Bipolar Disorder Affects Brain Regions Controlling Inhibition Emotion
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Analysis of a large sample indicated widespread bilateral patterns of reduced cortical thickness in adolescents and adults with bipolar disorder.
is known to be highly heritable with individual risk depending partially on genetics. However, the underlying neurobiological mechanism of the disorder remains unclear. The prognosis for individuals with is mixed: currently approved medications are ineffective for many patients,Derrek Hibar, PhD, of the University of Southern California, Marina del Rey, and colleagues wrote.
To better understand pathophysiology of bipolar disorder, researchers assessed cortical gray matter thickness and surface area measures from brain MRI scans of 1,837 individuals with bipolar disorder and 2,582 healthy controls.
Participants with bipolar disorder exhibited thinner cortical gray matter in frontal, temporal and parietal regions of both brain hemispheres.
Bipolar disorder had the largest effect on left pars opercularis, left fusiform gyrus and left rostral middle frontal cortex.
When accounting for age at the time of MRI, longer illness duration was associated with reduced cortical thickness in frontal, medial parietal, and occipital regions.
A history of psychosis was associated with reduced cortical surface area, but mood state at time of scan was not.
Does Bipolar Disorder Damage The Brain
Most research agrees: people with bipolar disorder have brains that are physically different from those without mood disorders. However, no one knows if bipolar disorder itself damages the brain. Those with bipolar disorder may be born with genetic abnormalities that cause physical changes to the brain: these physical changes may lead to bipolar disorders.
Luckily, these physical changes can be managed with medication. Certain medications can help regulate hormone imbalances, restore the brains gray matter, and reduce shrinkage to the hippocampus. People with bipolar disorder should discuss medications and therapy with their doctors. While bipolar disorder is a lifelong disorder, it can be well-managed in today’s medical ecosystem.
Bipolar Runs In My Family I Think I Might Have It Can It Skip A Generation Do I Have It
My grandma had bipolar and my 2 uncles have bipolar.
Ive had depression/anxiety most of my life. I go through periods and highs and lows daily. Ive tried anxiety and depression meds once and those triggered bad thoughts and I have never wanted to go back to meds.
Ive also had insomnia most of my life. I can go days without sleep and have gone the last 3 months with averaging 2-4 hours of sleep. I cant shut my brain off and have loads of energy. I also have adhd.
One thing my uncles get is they get such highs that they feel like they can rule the world. I have never seen this side of them but my mom says they are both on meds. I have highs, but Im generally realistic. I do have gambling problems, but I dont bet more then I can afford to lose. I also binge eat. My depression gets bad where i just stay isolated but never thoughts of self harm.
My mom 100% does not have bipolar. So if I did, it would skip a generation? Can that be possible?
With my Depression/Anxiety/ADHD and insomnia, coupled with family history, I am a little worried. I defiantly do not have extreme highs like my uncles. Does this sound like bipolar?
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I will be seeing a psychiatrist hopefully in a month regarding my insomnia and I will bring up bipolar. So I gonna get seen. Just wanted thoughts.
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Dysregulation Of Brain Regions
Various research studies reveal functional abnormalities in the below-mentioned regions of the human brain that elevate the risk of bipolar disorder and associated clinical manifestations .
What Is Bipolar Disorder Exactly
Everybody goes through mood ups and downs, but in bipolar disorder, a person experiences pronounced episodes of lows and highs .
These mood swings can interfere with day-to-day life, making it hard to do right by your relationships, function efficiently at your job, and take care of your own everyday needsgetting the laundry or grocery shopping done, getting enough sleep, that sort of thing.
The good news is that treatment can make a huge difference.
In order to be diagnosed with bipolar, you must have experienced at least one episode of mania or hypomania, a milder form of mania. If thats the case, then docs can delve deeper to find out which of the four types of bipolar you have:
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Bipolar I: This is the most severe type. People with bipolar I typically experience severe cycles of mania and depression.
