The Best Natural Ways to Treat Borderline Personality Disorder

Amen Clinics
July 16, 2025

BPD is complex but highly treatable. Learn symptoms, misdiagnosis risks, and natural strategies guided by brain imaging.

Do you or a loved one experience intense emotional dysregulation or rapid shifts in mood? Are you prone to impulsive behavior, unexplained outbursts, or black-and-white thinking? Or do you struggle with a distorted self-image?

These are just some signs of borderline personality disorder (BPD). While recognized by psychiatrists as far back as the 1930s, BPD often goes misdiagnosed or improperly treated, even today.

Borderline personality disorder is a serious and often misunderstood mental health condition, but it’s also highly treatable. That’s why it’s so important to understand and recognize the symptoms of borderline personality disorder.

Fortunately, a brain-based, integrative approach to treating BPD can lead to lasting recovery. Borderline personality disorder treatment and healing are possible—using natural, non-pharmaceutical strategies.

The key is to employ a holistic, or whole-person, approach. For example, functional brain imaging with a SPECT scan helps avoid misdiagnosis and pinpoint root causes of symptoms to guide an effective treatment plan. And targeted treatments contribute to long-term healing.

This blog will demystify the condition by exploring borderline personality disorder symptoms, causes, treatments, and more—including tips on how to support a loved one with this diagnosis.

Borderline personality disorder is frequently mistaken for bipolar disorder, posttraumatic stress disorder (PTSD), or depression, which can lead to years of ineffective treatment.

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WHAT IS BORDERLINE PERSONALITY DISORDER?

The roots of borderline personality disorder stretch back to 1938, when psychiatrist Adolph Stern first used the term “borderline personality.”

According to clinical guidelines of BPD, Stern wished to describe patients who “fit frankly neither into the psychotic nor into the psychoneurotic group.” The word “borderline” was used because it seemed to “border” on these other conditions.

It wasn’t until the 3rd edition of the Diagnostic and Statistical Manual of Mental Disorders, in 1980, that it received its own entry. Even today, however, it remains one of the most misunderstood and stigmatized mental health conditions.

Unlike mood disorders, BPD is a personality disorder, characterized by emotional dysregulation. Extreme shifts in mood and behavior, with difficulty controlling emotions, are common symptoms. The resulting periods of anger, anxiety, or depression may last a few hours or days.

Borderline also tends to be associated with a distorted self-image, as well as rapid and unexplainable changes in values and interests. This may lead to extreme views of people and situations, as seen in black-and-white thinking.

When interacting with a person with borderline personality disorder, you may notice symptoms like emotional outbursts, impulsiveness, and mood swings. All the issues listed above can affect an individual’s education, career, and relationships.

WHAT ARE SYMPTOMS OF BPD? AND WHY IS BPD OFTEN MISDIAGNOSED?

BPD usually begins not in childhood, but in a person’s late teens or early 20s. Borderline personality disorder symptoms include:

Fear of abandonment
Extreme mood swings
Unstable relationships
A shifting self-image
Feelings of emptiness, isolation, and boredom
Self-harm, such as cutting or suicidal behavior
Impulsivity and self-destructive behaviors, such as overspending, unsafe sex, or aggressive driving
Intense anger followed by guilt and shame
Difficulty trusting others or losing touch with reality, such as paranoia and periods of dissociation

Those with BPD may also show signs of other mental health issues, including depression, bipolar disorder (BD), anxiety disorders, or eating disorders. And BPD is frequently mistaken for bipolar disorder, posttraumatic stress disorder (PTSD), or depression.

Moreover, people with borderline personality who are not properly treated may self-medicate with drugs, including alcohol. This tends to worsen symptoms or lead to addiction, which generates its own problems.

More women than men are diagnosed with BPD, at a ratio of 75% to 25%. Still, some experts believe that males are simply undiagnosed or misdiagnosed. Men’s borderline personality disorder symptoms are more likely to be labeled as PTSD or depression.

Other research has pointed out that symptoms stemming from female hormonal changes, as well as chronic infections like Lyme disease, can be mistaken for BPD.

With many mental health overlaps possible, it’s important to address any co-occurring issues that occur with BPD. Only then can a person begin the healing process—and find optimal success with treatment.

BPD VS BIPOLAR DISORDER: KEY DIFFERENCES

When comparing BPD vs. bipolar disorder, it’s easy to see why misdiagnosis is a common pitfall. Both conditions have symptoms such as intense emotions, mood instability, and impulsivity.

However, bipolar disorder is characterized by cycles of manic and depressive episodes. Mania is associated with extremely elevated mood, racing thoughts, and grandiose ideas. Depressive episodes bring low energy and mood, loss of interest in pleasurable activities, and suicidal thoughts.

These bipolar disorder cycles tend to last longer than the rapid mood shifts associated with BPD. However, there is also a form of BD called rapid-cycling bipolar disorder, in which shifts are accelerated.

To reduce confusion, a study established that certain symptoms are present in BPD but not usually in BD, even the rapid-cycling type. These BPD symptoms include:

Avoiding abandonment
Interpersonal instability
Identity disturbance
Chronic emptiness
Intense anger
Paranoia/dissociation

Furthermore, dramatic mood changes in BPD generally stem from identifiable triggers (stressful events), while bipolar disorder cycles may not follow a predictable pattern. Ultimately, accurate diagnosis is critical to ensure that the correct condition is being addressed with treatment.

WHAT CAUSES BORDERLINE PERSONALITY DISORDER?

According to a 2024 comprehensive review, 0.7 percent to 2.7 percent of the general adult population will develop borderline personality disorder over the course of a lifetime. Among those receiving psychiatric services, that number jumps to 12 percent to 22 percent.

The review notes that research strongly suggests links between the development of BPD and influences like genetic factors, trauma, and adverse childhood experiences (ACEs).

All the potential underlying neurobiological factors are still being studied. Still, the review listed several attributes possibly associated with BPD, including:

A blunted cortisol response, reflecting a compensating down‐regulation after adversity and stress
Decreased oxytocin levels
Hyperactivity of the brain’s amygdala and hippocampal area during emotional processing
Impairments in habituation of the amygdala when faced with repeated negative stimuli

Another study estimates that heredity makes up 46% of the risk for developing BPD, while 54% stems from environmental factors.

Press Play for Dr. Amen’s Take on BPD

In this episode of ‪@PursuitOfWellnessPodcast with Mari Llewellyn, Dr. Amen describes why he is not a fan of borderline personality disorder as a diagnosis and gives his opinion on a better way to think about the condition and how to treat it.

Click below to tune in:

HOW DOES AMEN CLINICS DIAGNOSE AND TREAT BPD?

Brain imaging is an effective way to pinpoint the root causes of symptoms while assessing possible co-occurring conditions and BPD. At Amen Clinics, brain SPECT imaging is combined with a whole-person evaluation to guide clinicians in creating a personalized treatment plan.

SPECT, which stands for single photon emission computed tomography, measures blood flow and activity and shows abnormal brain activity in individuals with BPD and/or bipolar disorder. Over decades of performing scans, Amen Clinics has determined that borderline personality disorder is often associated with abnormal activity in the areas of the brain involved with fear, emotions, and impulsivity.

If symptoms are related to outside causes—such as chronic infections or mild traumatic brain injuries—instead of BPD, a SPECT scan can help identify them. Brain scans are also helpful for understanding co-existing conditions that could affect the course of treatment.

10 NATURAL STRATEGIES THAT SUPPORT HEALING FROM BPD

Some people are surprised to learn that natural treatment for BPD, rather than prescription medication, is the #1 recommendation for counteracting borderline personality disorder symptoms.

Brain-healthy, evidence-backed lifestyle interventions should complement professional treatment for best results. Here are some natural strategies that will help individuals with borderline personality disorder:

Psychotherapy: As a first line of defense, try approaches such as cognitive behavioral therapy or dialectical behavioral therapy. Meanwhile, family therapy can help improve interpersonal relationships.
Brain-healthy diet: Eat foods that nourish the brain. Aim for a variety of colorful vegetables, plus healthy fats and lean protein, at every meal.
Address allergens: Eliminate sugar, soy, dairy, gluten, corn, artificial dyes, preservatives, and food additives.
Avoid toxins: Limit alcohol and other drugs.
Avoid stimulants: Limit caffeine.
Nutrient supplementation: Ensure intake of important vitamins and minerals, especially omega-3 fatty acids, magnesium, vitamin D, and probiotics.
Daily exercise: Physical activity boosts mood and increases blood flow to the brain.
Stress-management techniques: To soothe anxiety, try deep breathing, meditation, gentle movement such as yoga, and journaling.

FAMILY SUPPORT: 5 PRACTICAL TIPS FOR CARING FOR SOMEONE WITH BPD

Family support for BPD will help you thrive despite a borderline diagnosis—whether your own or a loved one’s. If you don’t know how to assist a family member with BPD, here are some practical strategies that can help:

Don’t walk on eggshells.

Emotional dysregulation and mood swings are hallmark signs of borderline personality disorder. But you don’t need to tiptoe around your loved one in fear. Suppressing your thoughts and feelings to avoid a confrontation isn’t a healthy or sustainable solution over the long term.

