How Is Bipolar Disorder Diagnosed
Doctors diagnose bipolar disorder on the basis of a clinical evaluation. It may consist of an interview and discussion about experiences, symptoms, and progression of those over time. There must be at least one episode of mania or hypomania for a diagnosis of bipolar disorder. Doctors then assess the severity of those episodes to determine the type.
A doctor may also perform a physical exam and run blood work. They do this to rule out other potential causes for symptoms aside from bipolar disorder.
One major challenge for doctors is distinguishing between unipolar and bipolar depression. Unipolar depression is also called major depressive disorder and has the same criteria as bipolar depression. History of mania or hypomania along with depression is part of the diagnostic criteria for bipolar disorder, of which there are several types.
Your doctor cant diagnose bipolar disorder from a brain scan or blood test. However, new research has uncovered a possible link between the expression of a key brain molecule and the diagnosis of mood disorders.
Dont Panic Over Your Bipolar Brain
I know the picture and research above are alarming! However, just as bipolar can destroy grey matter, lithium re-grows it:
Just four weeks of treatment with lithium increases gray matter volume in the human brain, according to a study by Wayne State University School of Medicine on the bipolar brain. This regrowth is due to lithium helping with cognitive functions that are otherwise difficult for bipolar patients.
Think of lithium aiding the brain like a knee brace for a bad knee that allows someone to continue to lift weights and build muscle they otherwise would not be able to.
What Is The Neurological Cause Of Anxiety
Symptoms of mood and anxiety disorders are thought to result in part from disruption in the balance of activity in the emotional centers of the brain rather than in the higher cognitive centers. The higher cognitive centers of the brain reside in the frontal lobe, the most phylogenetically recent brain region.
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Feature Selection And Construction Of The Support Vector Machine
To obtain more sensitive features and improve the stability and efficiency of the classification in the SVM, a two-sample t-test with multiple comparisons was used in the VBM and ReHo statistical analyses . In the VBM analysis, we applied age, sex, education level, and total intracranial volume as nuisance covariates, and the t-map was corrected for multiple comparisons using the Gaussian random field theory . The grey matter volumes of the clusters showing significant differences were obtained from each subject using the DPABI toolbox. In the ReHo analysis, age, sex, and education level were regarded as nuisance covariates, and the t-map was corrected using the GRF approach . The ReHo values of each subject in the clusters showing significant differences were also extracted using the DPABI toolbox. Further, between these regions showed by VBM/Reho analyses, we used LASSO approach to identify the most informative regions and also reduce the dimensionality of the feature space to avoid over-fitting. Grey matter volumes and ReHo values in each cluster were selected as feature vectors for discrimination and inputted into the SVM to construct the final classification model.
Brain Imaging In Bipolar Disorder
Structural and functional brain imaging studies in bipolar disorder lend direct, support to the indications of prefrontal cortical pathophysiology from studies of neurocognition. Classic studies of patients with secondary mood disturbance as a consequence of organic pathology like stroke or tumor reported increased prevalence of depressed mood following damage to the left, frontal cortex and the left, basal ganglia., Cases of secondary mania arc unsurprisingly less common than poststroke depression, but, are reported to show the reverse pattern of laterality, associated with right-lateralized damage to the frontal cortex and basal ganglia. These data highlight the connectivity between the frontal cortex and basal ganglia, and this frontostriatal circuitry is thought, to support, many aspects of attentional, executive and emotional function. Neurological patients with basal ganglia pathology also show elevated levels of depression, compared with other patient, groups with disorders matched for level of disability
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Structural Neuroimaging Findings Implicating These Core Domains
Structural neuroimaging studies in adult BPI broadly support findings from functional neuroimaging studies. In adults, there are findings of enlarged amygdalae , decreased dorsal and ventral prefrontal cortices , and smaller or no change in hippocampi. Pediatric findings differ slightly.