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Bipolar II: Bipolar II comes with that milder form of mania, hypomania, as well as the typical depressive episodes.
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Cyclothymic Bipolar: Both the depression and mania are on the mild side.
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Unspecified Bipolar: Here, the symptoms are like bipolar, but theyre not frequent or lengthy enough to warrant the diagnosis of one of the other types of bipolar.
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Changes In Synaptic Function Bioenergetics And Oxidative Metabolism
Convergent evidence from imaging, neurochemical, and genetic studies points to disturbances in bioenergetics and mitochondrial function in the context of bipolar illness . A substantial portion of genes implicated in the etiology of bipolar disorder code for mitochondrial proteins. Hippocampal expression of genes related to mitochondrial proteins was substantially reduced in bipolar compared with control subjects . Previously described disease-related functional alterations in brain circuitry may have a reciprocal relationship with mitochondrial function. Namely, genetic control of mitochondrial function is influenced by the level of neuronal activity .
Beyond its well-known role in cellular bioenergetics, proper mitochondrial function is important for the regulation of neuroplasticity, apoptosis, and intracellular calcium levels. Of course, dynamic changes in endocellular calcium have a crucial role in the modulation of intracellular signaling cascades and neurotransmitter release . Furthermore, compromised mitochondrial function may be reflected in aberrant oxidative metabolism, down-regulated adenosine triphosphate-dependent proteasome degradation, and ensuing DNA damage contributing to neuronal apoptosis .
Neuroendocrine And Autonomic Dysregulation In Bipolar Disorder
Alterations in HPA axis function in bipolar disorder have been well substantiated . Exaggerated release of corticotropin-releasing factor contributes to greater adrenocorticotropic hormone secretion and a subsequent elevation of circulating glucocorticoids . These disturbances are most likely attributable to deficits in cortico-limbic regulation in bipolar disorder, with consequent amygdala over-activity, and a compromised hippocampal regulatory role . Moreover, glucocorticoid receptors appear to have diminished sensitivity in mood disorders, possibly due to elevation in inflammatory cytokines, thereby disrupting physiological feedback regulation on the HPA axis and immune system . Indeed, even euthymic bipolar patients exhibit a flattening of the cortisol curve compared with healthy controls. In patients unfortunate enough to have suffered multiple episodes, these abnormalities intensify, resulting in higher overall cortisol levels in addition to aberrant reactivity, and even greater flattening of their cortisol curves, compared with patients who have experienced only a few episodes . Highlighting the relevance of these neuroendocrine abnormalities, a recent study has associated elevated evening cortisol levels in bipolar individuals with a history of suicidal behavior .
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Vbm Comparisons Of The Combined Patient Group With The Healthy Controls
At a corrected threshold of P < 0.01, this analysis revealed seven clusters of significant difference between the controls and the combined patient group, all representing volume reductions in the patients. One was centered in the medial frontal cortex bilaterally, including parts of the gyrus rectus, the anterior cingulate cortex, and portions of the medial and superior frontal gyrus . There were also two bilateral clusters located in the superior frontal gyrus , with the cluster on the left also reaching the supplementary motor area and middle part of the cingulate gyrus . Additionally, there was a large rightsided cluster including parts of the insula and rolandic operculum, the inferior, middle and superior temporal cortex, the hippocampus, and reaching the postcentral, parietal, supramarginal, paracentral lobule, and the supplementary motor area . Another large cluster was located in the left hemisphere, including parts of the insula and rolandic operculum, the inferior, middle, and superior temporal cortex, reaching the postcentral, parietal, supramarginal, precentral lobule, and extending to the supplementary motor area . Finally, there were two bilateral clusters situated in the cerebellum .
S Of The Brain Impacted By Bipolar Disorder
The exact cause of bipolar disorder is unknown. However, most experts agree that bipolar disorder involves both environmental and physical factors. While whole-brain research is still in its infancy, many studies have already shown that bipolar disorder physically impacts many different areas of the brain. Multiple recent large-scale neuroimaging projects have demystified some of the core areas of the brain responsible for bipolar disorder.