Practice the 3 Cs.

Set healthy boundaries with yourself. Rather than being swept up in your loved one’s emotional ups and downs, repeat the 3 Cs:

I didn’t cause it.

I can’t cure it.

I can’t control it.

Understanding what you are and are not responsible for will prevent you from taking on negative feelings, like guilt and remorse.

Avoid isolation.

When someone struggles with BPD, it can be tempting to isolate. To push back against the feelings of hopelessness that accompany this disorder, ensure your loved one stays connected. Suggest meetups with family, friends, or support groups to provide encouragement and understanding.

Interpret emotions, not words.

Someone with BPD can get angry and lash out verbally. Rather than retaliating, remain calm and focus on the emotions behind what they’re sharing. Simply acknowledging their pain can help build trustworthy relationships and reduce reactivity.

Be patient.

When recovering from BPD, understand that healing takes time. Pace yourself for a marathon, not a sprint. Set realistic goals along the way but understand that setbacks are part of the process. Take baby steps—and celebrate wins, big or small.

Ultimately, it’s important to set healthy boundaries and learn communication techniques to best help your loved one with BPD. Armed with these strategies, family members can empower themselves to offer support—without suffering from burnout or enabling harmful behaviors.

WHY EARLY TREATMENT MATTERS AND WHY THERE’S HOPE

While untreated cases can be devastating, properly diagnosed BPD is highly treatable. With the right interventions, many patients dramatically improve within two to 10 years, often no longer meeting criteria for the diagnosis.

In fact, according to a decades-long study with results published in 2025, BPD is now considered the most treatable major mental health condition. After following more than 300 people diagnosed with BPD since 1992, researchers found that proper treatment, especially psychotherapy, can promote healthy, productive lives in these patients.

Borderline personality disorder, bipolar disorder, and other mental health conditions can’t wait. At Amen Clinics, we provide personalized, science-backed treatment plans designed to target the root causes of your symptoms. Our 360-approach includes brain SPECT imaging, clinical evaluations, innovative therapeutic techniques, medications (when necessary), and holistic lifestyle recommendations to promote the health of your brain, body, and mind. Speak to a specialist today at 888-288-9834 or visit our contact page here.

Amen Clinics

Founded in 1989 by double-board certified psychiatrist and neuroscientist Daniel G. Amen, MD, Amen Clinics Inc. (ACI) is known as the best brain and mental health company in the world. Our clinical staff includes over 50 healthcare specialists, including adult and child psychiatrists, integrative (functional) medicine physicians, naturopaths, addiction specialists, forensic psychiatrists, geriatric psychiatrists, nutritionists, licensed therapists, and more. Our clinicians have all been hand-selected and personally trained by Dr. Amen, whose mission is to end mental illness by creating a revolution in brain health. Over the last 35-plus years, ACI has built the world’s largest database of functional brain scans—over 250,000 SPECT scans on patients from 155 countries—related to how people think, feel, and behave.

FAQ

Is borderline personality disorder treatable without medication?

Yes. At Amen Clinics, we’ve seen many people improve through a comprehensive treatment plan that includes therapy, targeted nutraceuticals, brain-healthy habits, and functional brain imaging for BPD. Medication may help in some cases, but it’s not the only path to healing.

How is BPD different from bipolar disorder?

While both involve mood changes, borderline personality disorder is defined by rapid, emotionally reactive shifts often triggered by relationships or fear of abandonment. Bipolar disorder involves longer mood cycles and distinct episodes of mania or depression. Accurate diagnosis is essential, and that’s why we use brain SPECT imaging to help distinguish between the two.

What makes Amen Clinics’ approach to BPD different?

We don’t rely on guesswork or labels. Our approach includes brain SPECT imaging, a thorough assessment of your biological, psychological, social, and spiritual health, and a customized treatment plan that supports long-term transformation. We treat the whole person, not just the symptoms.

REFERENCES

National Collaborating Centre for Mental Health (UK). Borderline Personality Disorder: Treatment and Management. Leicester (UK): British Psychological Society (UK); 2009. (NICE Clinical Guidelines, No. 78.) 2, BORDERLINE PERSONALITY DISORDER. Available from: https://www.ncbi.nlm.nih.gov/books/NBK55415/

Eisenlohr-Moul TA, DeWall CN, Girdler SS, Segerstrom SC. Ovarian hormones and borderline personality disorder features: Preliminary evidence for interactive effects of estradiol and progesterone. Biol Psychol. 2015 Jul;109:37-52. doi: 10.1016/j.biopsycho.2015.03.016. Epub 2015 Mar 30. PMID: 25837710; PMCID: PMC4516641.

Leichsenring F, Fonagy P, Heim N, Kernberg OF, Leweke F, Luyten P, Salzer S, Spitzer C, Steinert C. Borderline personality disorder: a comprehensive review of diagnosis and clinical presentation, etiology, treatment, and current controversies. World Psychiatry. 2024 Feb;23(1):4-25. doi: 10.1002/wps.21156. PMID: 38214629; PMCID: PMC10786009.

Skoglund, C., Tiger, A., Rück, C. et al. Familial risk and heritability of diagnosed borderline personality disorder: a register study of the Swedish population. Mol Psychiatry 26, 999–1008 (2021). https://doi.org/10.1038/s41380-019-0442-0

Highly Treatable: Lessons Learned From Decades-Long Borderline Personality Disorder Study. March 28, 2025. McLean Hospital. https://www.mcleanhospital.org/news/highly-treatable-lessons-learned-decades-long-borderline-personality-disorder-study

Is Bipolar Disorder Genetic? What You Need to Know

Amen Clinics
July 9, 2025

Many with bipolar disorder are misdiagnosed with depression. Learn key symptoms and how a brain scan can help get the right treatment.

If you have a parent or sibling with bipolar disorder, you may have wondered: Am I at risk too? The truth is, bipolar disorder is one of the most heritable mental health conditions—with research showing a 44 percent to 90 percent increased risk if a close family member is affected. But genes are only part of the picture.

While the answer to, “Is bipolar disorder genetic?” is yes, it’s only part of the picture. Thanks to advances in genetic research and brain imaging, we now know that environmental triggers, trauma, and even brain activity patterns also play a major role in who develops bipolar disorder—and how it shows up.

In this blog, you’ll discover what science says about the genetic connection, plus how understanding your brain can lead to a more accurate diagnosis and more effective treatment.

Non-genetic or environmental factors significantly contribute to the risk of developing bipolar disorder, often interacting with genetic predispositions

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WHAT IS BIPOLAR DISORDER AND WHO DOES IT AFFECT?

Bipolar disorder (BD) is a serious mental health condition characterized by dramatic shifts in mood states and energy levels. These shifts are typically more pronounced than the normal ups and downs most people experience. They are intense emotional states or mood episodes that occur over a distinct period of time—lasting from days to weeks to months.

Formerly called manic-depressive illness, bipolar disorder’s mood states include periods of mania/hypomania (extreme happiness) and depression (sad or low mood). These episodes follow a cyclical pattern. That said, it’s not uncommon for people with bipolar disorder to have periods of neutral mood states as well.

Bipolar disorder’s manic states are characterized as intensely happy or highly agitated with a decreased need for sleep and having grandiose ideas or racing thoughts. The disorder’s depressive states are characterized as having low mood, loss of interest in activities once found pleasurable, and sometimes, suicidal thoughts. (A more comprehensive list of signs of manic/depressive episodes is listed below.)

More than 40 million adults worldwide are affected by bipolar disorder, as well as millions of children and adolescents. The disorder typically begins in young adulthood (late teens to mid-20s), but it can start earlier in childhood or in mid-life as well.

The National Institute of Mental Health (NIMH) reports that about 2.8 percent of U.S. adults had the mental disorder in the past year, impacting males (2.9 percent) and females (2.8 percent). About 4.4 percent of U.S. adults will have BD at some point during their lives.

Bipolar disorder is a serious mental health condition, ranking sixth on the list of the world’s leading causes of disability, according to the World Health Organization.

When left untreated, it can greatly impact a person’s quality of life and can cause major problems such as:

Self-esteem issues
Poor performance in school
Job performance issues
Relationship troubles
Substance abuse
Hospitalization (39 percent, the highest rate of all mental health disorders)
Shorter life expectancy (loss of more than nine years)
Increased risk of suicide (15 times greater than the general population)

On a hopeful note, research has found that early and accurate diagnosis combined with patient acceptance of the disorder are key to treatment success in many cases of BD.

Press Play to Learn More About What Bipolar Disorder Is

In this video, Dr. Faber, a clinical psychiatrist at Amen Clinics Encino, dives deep into understanding Bipolar Disorder. He clarifies what it is and explores common symptoms.

Click below to tune in.

IS BIPOLAR DISORDER GENETIC? UNDERSTANDING HEREDITARY RISK

Bipolar disorder runs in families. People with a parent or sibling with bipolar disorder are more likely to have bipolar disorder, but not everyone with higher bipolar disorder genetic risk will develop it. Also, many genes are involved in the development of the mental health disorder—no one gene can cause the condition.