Taken together, these findings implicate functional and structural abnormalities in distinct, distributed neural systems for emotion processing and executive control in bipolar disorder. We next examine the extent to which functional neuroimaging study findings suggest a distinction between functional abnormalities in neural systems underlying emotion processing and executive control in bipolar disorder versus those reported in UPD.
Future Perspectives: Replication Big Data And Shifting The Paradigm In Psychiatric Research
BD is a complex illness where individual factors confer a small proportion of the overall risk. The ENIGMA Bipolar Disorder Working Group is focused on applying innovative, big data approaches to provide reliable new discoveries on the biological underpinnings of BD, and to generate clinically relevant findings to improve diagnosis and treatment.
The current psychiatric research paradigm, which seeks markers that link high-level, behavioral-based diagnostic labels to underlying biology, is slowly changing. Neuroimaging may not provide the larger BD-related effect sizes once proposed by the âendophenotypesâ hypothesis, but the combination of large-scale neuroimaging data sets has led to a better understanding of the brain regions that mediate the link between genetic risk and the behavioral manifestations of BD.
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Here Are 10 Ways Spect Brain Scans Can Help You Understand And Treat Add/adhd
1. Brain scans show brain function.
While MRI and CT brain imaging studies show the structure of the brain, SPECT brain scans show how it functions. Basically, SPECT shows three thingshealthy activity, activity that is too high, and activity that is too low. In Sally, it showed that the activity was too low while she was concentrating. It can also reveal signs of head trauma, exposure to toxins, and drug and alcohol abuseall of which can contribute to symptoms associated with ADD/ADHD.
2. How can you know unless you look?
The health of your brain plays a major role in your ability to focus, pay attention, and be organized. There is no way to know about the health of your brain unless you look at it.
3. Brain scans offer a more accurate diagnosis.
Most psychiatric illnesses are diagnosed based on symptom clustersthe same way they have been diagnosed for over 100 years. SPECT brain imaging adds an objective, biological component to give doctors important additional information for a more accurate diagnosis. Common symptoms of ADD/ADHD include short attention span, poor impulse control, organization problems, being easily distracted, procrastination, and trouble with follow-through.
4. Brain imaging reveals there are 7 types of ADD/ADHD.
Limitations Of Brain Scans
Even though brain scans have many benefits, they do have some limitations. Mental illness is tricky to diagnose and not everyone with the same diagnosis will show the same brain abnormalities. Also, there might be multiple reasons for a single type of brain abnormality. Brain scans might also have difficulty identifying brain abnormalities during the early stages of certain mental health conditions. Generally, though, brain scans provide limited insight when:
- Mental illness presents differently in different individuals
- Mental health patients have overlapping symptoms or multiple diagnoses
- A mental health condition is in the earlier stages
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New Brain Scan May Diagnose Bipolar Disorder
Technique Tracks Chemical Changes in the Brain
Nov. 30, 2004 — Researchers using a special type of imaging that tracks brain chemicals are able to produce a “chemical fingerprint of bipolar disorder,” a development that may lead to earlier diagnosis and aid in treatment.
If the results of this initial study are confirmed in larger trials, the technique, called MR spectroscopy, could “be a valuable diagnostic tool in two to three years,” Mayo Clinic radiologist John D. Port, MD, PhD, tells WebMD. Port presented results of his preliminary study at the annual meeting of the Radiological Society of North America.
Doctors have long known that patients with bipolar disorder have abnormal amounts of certain chemicals in the brain that cause changes in mood – fluctuations between depression, normal mood, and mania.
MR spectroscopy uses ordinary MRI technology that is modified to view the chemical properties of brain tissue and thus theoretically can detect the chemical changes associated with bipolar disorder as well as other mental illnesses.
In Port’s study, MR spectroscopy was used to analyze various parts of the brain in 19 patients with bipolar disorder and 19 people without the condition. They looked at the parts of the brain believed to be involved in causing bipolar disorder as well as one “control” region that was not believed to be affected by the disease.
