Among serious forms of mental illness, bipolar disorder has been one of the least-funded in terms of research. In fact, it’s seen sharply diminishing support in recent years, even as federal funding for other forms of mental illness has increased. That has left the estimated 40 million people worldwide who suffer from the disorder to struggle with imperfect treatment options.
These options may involve longtime standard medication lithium, used since the middle of the last century, to control and stabilize the mood swings that characterize the disorder. There’s also psychotherapy, electroconvulsive therapy, transcranial magnetic stimulation and other treatments — but little hope for a timely cure.
Now, three wealthy families — all of whom have personal experience with bipolar diagnoses and the often complex quest for treatment — have partnered to accelerate basic understanding of the disorder and bring new therapies to the table. They’re doing this through the creation of BD²: Breakthrough Discoveries for thriving with Bipolar Disorder, which was designed to function not only as a funder, but, more importantly, as a global platform to coordinate science across disciplines and national borders and tackle this complex and still poorly understood disorder.
Launched with $150 million in initial funding from the families, the new organization’s founders are writer and mental health advocate Jan Ellison Baszucki and her husband David Baszucki, founder and CEO of the Roblox gaming platform (we’ve written in the last year about the Baszuckis’ deepening support for mental health causes); Kent and Liz Dauten (Kent Dauten is co-founder and chairman of private equity investment firm Keystone Capital); and Google co-founder Sergey Brin, who has in recent years been making substantial investments in research into Parkinson’s disease, another brain disorder that’s long overdue for advances and new treatments.
BD² (pronounced “BD-squared”) will be housed at the Milken Institute’s Center for Strategic Philanthropy. Individual givers and foundations often retain scientists and philanthropy professionals at the Milken Center for advice on how best to give to science and research. In this case, however, the Milken Center will administer BD², running it along with the funders.
“I think the big sea change here is we have funders coming together and collaborating to create the scale and the infrastructure to allow researchers, clinicians, and patient communities to bring forward advances,” said Cara Altimus, a senior director at the Milken Center for Strategic Philanthropy, who is now also managing director of BD².
The importance of this oversight and coordination cannot be overstated. Most biomedical research is funded on a project-by-project basis: a principal investigator gets a grant, publishes the findings, and hopefully, other scientists will build upon that work. While such individual projects will always be important, research leaders in philanthropy and public funding are increasingly pushing for more coordinated, unified strategies to solve problems more quickly and efficiently. “This is important news for bipolar disorder research and for biomedical philanthropy because it’s a global model of coordinating research,” Altimus said.
People who have bipolar disorder experience changes in mood, energy and activity levels, often going from manic and agitated to depressed and hopeless. (The condition used to be called manic depression.) It generally first emerges in the teen years or in young adulthood. There are at least three types of the disorder, depending on the pattern and type of mood changes involved, and there are people who don’t exactly fit any of the three primary types.
In fact, bipolar disorder may not even be a single condition, said Jan Baszucki, who dived into the subject with her husband when their teenage child was diagnosed — and started to learn how difficult the condition can be to control, and how much more the scientific community needed to understand the basic biology involved and to develop more effective therapies.
The biology of the brain and other aspects of human metabolism that may trigger disorders like bipolar are insufficiently understood to develop anything like a cure, Baszucki said. “We don’t have a single biomarker that can tell us whether someone has this illness or not, so we’re just looking at symptoms to make diagnoses,” she said. “It might be inflammation, it might be neurotransmitter imbalances — but what is causing the inflammation and the neurotransmitter imbalances in a particular individual, that’s what we’re trying to get at.” With that knowledge, she said, researchers may be able to develop therapeutics specific to the cause and personalized for the patient, rather than simply treating the symptoms.
BD² will fund and coordinate research through several programs, including multidisciplinary efforts to study cellular, genetic and other mechanisms of bipolar disorder. It will also organize the collection and genotyping of samples from diverse people with bipolar disorder, and will track thousands of patients in a long-term longitudinal study.
BD² funders Kent and Liz Dauten were also drawn to bipolar research and care after two of their children were diagnosed with the condition. Like the Baszuckis, they traveled widely to top medical experts in search of help for their kids and were confronted with a lack of effective treatments. “Every specialist I would meet, I would ask: ‘What does the field need most?’” Kent Dauten said. A top specialist told him the field’s clearest need was a central organization to coordinate research and prioritize capital allocation across the research community. “And that’s exactly what BD² is doing,” he said.
Another important goal for the BD² team will be to draw and retain more scientists into the bipolar research field. That’s a more hopeful prospect than in the past. Newer research tools are enabling enhanced study of the brain and human physiology more generally — right down to the function of individual genes and cells — and increasing the likelihood of significant progress. “For a long time, the best and brightest scientists didn’t want to come into this field because it would likely be a dead end in their careers,” Dauten said. “But I think in the last 10 years, that has changed. They’re now viewing it as a path that might really launch their professional careers because they can make meaningful progress.”
Significant funding for bipolar research is only now going into motion, but far more will be needed. “The fact of the matter is that the resources that have been dedicated to bipolar are just embarrassingly small,” Dauten said, adding that the $150 million to launch BD² is an important start, but won’t end the disorder. “More funders are needed because we hope to build upon this initial funding amount.”