While research on the rates of bipolar disorder heritability varies, one recent large study published in JAMA Psychiatry found a 44 percent heritability rate for BD. Not surprisingly, research with twins has shown higher estimated rates of heritability ranging from 60 percent and 90 percent.

Additionally, research on families with bipolar disorder suggest that different types of bipolar disorder—for example, bipolar 1 vs bipolar 2—are partly genetically distinct. The risk factor for bipolar 2 disorder is higher in relatives of people with bipolar 2 than relatives of those with bipolar 1. (The different types of bipolar disorder are explained in detail below.)

It’s important to note that many individuals with increased genetic risk for bipolar disorder do not develop the condition. That said, they may be more likely to develop it after experiencing trauma or other stressful life events.

THE ROLE OF NON-GENETIC RISK FACTORS

While genetics play a key role in bipolar disorder, they don’t tell the whole story. Other causes of bipolar disorder include environmental factors, such as trauma, chronic stress, substance use, sleep disruption, and the use of some medications. These factors can interact with genetic vulnerabilities and significantly increase the risk of developing the condition.

Understanding and addressing these non-genetic influences not only helps reduce the risk but can also improve outcomes for those already living with bipolar disorder.

Non-Genetic Risk Factors of BD

This is not an exhaustive list. There are other influencing factors too, such as birth-related factors, infections, and persona and social background.

HOW GENETIC RESEARCH IS CHANGING OUR UNDERSTANDING OF TREATMENT

Bipolar disorder is polygenic, meaning that many genes play a role in its development. In recent years, genetic research has yielded a number of discoveries that are progressing science to potentially develop new treatments to successfully manage the mental health issue.

In terms of psychiatric medication, lithium is currently the main treatment for bipolar disorder. However, it doesn’t help all patients and can have significant side effects

In 2025, findings were published from one of the largest genome-wide studies to date on bipolar disorder. An international team of psychiatric genetics researchers identified 298 regions of the genome (essentially a human’s “blueprint”) containing DNA variations that increase risk and 36 genes suspected to be relevant to it. More research will be conducted on these genes.

A 2022 genetic study involving thousands of people with bipolar disorder helped to reveal new insight into the disorder’s molecular underpinnings. The effort pinpointed a gene called AKAP11 as a particularly strong risk factor for both BD and schizophrenia—the first time a single gene had been identified as having a major impact on bipolar disorder risk.

What’s more, the protein product of AKAP11 was found to interact with another protein called GSK3B, which is a molecular target of lithium and a possible mechanism of efficacy. Isolating the AKAP11 gene may uncover more information about how lithium works and its effects in the body. This, in turn, could potentially lead scientists to identify other therapeutic targets.

Research also suggests that altered calcium functioning may play a role in bipolar disorder. Experts believe that dysregulation of calcium signaling (the process by which cells use calcium ions to communicate) pathways in the brain may contribute to the mood swings and cognitive impairments seen in bipolar disorder.

Other studies suggest the genes CACNA1C and ANK3 are risk factors for BD, as variants of these genes impact neuronal functioning by modulating calcium and sodium channels. However, more research is needed to more fully understand their role and impact in BD.

COMMON SYMPTOMS OF BIPOLAR DISORDER TO WATCH FOR

Signs of bipolar disorder include the following symptoms associated with manic and depressive episodes.

Signs of Manic Episodes

Unusually elevated mood
Inflated self-esteem
Less need for sleep
An influx of goal-oriented activity
Difficulty turning off the mind
Lack of good judgment, which results in risk-taking behavior
Grand ideas and plans
Talking more or faster
Unusually increased appetite
Social behavior that’s inappropriate
Aggression or irritability
Hallucinations or delusions
Racing thoughts
Compulsive sexual or hyper-religious behavior

Signs of Depressive Episodes

Sad or negative mood that persists
Loss of interest in activities that normally bring pleasure
Changes to sleep, getting either too much or too little, or awaking too early
Feeling “slowed down,” fatigued, decreased energy
Trouble concentrating
Feeling guilty, worthless, helpless, and hopeless
Morbid or suicidal thoughts, or suicide attempts

These symptoms appear at different levels of severity depending on which bipolar type an individual has.

THE 4 MAIN TYPES OF BIPOLAR DISORDER

Like so many mental health conditions, bipolar disorder is not a simple or single condition—it manifests in different ways. Mental health experts have identified at least four types of the condition. Knowing an individual’s type is essential for developing the right medication and therapeutic approach.

The types are distinguished by the severity of the symptoms (yet all four types are equally serious):

Bipolar I disorder (also called bipolar 1 disorder) has manic and depressive symptoms and is considered the most severe form of the condition.
Bipolar II disorder (also called bipolar 2 disorder) has depressive and hypomania symptoms that are easy to get misdiagnosed. It’s more common in women.
Cyclothymic disorder exhibits the presence of numerous periods of hypomanic and depressive symptoms for at least two years in adults (one year in children and adolescents).
Bipolar disorder not otherwise specified is a catch-all subtype used when symptoms don’t fall into established patterns. It’s typically given when an individual experiences mood fluctuations (mania and depression) characteristic of BD, but doesn’t exactly meet the diagnostic criteria for one of the other bipolar diagnoses.

HOW BRAIN IMAGING HELPS TO DIAGNOSE AND TREAT BIPOLAR DISORDER

The great news is that bipolar disorder responds well to proper treatment. However, getting an accurate diagnosis to determine your bipolar type can be challenging. Unfortunately, research shows that 69 percent of patients with bipolar disorder are misdiagnosed initially. And they can remain misdiagnosed for over seven years.

When functional brain imaging, such as the SPECT scans used at Amen Clinics, is part of a comprehensive evaluation, it can aid in the accurate diagnosis of bipolar disorder. Brain SPECT imaging evaluates blood flow and activity in the brain. It shows three things: healthy activity, too little activity, or too much activity.

SPECT scans of people with cyclic mood disorders often show focal areas of increased activity in the limbic system as well as too much activity across the surface of the brain.

Another benefit of a SPECT scan for bipolar disorder is that it can help differentiate between bipolar disorder vs traumatic brain injury. The brain-imaging work at Amen Clinics shows that many people misdiagnosed with bipolar disorder actually have a TBI that has never been properly diagnosed or treated. For these people, healing the underlying TBI can be instrumental in alleviating symptoms linked to BD.

A SPECT scan for bipolar disorder can also help with compliance, which is a common problem for many people with bipolar disorder. When they start to feel better, they don’t believe they have a problem at all and often stop taking their medication.

For many patients, seeing their brain scan helps them accept their diagnosis, stay compliant with treatment, and feel empowered to heal.

WHY THERE IS HOPE: BIPOLAR DISORDER IS TREATABLE

Individuals diagnosed with bipolar disorder or genetically predisposed to bipolar disorder have reason to be more hopeful than ever before. With accurate diagnosis and early treatment, good outcomes follow.

World Health Organization survey research shows that the majority of individuals with bipolar symptoms find that treatment helps. And the National Alliance on Mental Illness (NAMI) reports that when serious mental illnesses are addressed with the best treatments, between 70 and 90 percent of individuals have a significant reduction of symptoms and improved quality of life.

FAQ

Is bipolar disorder genetic or environmental?

Bipolar disorder is influenced by both genetics and life experiences. You may have a genetic predisposition, but trauma, brain injury, substance use, and stress can also play a major role.

Can a brain scan help diagnose bipolar disorder?

Yes. At Amen Clinics, we use SPECT brain imaging as part of a comprehensive evaluation. Brain scans can help identify bipolar patterns and rule out other conditions that mimic its symptoms such as depression, anxiety, or even trauma-related issues.

What’s the best way to treat bipolar disorder long term?

We believe in a comprehensive approach tailored to your brain. That means combining medication (when necessary) with lifestyle changes, nutritional support, therapy, and ongoing monitoring to improve stability, focus, and quality of life.

Mood disorders, such as depression or bipolar disorder, and other mental health conditions can’t wait. At Amen Clinics, we provide personalized, science-backed treatment plans designed to target the root causes of your symptoms. Our 360-approach includes brain SPECT imaging, clinical evaluations, innovative therapeutic techniques, medications (when necessary), and holistic lifestyle recommendations to promote the health of your brain, body, and mind. Speak to a specialist today at 888-288-9834 or visit our contact page here.

Amen Clinics

REFERENCES

Cullen-Drill M, Cullen-Dolce D. Early and accurate diagnosis of bipolar II disorder leads to successful outcomes. Perspect Psychiatr Care. 2008 Apr;44(2):110-9.

Kendler K et al. An Extended Swedish National Adoption Study of Bipolar Disorder Illness and Cross-Generational Familial Association With Schizophrenia and Major Depression. JAMA Psychiatry. 2020 Mar 18;77(8):1–9.

Connell K and Combes B. Genetic contributions to bipolar disorder: current status and future directions. Psychol Med. 2021 Apr 21;51(13):2156–2167.