“Differences were clearly visible based on mood state ,” he says.
Support Vector Machine Classifier
We a priori chose to use support vector machine , which is the most frequently used ML method in psychiatric brain imaging . The present analyses implemented a linear kernel, because this limits the risk of overfitting, contains only a single parameter, see below, and the coefficients of a linear classifier can be interpreted as relative measures of feature importance. However, we also performed sensitivity analyses to determine the impact of using a non-linear kernel on results. All ML analyses were implemented in the Python programming language v. 3.6 using the Scikit-Learn package v. 0.19 .
As the features used in the present study are engineered , we opted against further feature selection. This decision was also supported by the large sample size and the fact that we had 20 times more participants than features. Importantly, in the above-described methods, the SVM models are independent across folds and no statistical harmonization, model selection or comparison was done prior to splitting the samples into testing and training. Consequently, we have minimized the potential for information leak.
Classification performance was measured using standard metrics including accuracy, sensitivity, specificity, positive predictive value, negative predictive value and area under the receiver operating characteristic curve .
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What Is Central Nervous System Depression
Central nervous system or CNS depression happens when the bodys normal neurological functions slow down. It can result from substance overdoses, poisoning, or other medical conditions. Depression of the central nervous system or CNS often occurs when a person misuses a substance that slows brain activity
Association Of Cortical Surface Area With History Of Psychosis And Mood State Findings At The Time Of Scanning
When comparing 768 adult BD patients with a history of psychosis with 619 patients without a history of psychosis, we found evidence of reduced surface area in the right frontal pole of BD patients with a history of psychosis . We did not detect differences in cortical thickness or surface area in any other regions of interest . Further, we did not detect differences in cortical thickness or surface area when comparing patients who were depressed at the time of scanning with patients who were euthymic at the time of scanning . Comparisons with other mood states such as hypomanic, manic and mixed were not possible due to small sample sizes.
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Can You Get A Brain Scan For Mental Illness
Scientists know that mental health conditions like depression, anxiety, and PTSD originate in the brain. Research has also helped scientists discover which parts of the brain trigger and affect certain conditions. But even with all of that information, diagnosing a mental illness is far from easy. Unlike other conditions like cancer, diabetes, or heart disease, there are no specific lab tests or tools that can detect mental health disorders. In fact, diagnosing a mental illness is a complex process thats based on your symptoms, behavior patterns, and your doctors medical opinion.
To help bring some clarity to mental health diagnoses doctors, scientists, and behavioral health experts have started to look at brain scans as a way to help diagnose mental illness.
Diagnosing Bipolar Disorder In Children
Bipolar disorder isnt only an adult problem, it can also occur in children. Diagnosing bipolar disorder in children can be difficult because the symptoms of this disorder can sometimes mimic those of attention-deficit hyperactivity disorder .
If your child is being treated for ADHD and their symptoms havent improved, talk to your doctor about the possibility of bipolar disorder. Symptoms of bipolar disorder in children can include:
- impulsiveness
- emotional outbursts
- periods of sadness
The criteria for diagnosing bipolar disorder in children is similar to diagnosing the condition in adults. Theres no particular diagnostic test, so your doctor may ask a series of questions about your childs mood, sleep pattern, and behavior.
For example, how often does your child have emotional outbursts? How many hours does your child sleep a day? How often does your child have periods of aggression and irritability? If your childs behavior and attitude are episodic, your doctor may make a bipolar disorder diagnosis.
The doctor may also ask about your family history of depression or bipolar disorder, as well as check your childs thyroid function to rule out an underactive thyroid.
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Looking Inside The Brain To Distinguish Bipolar From Depression
- Date:
- Westmead Institute for Medical Research
- Summary:
- New research has found that neurons deep inside the brain could hold the key to accurately diagnosing bipolar disorder and depression.
New research has found that neurons deep inside the brain could hold the key to accurately diagnosing bipolar disorder and depression.
