Brain scans and bipolar disorder: what’s the connection?

MRIs and CT scans can provide detailed images of the brain and its structures. But currently, doctors don’t use them to diagnose bipolar disorder.

Detection of bipolar disorder is usually done through a diagnostic interview with a mental health professional.

Although imaging tests are not used as a diagnostic tool for bipolar disorder, researchers use them to explore the effect of bipolar disorder on the brain. They also use imaging to examine any unique characteristics the brain may have.

Although brain scans are not used to diagnose bipolar disorder, they can help rule out other conditions.

According to the Depression and Bipolar Support Alliance, these conditions can cause symptoms resembling those of bipolar disorder, such as brain damage, tumor, or stroke. People who get brain scans related to bipolar disorder usually do so for research purposes rather than to diagnose the disorder.

Brain scans can show which structures are involved in different disease processes. They can also show whether certain functions or differences are involved in a mental health condition. Experts believe there may be an association between structural differences in the brain and bipolar disorder.

But one 2018 imaging study had inconsistent results. The researchers found finer cortical gray matter in the frontal, parietal, and temporal areas of both hemispheres of the brain. Cortical thickness was also affected, but this may be from certain drugs, such as lithium.

The amygdala, which helps process emotions, can also react differently depending on whether a person has bipolar disorder or depression. In those living with bipolar disorder, a small 2019 study suggests that the left side of the amygdala is less active and less connected with other areas of the brain, unlike those living with depression.

On 60 percent of people with bipolar disorder are initially misdiagnosed as depression. Experts hope that imaging scans may eventually be helpful in distinguishing between the two conditions. But more research is needed first.

Imaging scans can tell us a lot about the brain. But, at present, brain scans are not used to diagnose bipolar disorder.

To diagnose this condition, a psychologist or other mental health professional may do a physical exam or order lab tests. These can help rule out any other medical conditions causing your symptoms. They will also ask you questions to learn more about the symptoms you are experiencing.

The “Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5)” is used to assess whether a person meets the criteria for a mental health problem.

There are different types of bipolar disorder. The DSM-5 helps a clinician differentiate between them and make the proper diagnosis.

  • Bipolar I disorder. You must have had at least one manic episode lasting at least 7 days to be diagnosed with bipolar 1 disorder, according to the National Institute of Mental Health (NIMH). The symptoms of a manic episode can be so severe that you need hospital care. Depressive episodes also occur, usually lasting at least 2 weeks.
  • Bipolar II Disorder. The NIMH defines this guy bipolar disorder as a pattern of depressive episodes and hypomanic episodes, but not fully manic episodes.
  • Cyclothymic disorder. This type of bipolar disorder is also known as cyclothymia. the NIMH says it is defined by periods of hypomanic symptoms alternating with periods of depressive symptoms lasting at least 2 years, or 1 year in children and adolescents. These symptoms do not fully meet the criteria for a hypomanic episode or a depressive episode.

Depending on the type of bipolar disorder and the severity of the mania or depression, symptoms may vary.

According to the American Psychiatric Association, symptoms of mania can include:

  • less need to sleep
  • increased or faster speech
  • uncontrollable racing thoughts
  • increased activity or risky behavior

Hypomanic symptoms are less severe manic symptoms. They do not cause the functional disturbances that manic symptoms cause.

Symptoms of a major depressive episode include:

  • intense sadness or despair
  • loss of interest in previous activities
  • feelings of worthlessness or guilt
  • fatigue
  • changes in sleep or appetite
  • difficulty concentrating
  • thoughts of death or suicide

Bipolar disorder is a lifelong illness. Although it cannot be cured, it can be treated and managed. Medication and psychotherapy are common elements of treatment.

According to NIMHtreatment often includes:

What works for one person may not work for another. You may need to try different medications to find the best one for you. Talk to your therapist and healthcare professional about how your medicine is working, if there are any problems, and if you find the therapy helpful.

Other treatments people may find helpful include:

  • Electroconvulsive therapy. It is an effective treatment for severe depressive and manic episodes, especially if medication or therapy is not helpful.
  • Transcranial magnetic stimulation. This treatment uses magnetic waves to stimulate the brain, but is still being studied for bipolar disorder.

Always talk to your healthcare professional about the vitamins, medications and supplements you take. Even “natural” products can interact with medications and have unwanted side effects.

Although brain scans aren’t typically used to diagnose bipolar disorder, researchers use them to explore the condition. This can help with future diagnostic processes and potentially with treatment.

Currently, mental health professionals diagnose bipolar disorder through a clinical interview. From there, you can work together to develop a treatment plan. With proper treatment, bipolar disorder can be effectively managed.

About Margie Peters

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