Barnett J and Smoller J. The Genetics of Bipolar Disorder. Neuroscience. 2009 Apr 7;164(1):331–343.

Johnson SL. Life events in bipolar disorder: towards more specific models. Clin Psychol Rev. 2005 Dec;25(8):1008-27.

Park YM, Shekhtman T, Kelsoe JR. Effect of the Type and Number of Adverse Childhood Experiences and the Timing of Adverse Experiences on Clinical Outcomes in Individuals with Bipolar Disorder. Brain Sci. 2020 Apr 27;10(5):254.

Cheng KY, Robinson N, Ploner A, Kuja-Halkola R, Molero Y, Lichtenstein P, Bergen SE. Impact of traumatic brain injury on risk for schizophrenia and bipolar disorder. Psychiatry Res. 2024 Sep;339:115990. 1911.

O’Connell, K.S., Koromina, M., van der Veen, T. et al. Genomics yields biological and phenotypic insights into bipolar disorder. Nature 639, 968–975 (2025).

Palmer, D.S., Howrigan, D.P., Chapman, S.B. et al. Exome sequencing in bipolar disorder identifies AKAP11 as a risk gene shared with schizophrenia. Nat Genet54, 541–547 (2022).

Harrison, P.J., Hall, N., Mould, A. et al. Cellular calcium in bipolar disorder: systematic review and meta-analysis. Mol Psychiatry 26, 4106–4116 (2021).

Nava Sosa AP et al. Association Study Between CACNA1C and ANK3 Genes in the Etiology of Bipolar Disorder in Mexican Patients. European Neuropsychopharmacology, Volume 75, Supplement 1,2023,Page S239.

Singh T, Rajput M. Misdiagnosis of bipolar disorder. Psychiatry (Edgmont). 2006 Oct;3(10):57-63.

Nierenberg AA et al; WHO World Mental Health Survey Collaborators. Perceived helpfulness of bipolar disorder treatment: Findings from the World Health Organization World Mental Health Surveys. Bipolar Disord. 2021 Sep;23(6):565-583.

NAMI California website

https://namica.org/what-is-mental-illness/#:~:text=The%20best%20treatments%20for%20serious,the%20impacts%20of%20mental%20illness. Accessed June 27, 2025

Cannabis: The Heart and Brain Risks No One Warned You About

Amen Clinics
May 21, 2025

New studies link cannabis use to heart attack, stroke, poor blood flow, and increased risk for mental health disorders.

As more states enact legalization and usage increases among the American public, cannabis is often considered a “natural remedy” or a “soft drug.” But its negative impacts on the human body shouldn’t be taken lightly.

An increasing number of studies show that marijuana is far from harmless. In recent years, researchers have even drawn links between marijuana use and increased risk of heart attack, stroke, and heart failure. And because cardiovascular health is inextricably linked with brain health, that’s bad news for mental health, too.

Cannabis use boosts the risk for mental health issues. These include psychosis and schizophrenia, as well as mood disorders, such as clinical depression and anxiety disorders.

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CANNABIS AND HEART HEALTH

In March 2025, findings were presented at the American College of Cardiology’s Annual Scientific Session that linked cannabis use with heart attacks. This presentation combined a study with more than 4.6 million participants and a meta-analysis of 12 previous studies that, in total, involved 75 million-plus people.

The study found that cannabis users under the age of 50 were more than six times likelier to have a heart attack, compared to non-users. And the meta-analysis showed that users had a 50% increased risk of heart attack.

The study also noted cannabis users had a fourfold risk of ischemic stroke, double the risk of heart failure, and a threefold risk of cardiovascular death, heart attack, or stroke. Participants had no “significant cardiovascular comorbidities,” such as high blood pressure or cholesterol, diabetes, tobacco use, or preexisting coronary artery disease.

These findings supported a previous study that was presented at the American College of Cardiology’s Annual Scientific Session in 2023. It found that daily marijuana users were one-third more likely to develop coronary artery disease, compared with those who’d never used the drug.

Similarly, in 2024, the Journal of the American Heart Association reported research that found any use of cannabis (smoking, vaping, or eating) was correlated with an increased risk for stroke and heart attack. Again, this held true even without other underlying cardiovascular risk factors present, including smoking tobacco.

This study analyzed survey data from the Centers for Disease Control and Prevention, tracking 434,104 U.S. adults from 2016 to 2020. It found that “any marijuana use was linked to a higher risk for heart attacks and strokes, but people who used it most frequently had the highest odds.”

Daily users had 25% higher odds of having a heart attack and 42% higher odds of stroke than non-users. Among men under age 55 and women under age 65, marijuana use created 36% higher combined odds for coronary heart disease, heart attack, or stroke.

HOW MARIJUANA AFFECTS YOUR HEART AND BRAIN

It’s no surprise that cardiovascular issues are associated with negative effects on overall cognitive function and mental health. What’s bad for the heart is bad for the brain. Marijuana and brain health don’t mix.

Amen Clinics founder Dr. Daniel Amen wrote in The End of Mental Illness about his early experience witnessing the connection between cardiovascular disease and depression. After his grandfather, Daniel Ara, had a heart attack at age 69, his personality drastically changed.

Once a happy and positive man, after the heart attack he cried easily, suffered from sleeping troubles, and lost his usual joyful attitude. Eventually, he was diagnosed with major depression and prescribed antidepressant medication.

“He’s one of the main reasons why I fell in love with helping people who are suffering from brain health/mental health issues,” Dr. Amen wrote. “I wish I had known then what I know now about sugar, blood flow, heart disease, and depression.”

Blood flow is critical for the human body—transporting nutrients, including oxygen, to cells while flushing toxins. And the brain especially needs blood flow to function. Though it makes up only 2% of a human’s body weight, it uses 20% of the body’s oxygen and blood flow.

That’s one reason why marijuana, and anything else that inhibits blood flow, will damage the heart and blood vessels—and inevitably harm the brain. Conversely, maintaining heart health helps promote optimal brain health. The link between cardiovascular and mental health has been firmly established in the field of study known as psychocardiology.

Research in this field has shown that those with mental health conditions (including depression, anxiety, bipolar disorder, and schizophrenia) are more likely to develop cardiovascular diseases, even at young ages. And the relationship is bidirectional: People with cardiovascular disease are more likely to suffer from conditions like depression and dementia.

Therefore, protecting the blood vessels that feed the body’s neurons will boost not only heart health, but brain health. The result is a sharper mind as well as improved mental health.

On the other hand, low blood flow has been observed through SPECT brain scans to accompany numerous mental health conditions and symptoms. These include depression, suicide, bipolar disorder, schizophrenia, ADHD, traumatic brain injury, substance abuse, and more. Studies have shown that using marijuana is associated with lower cerebral blood flow.

The effects over time can be devastating. A study of more than 7,700 brain images found that vascular dysregulation within the brain was a key signal in the early development of Alzheimer’s disease. In fact, low blood flow (detectable by SPECT scan) is the #1 predictor that a person will develop this condition.

CANNABIS AND MENTAL HEALTH RISKS

Clearly, the potential mental health effects of cannabis are alarming. Numerous studies have examined the links between marijuana use and brain health, with dangerous implications for mental health.

These effects are particularly insidious for young users (adolescents, teens, and young adults), whose brains are still developing. Studies have found numerous dangers of using cannabis during neurodevelopment, including:

Disruption of the endocannabinoid system
Interference with crucial brain processes, including synaptic pruning and neuroplasticity
Reduced hippocampal neurogenesis, leading to memory deficits and cognitive decline
Effects on neurotransmitter systems, including the dopaminergic, glutaminergic, and GABAergic systems
Structural and functional brain changes in the prefrontal cortex and hippocampus
Decline in cognitive performance, attention, and memory
Risk for developing dependence, known as marijuana use disorder

In addition, cannabis use boosts the risk for mental health issues. These include psychosis and schizophrenia, as well as mood disorders, such as clinical depression and anxiety disorders. Users may also experience emotional dysregulation.

Finally, cannabis inhibits normal functioning, interfering with everyday tasks. The World Health Organization warns that the drug impairs psychomotor skills, affecting coordination and attention.

For example, cannabis can interfere with safe machinery operation for as long as 24 hours after smoking it, raising the risk of dangers like car accidents. Accidents can lead to concussion and traumatic brain injury, which trigger their own negative impacts on the brain and mental health.

Press Play to Discover More About Cannabis and Mental Health

In this eye-opening episode, Dr. Daniel Amen and Tana Amen reveal the darker side of marijuana no one’s talking about. Discover what brain SPECT scans show about its effects on brain health, mental well-being, and mood regulation—and learn why it’s important to know the full story before you decide if it’s right for you.

QUITTING CANNABIS FOR BETTER HEART AND BRAIN HEALTH

Legal drugs like marijuana are often construed as safe or low-consequence. But we know that legal drugs, such as nicotine and alcohol, can be just as unsafe as many so-called hard drugs.

Despite its medical uses and widespread legalization, don’t be fooled by marijuana’s “health halo.” With a long list of negative side effects, and with varieties sold now more dangerously potent than ever, avoiding or quitting cannabis is a must to maintain optimal heart and brain health.