The research team used sophisticated MRI scanning to see how the amygdala — a set of neurons that play a key role in processing emotions — reacts as a patient processes facial expressions such as anger, fear, sadness, disgust and happiness.
The research showed that this key structure within the brain responds differently depending on whether the person has bipolar disorder or depression.
In people with bipolar disorder, the left side of the amygdala is less active and less connected with other parts of the brain than in people with depression.
The findings from this study had 80% accuracy in making this distinction.
Lead researcher Dr Mayuresh Korgaonkar from the Westmead Institute for Medical Research and the University of Sydney said these differences could potentially be used in the future to differentiate bipolar disorder from depressive disorders.
“Mental illness, particularly bipolar disorder and depression, can be difficult to diagnose as many conditions have similar symptoms,” Dr Korgaonkar said.
“These two illness are virtually identical except that in bipolar individuals also experience mania.
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Can A Brain Scan Show Anxiety
Brain imaging can reveal unsuspected causes of your anxiety. Anxiety can be caused by many things, such as neurohormonal imbalances, post-traumatic stress syndrome, or head injuries. Brain scans can offer clues to potential root causes of your anxiety, which can help find the most effective treatment plan.
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Diagnosis Guide For Bipolar Disorder
Testing for bipolar disorder
People with bipolar disorder go through intense emotional changes that are very different from their usual mood and behavior. These changes affect their lives on a day-to-day basis.
Testing for bipolar disorder isnt as simple as taking a multiple choice test or sending blood to the lab. While bipolar disorder does show distinct symptoms, theres no single test to confirm the condition. Often, a combination of methods is used to make a diagnosis.
Can Brain Scans Diagnose Mental Illness
As wonderful as brain scans are, they cannot singlehandedly detect mental illnesses. That doesnt mean images of the brain cant help detect and diagnose mental health conditions, though. When used alongside traditional assessment techniques, brain scans can help narrow down brain abnormalities and confirm mental health diagnoses. A single brain scan probably cant tell you the exact mental health condition you have. But images of your brain can help your doctor understand whats going on with your mental health, confirm your doctors clinical observations, and help them develop an appropriate treatment plan. There are many benefits brain scans provide that help detect, diagnose, and confirm mental health disorders.
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What Does A Doctor Need To Know To Diagnose Bipolar Disorder
A bipolar disorder diagnosis is made only by taking careful note of symptoms, including their severity, length, and frequency. “Mood swings” from day to day or moment to moment do not necessarily indicate a diagnosis of bipolar disorder. Rather, the diagnosis hinges on having periods of unusual elevation or irritability in mood that are coupled with increases in energy, sleeplessness, and fast thinking or speech. The patientâs symptoms are fully assessed using specific criteria from the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders or DSM-5.
In making the diagnosis of bipolar disorder, the psychiatrist or other mental health expert will ask you questions about your personal and family history of mental illness and bipolar disorder or other mood disorders. Because bipolar disorder sometimes has a genetic component, family history can be helpful in making a diagnosis.
Also, the doctor will ask detailed questions about your bipolar symptoms. Other questions may focus on reasoning, memory, ability to express yourself, and ability to maintain relationships.
There Are Some Benefits To Using Brain Scans In The Diagnosis Of Mental Health Conditions But Imaging Can Also Some Limitations
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Diagnosing mental illness can be a subjective process, as it is largely based on client reports and practitioner assessments. Upon examination, it is possible that multiple practitioners could come up with varying diagnoses for the same client. More objective diagnostic methods are necessary to prevent misdiagnosis and to ensure proper treatment. Brain scans for mental illness are being studied as an objective tool, which can be used alongside traditional client assessment techniques.
Brain scans and other technology are becoming more and more proficient at diagnosing mental illness and are being used to create new psychiatric medications. Mental health brain scans show the structures and tissue of the brain and provide information about blood flow and cellular energy use.
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