs and lows are always fluctuating without medical intervention. This can be distressing within itself. There are so many neurotransmitters/steroids at play it is difficult to know what benefit these would be by targeting just one. Of course Dopamine and Somatostatin take centre stage. However, the manipulation of these two can easily promote a new illness on top of the existing bipolar. This includes cancer in the way of malignant tumours.