Gray matter
The human brain has two types of tissue: gray matter and white matter. Gray matter is responsible for the majority of mental processing, while white matter is responsible for communication between regions of the brain with gray matter. Large MRI-based studies² in people with bipolar disorder have shown a thinning of gray matter in different areas of the brain.
The two areas most commonly affected by this gray matter thinning are the frontal and temporal regions. Both of these regions are functionally involved in emotional processing, decision making, motivation, inhibition, and motor skills. Research shows that people with reduced gray matter volume in these areas may experience symptoms such as:
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An inability to focus
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Problems with motor skills
Hippocampus
For years, scientists have known that the hippocampus an area of the brain heavily involved in learning, memory, and emotion is smaller in those with the brain disorder, schizophrenia.
People with reduced volume in the hippocampus may experience symptoms such as:
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Conflict Of Interest Statement
Dr. Vladimir Maletic has served on advisory boards for Eli Lilly and Company, Lundbeck, Otsuka America Pharmaceuticals, Inc., Pamlab, Pfizer, Sunovion, Teva Pharmaceuticals, and Takeda Pharmaceuticals and as a speaker for Eli Lilly and Company, Lundbeck, Merck, Pamlab, Pfizer, Sunovion, Teva Pharmaceuticals, and Takeda Pharmaceuticals, and has prepared CME materials for NACCME and CME Incite. Dr. Charles Raison has served on advisory boards for Lilly and Pamlab and as a speaker for Pamlab and has prepared CME materials for NACCME and CME Incite.
How Does It Affect People
Bipolar disorder affects both men and women. For many people, the first symptoms show up in their early twenties. However, research has shown that the first episode of bipolar disorder is occurring earlier: It often shows up in adolescence, and even children can have the disorder.
Recent research suggests that kids and teens with bipolar disorder don’t always have the same behavioral patterns that adults with bipolar disorder do. For example, kids who have bipolar disorder may experience particularly rapid mood changes and may have some of the other mood-related symptoms listed below, such as irritability and high levels of anxiety. But they may not show other symptoms that are more commonly seen in adults.
Because brain function is involved, the ways people with bipolar disorder think, act, and feel are all affected. This can make it especially difficult for other people to understand their condition. It can be incredibly frustrating if other people act as though someone with bipolar disorder should just “snap out of it,” as if a person who is sick can become well simply by wanting to.
Bipolar disorder isn’t a sign of weakness or a character flaw it’s a serious medical condition that requires treatment, just like any other condition.
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Telomeres And Biological Aging
Telomeres act as protective caps on the ends of DNA strands. Each time a cell divides, the telomere becomes shorter, until it is so short that the cell can no longer replicate.
In this way, telomere length can be used as a measure of biological aging and susceptibility to disease. In older people, telomeres are generally shorter. However, biological aging is different from chronological aging.
Various genetic and environmental factors can influence the rate of biological aging, meaning that two people of the same chronological age might be different ages biologically.
Telomere length is currently being investigated as a biomarker for neuropsychiatric conditions. For instance, shortened telomeres have been found in individuals with major depressive disorder, , and dementia.
An association has also been found between telomere length and the structure of the hippocampus, which is an area of the brain involved in memory and mood regulation. Similarly, shorter telomeres are associated with
Bipolar Medication May Help Restore Normal Brain Function
Posted by:Lawrence V. Tucker, M.D.
Its no secret that medication can make all the difference to a person who is diagnosed with bipolar disorder. While natural treatment including diet, exercise and regular visits to a Newport Beach psychiatrist are extremely beneficial, sometimes the patient does need medication for the most effective management of the disorder. Now, a new review is being conducted to see if common medications for bipolar disorder can actually help restore the brain function to a normative state.
During the review process, the researchers have looked at the ways that lithium, mood stabilizers, antipsychotic medication and antidepressant medications affect the brain of those affected by bipolar disorder. They have noted that advances in magnetic resonance imaging analyses over the last several decades have led to the identification of neuroanatomical abnormalities in a range of mental disorders. In other words, we are now better able to see exactly how certain medications impact the bipolar brain.