WHY BIPOLAR DISORDER IS OFTEN MISSED OR MISDIAGNOSED

Many people assume bipolar disorder always involves extreme manic episodes, but that’s not the case. There are several types of bipolar disorder, including bipolar 1, bipolar 2, and cyclothymia. When it comes to bipolar 1 vs bipolar 2 and cyclothymia, the latter two involve milder forms of mania (hypomania), making them harder to recognize.

These episodes may not disrupt daily life in obvious ways, which is why people often don’t realize they have a mood disorder. The early signs of bipolar disorder in adults can include subtle mood shifts, impulsive behaviors, chronic irritability, and periods of extreme productivity.

Often, these symptoms can be spotted by those around you or if you’re aware and tracking your own behaviors. Unfortunately, there are often missed symptoms or confusing bipolar disorder signs most people miss that aren’t always discussed in mental health circles.

Common Misdiagnoses of Early Signs of Bipolar Disorder in Adults

Bipolar disorder is frequently mistaken for other mental health conditions, leading to delayed or incorrect treatment. This can be devastating if you’re unsure of how to talk about your symptoms with your doctors.

Other mental health conditions can “mask” early symptoms of bipolar disorder in adults, so it’s just as important to know the most common misdiagnoses to talk about it early.

Depression – Many people with bipolar disorder experience more depressive episodes than manic ones, also known as “rapid cycling”, leading doctors to diagnose unipolar depression instead.
ADHD – Impulsivity, restlessness, and difficulty concentrating are hallmark symptoms of both conditions.
Anxiety disorders – Periods of excessive worry and racing thoughts in bipolar disorder can be confused with generalized anxiety disorder (GAD).
Borderline Personality Disorder (BPD) – The emotional instability in BPD can resemble the mood swings seen in bipolar disorder. Though some may mistakenly interchange these mental disorders, their symptoms are distinct.

Press Play for More on Bipolar Disorder vs ADHD

In this video, Dr. Steven Storage, a psychiatrist at Amen Clinics, discusses three key dissimilarities in these two mental health conditions.

Why Standard Mental Health Screenings May Fail

Traditional mental health assessments often focus on depressive symptoms rather than mood fluctuations, which means bipolar disorder can go unnoticed. A 2020 study found the average delay in diagnosing bipolar disorder can be 10 to 15 years from the onset of symptoms. This delay can prevent people from getting the right treatment early on.

SUBTLE SIGNS OF BIPOLAR DISORDER

Bipolar disorder doesn’t always involve extreme mood swings or obviously dramatic behavioral changes. Here are some lesser-known symptoms or often unrecognized symptoms of bipolar disorder:

Chronic irritability & angry outbursts – Unexplained frustration or sudden aggression without an apparent cause.
Unpredictable sleep patterns – Staying up late with high energy for days, followed by prolonged exhaustion for days.
Impulsive decision-making – Engaging in reckless spending, quitting jobs impulsively, or taking on unrealistic projects.
Periods of intense productivity (“hypomania”) – Feeling unstoppable, highly creative, or hyper-focused, but eventually burning out.
Feeling “high” on life without a reason – Experiencing sudden surges of confidence, optimism, or grandiosity. This can often lead to making impulsive choices with what should be clearly dangerous potential outcomes.
Depressive episodes that feel different from typical depression – A mix of deep sadness, agitation, and restlessness.
Unstable self-image – Fluctuating between feeling highly capable and worthless with other issues like body dysmorphia, imposter syndrome, or identity crisis.

THE EMOTIONAL ROLLERCOASTER: MORE THAN JUST MOOD SWINGS

Bipolar disorder isn’t just about mood swings—it affects your relationships, work, and daily routines in profound ways.

Bipolar Disorder and Relationships

Research shows that having bipolar disorder has a negative impact on relationships. In part, this is can be due to intense emotional reactions, impulsive behaviors, and periods of withdrawal.

Loved ones may feel confused by sudden shifts in mood and energy levels. Communicating your concerns and being transparent about what you’re each going through can help you find solutions to common problems when dealing with bipolar disorder.

The “Bipolar Hangover”

After a hypomanic episode, many people with bipolar disorder can experience what’s known as a “bipolar hangover”—a period of exhaustion, regret, and emotional depletion.

These post-hypomania hangovers can lead to feelings of guilt or embarrassment over actions taken during a hypomanic phase. It can also make it harder to recognize the pattern of mood swings because the emotional crash can be mistaken for ordinary stress or fatigue rather than a sign of the underlying condition.

The Risk of Self-Medication

Some people turn to alcohol, caffeine, or drugs to manage their fluctuating moods. Research reveals up to 60% of people with bipolar disorder struggle with substance abuse at some point in their lives.

However, self-medicating only worsens symptoms and increases the risk of long-term consequences. It is critical to your mental and physical health and safety to speak openly and honestly with your mental health professional and physician about using alcohol, marijuana, or other substances to self-medicate.

HOW TO TELL IF YOU HAVE SIGNS OF BIPOLAR DISORDER

If you suspect that you or someone you love may have bipolar disorder, here are some questions to start:

Do I experience periods of extreme energy or restlessness, followed by deep exhaustion?
Have I made impulsive decisions that I later regretted?
Do my moods shift dramatically without an obvious cause?
Have I ever felt “on top of the world” for no reason, only to crash into depression later?
Have mental health professionals diagnosed me with depression, ADHD, or anxiety, but treatments haven’t fully worked?

Keep a Mood Journal

Tracking your mood patterns over time can help identify hidden signs of those high and low emotions. To help identify the bipolar disorder signs most people miss, or if you just don’t know where to start, here’s a breakdown of what a mood journal should include:

Night/morning routine and sleep patterns
Energy levels throughout the day
Emotional state at the start and end of the day
Major life events and stressors

WHAT TO DO IF YOU RECOGNIZE THESE SIGNS

If you or a loved one exhibit these symptoms, early intervention for bipolar disorder is key, according to a review in the American Journal of Psychiatry. Tracking symptoms as soon as they appear can simplify the diagnosis process and development of an effective treatment plan.

Brain-Healthy Treatments for Bipolar Disorder

Some bipolar disorder interventions include:

Nutrition – A consistent diet rich in omega-3 fatty acids, lean proteins, complex carbohydrates, and micronutrient supplements supports mood stability.
Therapy – Cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT) can help with emotional regulation.
Lifestyle – Regular exercise, stress management, and proper sleep hygiene play a crucial role in mood stability.
Medication – Mood stabilizers and other bipolar disorder medications may be necessary for some people after speaking with their doctor.

How To Talk to Your Doctor

Be honest about your mood fluctuations and impulsive behaviors.
Keep a detailed symptom tracking journal to share with your physician.
Ask about objective diagnostic tools like brain SPECT imaging for a more comprehensive evaluation.

Bipolar disorder isn’t always obvious, but recognizing the hidden signs can be life changing. If you or someone you love struggles with mood swings, impulsivity, or unexplained emotional shifts, seeking a comprehensive mental health evaluation is the next step.

To help rule out other mental health conditions, such as ADHD, clinical depression, and schizophrenia, consider seeking an evaluation that includes brain SPECT imaging. This functional brain imaging technology helps detect underlying brain activity patterns associated with a variety of mental health problems.

This leads to a more accurate diagnosis and more effective treatment. With the right treatment plan for bipolar disorder, stability, balance, and a fulfilling life are possible.

WHAT IS BRIGHT LIGHT THERAPY?

Bright light therapy, also known as light exposure therapy, circadian light therapy, light therapy, and phototherapy, has been a first-line treatment for seasonal affective disorder for several decades.

During a light therapy session, patients sit in front of a special light box positioned 16 to 24 inches away from the face for a set amount of time each day, often in the morning at home. The duration and frequency of the therapy is determined by a medical doctor or mental health professional.

The light therapy mimics natural outdoor light, but without the harmful UV rays. A session may last from 20 to 40 minutes, usually at the optimal intensity of 10,000 lux.

When the light sends signals to the brain, a number of brain chemical responses are triggered that can both uplift mood and help to beneficially impact an individual’s circadian rhythm (the sleep/wake cycle). Studies show only mild side effects (jumpiness, headache, nausea) in some cases.

SEASONAL AFFECTIVE DISORDER

Seasonal affective disorder (SAD) is a type of depression sometimes called seasonal depression or winter depression because the symptoms most often occur during the fall and winter months when there is less sunlight. While the cause of SAD is not entirely clear, researchers believe that the reduced sunlight in fall and winter may trigger winter-onset SAD.

SAD is typically associated with depressive symptoms—feeling sad, losing interest or pleasure in activities once enjoyed, appetite changes, fatigue, feeling low self-esteem, trouble concentrating and making decisions, and even suicidal thoughts. In addition, weight gain is common with SAD due to increased cravings for carbohydrates and an increase in sleep. Symptoms last typically 40% of the year.