Bipolar disorder can cause significant suffering and disability, but most patients can be treated successfully with mood stabilizing medication like valproate or lithium. Sometimes antipsychotic or antidepressant medication is administered during bipolar episodes or particularly stressful times in the persons life.
It is exciting to see what the future holds for treatment of bipolar disorder and the role medication will play in restoring mental health.
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What Causes Bipolar Disorder
Millions of people in the world are affected by manic depression , however, it can take years to be properly diagnosed with the disease, depriving people of the assistance that they have . As the name reflects, people with bipolar disorder experience two extremes, or poles, with their mood: depression and mania.
Mania is the polar opposite of depression. A manic person can have an uplifted mood or experience feelings of grandiosity. They might be relentlessly talkative, hyperactive, or may claim to have special powers or express paranoia, anger, or anguish.
Bipolar disorder has traditionally been viewed as a purely biological one, but in reality the episodes of this complex condition are best understood within a biopsychosocial framework, which is interactions between genes, neural pathways, and socioenvironmental influences.
Demographic And Clinical Data
The findings for the three patient groups and the controls are shown in Table 1. The groups were preselected to be matched for age, sex, and estimated premorbid IQ they were also not significantly different in duration of illness. As expected, the patients with schizophrenia showed a lower current IQ than the healthy controls. This also applied to the patients with schizoaffective disorder and the patients with bipolar disorder.
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Prefrontal Cortical Abnormalities In Bipolar Disorder
Prefrontal cortical abnormalities are a common finding in bipolar disorder. Imaging studies have reported functional and structural changes in the vmPFC of adolescents and young adult bipolar patients relative to healthy controls . Dysfunction of vmPFC activity may be common to mood disorders and independent of mood state because it has been described in both unipolar and bipolar depression as well as in the context of elevated mood . The vmPFC has rich reciprocal connections with limbic formations and the hypothalamus. Together with the ACC and amygdala, the vmPFC may belong to an integrative network involved in processing emotionally relevant information, which coordinates autonomic and endocrine responses and influences behavior . Aberrant vmPFC activity in the context of bipolar illness may therefore be reflected in compromised ability to adapt to changes in emotional and social circumstances. Manic patients tend to be excessively preoccupied by hedonic interests, whereas depressed individuals demonstrate impaired emotional and endocrine homeostasis. Furthermore, endocrine disturbances are also a common feature of elevated mood states . The vmPFC is also a source of feedback regulation to monoaminergic brainstem nuclei, so its malfunction may be reflected in altered neurotransmission .
How Bipolar Disorder Affects Everyday Life
While you can begin to understand how bipolar disorder works by reviewing a list of symptoms, you have to remember that nobodys life is ever as simple as that. Behind every bipolar diagnosis is an individual striving to achieve a state of well-being, just like everyone else. Thats why we at PCH find it helpful to view bipolar behavior as more than a diagnosis and as a real mood pattern that affects everyday life.
In this post, well look at how bipolar affects a persons everyday life in these eight key areas:
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Summary Of Imaging Findings In Bipolar Disorder
Cumulative imaging evidence of functional, structural, and white-matter abnormalities implicates a compromised integrity of frontalsubcortical and prefrontallimbic circuits in the pathophysiology of bipolar disorder. Additional involvement of frontalbasal gangliathalamiccerebellar networks is likely. In summary, structural and functional changes support an organic basis for the emotional, cognitive, and neuroendocrine symptomatology of bipolar illness . Both regional gray-matter and white-matter changes appear to be present relatively early in disease development. Altered emotional homeostasis and cognitive difficulties stemming from these prodromal functional changes may compromise stress coping and social adaptation, hastening the onset of bipolar illness. In some instances, there is evidence of a cumulative effect of disease duration and the number of prior episodes of brain function and structure.