In roughly 10% of those with SAD, the disorder has the opposite seasonal pattern, occurring in the spring and summer months and going away during the fall and winter months. These individuals usually have a loss of appetite and sleep. In some people with bipolar disorder, spring and summer can bring on symptoms of mania or a less intense form of mania (hypomania), and fall and winter can be a time of depression.

A 2020 study estimates that SAD affects .5 to 2.4% of the population. It is more prevalent among younger people, women, and individuals in northern climates.

WHAT CAUSES SEASONAL AFFECTIVE DISORDER?

The exact cause of SAD is not clear. It is a complex disorder resulting from a combination of factors. The decrease in sunlight may disrupt your body’s internal clock and lead to feelings of depression. A drop of serotonin levels also may factor in. Reduced sunlight can cause a drop in serotonin, which can trigger depressive symptoms. The seasonal change can also disrupt the body’s melatonin levels, which can impact sleep patterns and mood. Additional contributing mechanisms may include retinal sensitivity to light, neurotransmitter dysfunction, and genetic variations affecting circadian rhythms.

STUDIES ON BRIGHT LIGHT THERAPY AND SAD

The great news for those experiencing SAD is that consistent use of bright light therapy is an effective treatment. One study examining SAD patients who underwent BLT found immediate improvement in mood in as little as 20 minutes, and greater improvement with 40 minutes of exposure.

Another BLT study showed remission of SAD symptoms and an “antidepressant effect” over placebo after 3 weeks of regular light therapy treatments. A longer study that tracked SAD patients undergoing BLT for short-term (2-8 weeks) and long-term (fall and winter months for 3-6 years) treatment found that “light therapy yields about 75% clinical remissions” and was as effective as an antidepressant.

Compelling research in a 2023 issue of Translational Psychiatry found that just four weeks of bright light therapy increased brain volume in an area associated with mood regulation and memory. The study involved 24 adults diagnosed with either major depression or bipolar disorder.

In the group that received bright light therapy, there were significant increases in the left hippocampal dentate gyrus as well as marked improvements in depressive symptoms.

BENEFITS OF LIGHT THERAPY FOR MOOD DISORDERS, ADHD, INSOMNIA, AND DEMENTIA

In recent years, bright light therapy has shown benefits for a number of additional mental health conditions—all of which are in some way impacted by disruption to a patient’s circadian rhythm.

Bright Light Therapy for Bipolar Disorder and Depression

Altered sleep patterns and disrupted circadian rhythms play a role in both bipolar disorder and depressive disorder. A 2020 meta-analysis was performed evaluating 12 bright light therapy studies involving 847 patients with bipolar disorder. The results showed that BLT significantly reduced the severity of bipolar depression.

An extensive review in Neuropsychobiology examined studies on bright light therapy for the treatment of mood disorders. It found substantial evidence for BLT efficacy in the treatment of chronic depression, antepartum depression, premenstrual depression, bipolar depression, and disturbances of the sleep-wake cycle. While more studies are recommended, this research is very promising.

Bright Light Therapy for ADHD

New research from the Netherlands has noted delayed circadian rhythms in individuals with ADHD. In fact, this study estimates a whopping 73–78% of children and adults with ADHD have the issue, which means they are night owls and don’t get sleepy or tired enough to fall asleep until 2 or 3 a.m. Hence, getting a good night’s sleep is an integral part of ADHD treatment.

Light therapy was used to treat ADHD in a 2006 pilot study. The study found the shift toward an earlier circadian preference with BLT was the strongest predictor of improvement on both subjective and objective ADHD measures. Similar findings were found in a more recent study in the Journal of Psychiatric Research. These results are promising for further investigation in larger studies.

Bright Light Therapy for Insomnia and Dementia

The Sleep Foundation touts light therapy as helpful to those who suffer from insomnia, especially sleeplessness that is linked to circadian rhythm sleep disorders. A 2016 review study on light therapy and sleep problems surveyed 53 studies with a total of 1,154 participants. It concluded that “light therapy is effective for sleep problems in general, particularly for circadian outcomes and insomnia symptoms.”

One of the main symptoms of dementia after impaired cognition is that of sleep disturbances. The most problematic sleep disturbances are found in Alzheimer’s disease. While more research is needed, a small 2016 study in Psychogeriatrics using bright light therapy showed improvement of sleep disturbances in patients with mild to moderate Alzheimer’s disease.

A BRIGHT FUTURE FOR LIGHT THERAPY

Despite the wealth of research showing its efficacy, this simple, non-drug therapy remains underutilized, according to a recent study. Hopefully with education and increased awareness, many more people struggling with seasonal affective disorder and other mental health issues can be helped by bright light therapy.

WHAT IS BIPOLAR DISORDER?

Bipolar disorder is a cyclic mood disorder, shifting between manic episodes and depressive episodes that are characterized by severe changes in mood, energy, and activity levels. The recent discussions in the media and on social media have brought to light some of the most common bipolar disorder symptoms.

For example, manic episodes are characterized by:

An abnormally elevated mood
Inflated self-esteem
Grandiose ideas
Racing thoughts
A decreased need for sleep

On the other end of the spectrum, depressive episodes are associated with:

Sad or negative moods
Loss of interest in usually pleasurable activities
Feelings of helplessness and hopelessness
Decreased energy
Suicidal thoughts and behavior

Note that you may not experience all of these symptoms of bipolar disorder. In addition, symptoms of mania and depression can range in severity.

TYPES OF BIPOLAR DISORDER

Experts have identified multiple types of bipolar disease, including:

Bipolar 1 disorder (also known as bipolar I):
This type is marked by the presence of mania, which may or may not be accompanied by depressive episodes. During manic episodes, individuals often feel excessively energized, euphoric, and highly confident. It’s common for those experiencing mania to develop grandiose ideas, initiate numerous large projects, and forgo sleep.
Bipolar 2 disorder (also known as bipolar II)”:
Individuals with this type typically experience both emotional highs and low moods in a cyclical pattern. However, the key distinction between these types of the disorder is that the elevated mood episodes in bipolar 2 are less intense than those in bipolar 1 and do not reach the level of full-blown mania. These episodes in bipolar 2 are referred to by mental health professionals as “hypomanic.”

Cyclothymic disorder:
People with this type experience periods of hypomanic and depressive symptoms, however they are not severe enough to meet the criteria of episodes. These individuals may have chronic mood instability.

Other specified or unspecified bipolar disorder:
This term is used for people who experience symptoms of abnormal mood elevation but don’t meet the diagnostic criteria for other types of bipolar disorder.

Bipolar 1 and bipolar 2 are the most common types of the condition. Knowing which type you have is critical to getting the most effective treatment.

BIPOLAR DISORDER IN THE BRAIN

A growing body of neuroimaging research shows that people with bipolar disorder tend to have abnormal activity patterns in the brain. For example, one study on brain function in bipolar disorder revealed deficits in a trio of areas:

Attention
Executive function
Emotional processing

Functional brain scans suggest that the underlying pathophysiology involves widespread neural circuits, including the prefrontal cortex and anterior cingulate cortex, as well as limbic system regions like the amygdala and ventral striatum.

Functional imaging of people during a manic episode has revealed abnormal changes in blood flow and metabolism, especially in the orbitofrontal cortex.

For over 30 years, Amen Clinics has been utilizing a brain imaging technology called single photoemission computed tomography (SPECT), which measures blood flow and activity.

For the patients at Amen Clinics and their families, seeing their brain scans helps them understand that symptoms and behaviors associated with bipolar disorder are not “mental disorders” or character flaws, rather, they’re “brain health” problems.

Unfortunately, millions of people in America who are suffering from bipolar disorder and other mental health issues don’t get the help they need due to the stigma surrounding mental health.

Reframing the discussion from mental health to brain health helps overcome that stigma because it shows that conditions are not moral, they’re medical.

For Amen Clinics patients with bipolar disorder, brain imaging has also revealed some surprising findings. For example, SPECT scans show that many people who are diagnosed with bipolar disorder also have an underlying concussion or traumatic brain injury that has never been properly diagnosed or treated.

Many of these people don’t even remember experiencing a head injury. This hidden trauma can be the result of one or more head injuries that happened months, years, or even decades earlier.

Some of the most common causes include falls (falling off a bike, falling off a ladder, or falling down a flight of stairs), vehicle accidents, or sports-related concussions. Having a brain injury can exacerbate the ups and downs of bipolar disorder.

SPECT scans can also help detect other mental health conditions that commonly co-occur with bipolar disorder. For example, research in Clinical Psychology shows that 62% of people with bipolar disorder also meet the clinical criteria for attention deficit hyperactivity disorder (ADHD), also called attention deficit disorder (ADD). Anxiety disorders and substance use disorders are also common in people with bipolar disorder.

Addressing co-existing mental health problems is a critical aspect of bipolar disorder treatment. Only when all issues are treated can you get the relief you want.

CONSEQUENCES OF MISDIAGNOSED OR MISTREATED BIPOLAR DISORDER

Without the added help of brain imaging, bipolar disorder is often misdiagnosed for other conditions, such as depression or schizophrenia.

In fact, most people experience signs of bipolar disorder for an entire decade before getting an accurate diagnosis. This can have devastating effects because following the wrong treatment plan can make symptoms worse.

When left untreated or mistreated, the condition is associated with a decrease of over 9 years in life expectancy. In addition, people with bipolar disorder are 15 times more likely to attempt suicide than the general population, and 1 in 5 people with the condition eventually take their own life.

TREATMENTS FOR BIPOLAR DISORDER

Bipolar disorder is treatable. It is generally responsive to a treatment program that is personalized to enhance brain health and that may include:

Nutritional supplements
Healthy nutrition
Exercise
Lifestyle changes
Psychotherapy
Medication (when necessary)

The patient population at Amen Clinics shows that healing the brain can be very helpful in reducing symptoms associated with bipolar disorder.

We Are Here For You

Bipolar disorder, ADD/ADHD, anxiety, and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.

Get Started

Amen Clinics

REFERENCES

Youngstrom, Eric A et al. “Bipolar and ADHD Comorbidity: Both Artifact and Outgrowth of Shared Mechanisms.” Clinical psychology : a publication of the Division of Clinical Psychology of the American Psychological Association vol. 17,4 (2010): 350-359. doi:10.1111/j.1468-2850.2010.01226.x

Clark, Luke, and Barbara J Sahakian. “Cognitive neuroscience and brain imaging in bipolar disorder.” Dialogues in clinical neuroscience vol. 10,2 (2008): 153-63. doi:10.31887/DCNS.2008.10.2/lclark

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Brain fog, depression, confusion, difficulty concentrating, anxiety, irritability, and trouble sleeping—these are all symptoms that can prompt you to seek help. In many cases, standard treatments can be very helpful. If treatment for mental health problems isn’t working, however, it could be due to a hidden underlying issue—mold toxicity.

If treatment for mental health issues isn’t working, it could be due to a hidden underlying issue—toxic mold. Consider the case of a woman who spent years suffering from debilitating symptoms before finding the root cause.

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CAST STUDY: MOLD TOXICITY

Kimberlyn, a 46-year-old married mother living in Arizona, had a master’s degree in pattern analysis and was highly detailed, analytical, and logical. Out of nowhere, Kimberlyn went from being a highly effective, busy, working mother to being a disorganized, uninvolved, confused individual. She could no longer focus long enough to put together cohesive, coherent thoughts. She was no longer able to make decisions for herself and struggled with everyday tasks. She even had trouble getting dressed in the morning. Along with the confusion she was experiencing, Kimberlyn also developed insomnia, anxiety, and a loss of appetite. “It was like I lost my personality,” she says. In a matter of months, she also lost 25 pounds, was forced to abandon her practice, and withdrew from activities outside the home. She didn’t know it at the time, but these are all warning signs of mold toxicity. When Kimberlyn got sick, she applied many of the skills from her work life to try to uncover what was adversely affecting her. Even so, getting an accurate diagnosis wasn’t easy.

DIAGNOSING MOLD TOXICITY

For most people, getting a mold illness diagnosis is a lengthy process. Because mold that is toxic can cause such a wide variety of physical, cognitive, and emotional issues, it is often misdiagnosed. Mold allergies and other consequences of exposure are often not considered. This was the case for Kimberlyn. At first, her doctor, family, and friends told her that they thought she had depression or even bipolar disorder. Even in her confused and debilitated state, Kimberlyn resisted these possible diagnoses. She insisted on further testing, believing that something was terribly wrong. After a series of blood tests, Kimberlyn’s general practitioner diagnosed her with heavy metal poisoning and recommended she undergo chelation therapy. After undergoing this treatment, she felt better, but not for long. Within five months, her mysterious symptoms returned. During her second cycle of illness, Kimberlyn sought out another doctor who took additional blood samples from her and performed a more extensive series of tests. This is when Kimberlyn learned she may be suffering from black mold toxicity. This was the first time black mold had been suggested as a possible cause for Kimberlyn’s symptoms. She was surprised because she lived in an arid climate in Arizona. Typically, mold growth thrives in damp areas. However, minor water damage due to a water leak from a sink, window, or roof can trigger the growth of mold in walls, on hard surfaces, ceiling tiles, exhaust fans, and other areas where there is indoor humidity. Moldy surfaces anywhere indoors can wreak havoc on human health. Even an air conditioner can be among the risk factors. A musty smell might be a clue that mold spores could be silently wreaking havoc on your health. Kimberlyn decided to have her home tested for indoor mold. The inspectors discovered 3 different mold species, including Stachybotrys chartarum, also known as black mold, one of the more threatening types of mold.

COMMON SYMPTOMS OF MOLD TOXICITY ON HUMAN HEALTH

Primarily, black mold can trigger an inflammatory response, such as allergic reactions that mimic seasonal allergies, such as a allergic rhinitis (stuffy nose). Respiratory symptoms such as wheezing, coughing, watery eyes, and skin irritation are the predominant symptoms. Black mold exposure can cause chronic inflammation, trigger asthma symptoms, and affect the immune system. This may lead to potentially life-threatening primary and secondary infections in some people as well as chronic illness. People who have a weakened immune system may be even more vulnerable to health problems. Mold exposure has also been linked to more serious, long-term effects. Some of the common toxic effects leading to mental and cognitive symptoms from mold injury include:

Memory loss
Trouble with focus and concentration
Confusion
Disorientation
Mood swings
Depression
Anxiety
Chronic fatigue
Trouble sleeping
Irritability

Black mold symptoms can begin soon after exposure to toxic mold or they may develop over time.

HOW BLACK MOLD AFFECTS THE BRAIN

A mold injury can elicit an immune response and have negative impacts on the brain. For example, a 2020 study found that black mold inhalation can cause:

Inflammation in the hippocampus (an important memory center)
Reduced neurogenesis (the growth of new brain cells)

Some of mold’s harmful effects on the brain are due to mycotoxin exposure. Mold produces mycotoxins, which are poisonous substances. Research shows that mold and mycotoxins may be a risk factor in Alzheimer’s disease. For example, one study suggests that a subtype of Alzheimer’s disease may be the result of exposure to mycotoxins and other toxic substances. In one study by the Environmental Health Center-Dallas, 100 participants were examined in an effort to uncover how exposure to mold that is toxic can affect the brain and lead to cognitive and emotional impairments. After the mold exposure, nervous system challenges were observed in all 100 patients. In this study, brain scans using single photon emission computed tomography (SPECT) also identified abnormalities in a significant portion of the patients studied.

TREATING MOLD TOXICITY

After Kimberlyn was diagnosed with toxic exposure to mold by her doctor in Arizona, she took steps to remove mold from her home and began treatment protocols to help reduce her symptoms, but she still felt it wasn’t enough. She continued to research mold illness and finally found a blog about a patient who was treated at Amen Clinics.

“It was the first time I had read anyone’s experience that matched my own,” says Kimberlyn. “I read and read and read and made an appointment that day.”

As part of a comprehensive evaluation at Amen Clinics, Kimberlyn underwent brain SPECT imaging.

“Just to really see exactly what was happening to my brain in the SPECT scans and that I do have a toxic injury due to mold was amazing,” says Kimberlyn. “When my brain swelled from the mold exposure, I was getting almost no blood flow to my prefrontal cortex.”

Based on her SPECT scans, neuropsychiatric testing results, and personal history, Kimberlyn was also diagnosed with attention-deficit/hyperactivity disorder (ADHD), also known as attention-deficit disorder (ADD), and a previous traumatic brain injury. These issues were exacerbating the effects of the mold toxicity. Co-occurring conditions that can increase the effects of an injury or illness on the brain are common, although they are often overlooked. Kimberlyn was shocked to hear that the head injury she had suffered in high school was impacting her life today and even more surprised that she had ADHD.

“The medication for ADHD has made a huge difference in my productivity and ability to focus. That was like the bonus prize that I wasn’t even expecting,” she says.

With a comprehensive treatment protocol, Kimberlyn began seeing positive results quickly. In addition to the medication prescribed for ADHD, Kimberlyn completely changed her diet and started a supplement regimen to support brain health. Other recommendations for her treatment included hyperbaric oxygen therapy (HBOT) to promote brain healing.

“To see the scans and to know that you are not bipolar, you are not depressed…to see what I knew in my own gut backed up on the scans…it’s so validating and powerful,” says Kimberlyn. “The idea that there is a way to address what’s happening and that you can get better, it’s just so wonderful.”

Unresolved cognitive and mental health symptoms that may be related to mold toxins can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here. Does your child seem to have mood swings that are much more dramatic than others their age. Are these rollercoaster emotions characterized by intense highs and lows? Do they cycle through high-energy periods followed by depressive episodes that last hours, days, weeks, or months? Are these ups and downs causing problems in their relationships or school studies, or making it difficult for them to complete everyday tasks? Does their recent behavior seem out of character? While most children and teens experience occasional moodiness and even temper tantrums, extreme mood swings may point to a deeper mental health issue. Bipolar disorder (BD), also called bipolar spectrum disorder (BSD), can feel like an unpredictable and difficult condition to manage in your child. But with the right diagnosis and treatment, there is hope for recovery. People with bipolar disorder are 15 times more likely to die by suicide and overall have a shorter life expectancy than the general population by more than 9 years.

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WHAT IS BIPOLAR DISORDER?

Bipolar disorder is a type of cyclical mood disorder, which means that symptoms can come and go. Mood disorders are also called affective disorders. Because symptoms may occur at varying levels of intensity, bipolar is considered a spectrum disorder. In the past, BD was known as manic depression, because it features symptoms of both mania and depression. Nearly 6 million adults in America have bipolar disorder, and symptoms of BD most commonly start in young adulthood, from the late teens to mid-20s. But children and adolescents can also be affected. Data from the National Comorbidity Survey, carried out in 2001-2004, showed that an estimated 2.9% of adolescents had bipolar disorder, with 2.6% of them experiencing severe impairment. Prevalence among adolescents was higher for females (3.3%) than for males (2.6%). However, since those statistics were gathered, mental health conditions have been growing among our young people, alongside increased societal awareness of these issues. The COVID-19 pandemic also had devastating impacts on the mental health of our nation’s youth. In addition, bipolar often occurs with other conditions, according to a clinical synthesis about BD in children and adolescents published in the psychiatry journal Focus. The report pointed out that symptoms of mania may overlap with those of ADHD, oppositional defiant disorder (also called conduct disorder), depression, and anxiety. ADHD is bipolar’s most common co-occurring disorder, present in 70%-95% of pre-adolescents and in 50% of adolescents with BSD.

WHAT CAUSES BIPOLAR DISORDER?

While BSD has a hereditary link, various environmental factors can also contribute to its development, including:

Emotional trauma
Traumatic brain injury (TBI)
High stress levels
Substance abuse
Changes in the structure and function of the brain
Infections (such as Lyme disease) or other medical issues
Co-occurring mental health disorders
Poor sleep

CONSEQUENCES OF BIPOLAR DISORDER

BD can improve through lifestyle changes and other treatments, such as therapy and peer support groups. But left untreated, bipolar can lead to a lifetime of struggle, particularly when it affects young people. Kids with bipolar may not perform as well in school or drop out altogether. Later in life, they can encounter similar issues in the workplace. They’re also prone to experiencing low self-esteem, relationship issues, and substance abuse. Most alarmingly, people with bipolar are 15 times more likely to die by suicide. And overall, they have a shorter life expectancy than the general population by more than 9 years.

SIGNS OF BIPOLAR DISORDER IN TEENS AND CHILDREN

Children and teens are notoriously susceptible to mood swings, but bipolar disorder symptoms are persistent and chronic, occurring in a cyclical pattern over longer periods of time. However, not all BSD looks the same. There are two types of bipolar disorder: bipolar 1 and bipolar 2. A less-severe type of BSD is called cyclothymia. In addition, the cyclical nature of the disorder means that symptoms can look dramatically different, based on whether the episode is manic or depressive. Episodes can last for hours, days, weeks, or months. It’s also important to note that symptoms may be absent for stretches of time. Mixed episodes, in which symptoms of manic and depressive episodes occur at the same time or in rapid succession, are also possible. Manic episodes are characterized by an elevated, euphoric, or energized emotional state. Telltale signs include:

Abnormally elevated mood (giddiness, silliness, or excessive happiness)
Inflated self-esteem, with grandiose notions or plans
Decreased need for sleep
Increase in goal-oriented activity
Talkativeness or pressurized speech
Racing thoughts or inability to “turn off” the mind
Poor judgment, leading to risk-taking behavior
Excessive appetite
Lack of focus
Inappropriate social behavior
Irritability or aggression
Delusions or hallucinations

During depressive episodes, you will likely notice a dramatic slowdown in your child. Symptoms include:

Persistent sad or negative mood
Low energy or fatigue
Loss of interest in previously enjoyable activities
Sleeping too much or too little
Feelings of guilt, worthlessness, helplessness, and hopelessness
Difficulty concentrating
Thoughts of death or suicide, or suicide attempts

Keep in mind that young people may also show subtle symptoms of mental health conditions. They can have physical aches and pains, changes in their eating habits, or unusually argumentative or aggressive behavior. Meanwhile, extreme mood swings may show up as emotional outbursts, excessive crying, or temper tantrums.

THE BIPOLAR BRAIN

Like all mental health conditions, BSD is not a weakness or character defect, and children cannot simply “snap out of it.” Bipolar disorder indicates a brain that works differently. Putting symptoms in this perspective for your child or teen can help counteract possible feelings of unworthiness, guilt, or shame around their condition. At Amen Clinics, functional brain imaging using single photon emission computed tomography (SPECT) shows that those with bipolar disorder typically have heightened activity in the limbic system. This system includes the amygdala, hippocampus, and cingulate gyrus, which impact emotion, memory, sensory information, and fear. Brain scans show that cyclic mood disorders like bipolar are also associated with too much activity across the surface of the brain. For young people with extreme mood swings, getting a brain scan can be life-changing. That’s because mental health professionals may misdiagnose BSD as depression, ADD/ADHD, or even schizophrenia. When adolescents are misdiagnosed or don’t get the proper treatment for bipolar disorder, symptoms can worsen. Brain imaging helps establish not only an accurate diagnosis, but an effective treatment plan. Proper treatment can help balance areas of the brain that are either overactive or underactive. Moreover, a brain scan can pinpoint or rule out other potential factors contributing to mood issues. For example, brain scans can detect a traumatic brain injury—such as from a fall or traffic accident—which is a relatively common hidden trigger for BSD. Studies have estimated that people with TBI are 28 times more likely to have bipolar disorder, especially if the head injury occurred between ages 11-15.

THE ROAD TO RECOVERY FOR BIPOLAR YOUTH

Receiving a mental health diagnosis at a young age can seem devastating, for both children and their parents. But it’s actually the first step toward a healthier, happier, more productive future. There is no single or simple cure for bipolar disorder. By following a comprehensive treatment plan that includes lifestyle changes, natural interventions, and medication (when necessary), the road to recovery can begin. Through managing their symptoms, children will experience a better quality of life, while parents can find relief in their child’s journey toward a more stable sense of well-being. Bipolar disorder and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here. Living with bipolar disorder isn’t easy. Just ask anyone who struggles with the ups and down of this serious mental health condition. What many of these sufferers don’t realize is that their everyday habits could be making their bipolar disorder symptoms worse. In this blog, you’ll discover the 5 worst habits for bipolar disorder as well as healthier habits that can help people with the condition achieve better emotional balance. Living with bipolar disorder isn’t easy. What many of these sufferers don’t realize is that their everyday habits could be making their bipolar disorder symptoms worse.

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WHAT IS BIPOLAR DISORDER?

Bipolar disorder, also known as bipolar spectrum disorder, is a brain-based mental health disorder that is characterized by extreme changes in mood and energy levels. The highs and lows associated with bipolar disorder typically cycle from manic episodes to depressive episodes.

Manic episodes: During manic episodes people with bipolar disorder tend to feel highly energized, creative, and euphoric. They may feel invincible, which leads them to engage in risky activities or inappropriate social behaviors.
Depressive episodes: These periods are associated with a significant drop in mood and energy levels. People can feel sad, lethargic, and hopeless.

Although many people with bipolar disorder experience these cyclical energy and mood swings, some people don’t. That’s because bipolar disorder is not a singular condition. In fact, there are multiple types of bipolar disorder, including:

Bipolar I
Bipolar II
Cyclothymic disorder
Bipolar disorder not otherwise specified (NOS)

BIPOLAR DISORDER AND THE BRAIN

Functional brain imaging at Amen Clinics using SPECT scans reveals that bipolar disorder is associated with abnormal patterns of brain activity. SPECT scans of people with the condition often show overactivity in certain brain regions, such as the limbic system. The limbic system is involved in:

Setting the emotional tone of the mind
Modulating motivation, fear, and memory
Processing sensory information

SPECT scans can also help identify brain activity patterns associated with other mental health disorders. This is important because having bipolar disorder increases the risk of having other conditions. For example, approximately 62% of individuals with bipolar disorder also have ADD/ADHD, according to research. Other mental health problems commonly seen in people with bipolar disorder include anxiety disorders and substance use disorders. Diagnosing these co-existing conditions can be beneficial because getting treatment for all underlying issues is the key to getting more emotional balance.

5 THINGS THAT MAKE BIPOLAR DISORDER WORSE

Many life events and habits can exacerbate bipolar symptoms. Here are 5 things not to do if you have bipolar disorder.

Don’t skimp on sleep: In those with bipolar disorder, inadequate or disrupted sleep can have negative impacts on mood stability. Based on a 2018 study, not getting enough sleep is associated with heightened severity of depressive and manic episodes. In this study, the worsened bipolar symptoms were more evident in women compared with men.
Don’t ignore relationship problems: It can be challenging for people with bipolar disorder to have stable relationships. Bipolar symptoms, including risky sexual behavior, irritability, and moodiness, can lead to rocky relationships.

Experiencing arguments breakups, or a divorce is also associated with heightened stress, which can exacerbate bipolar symptoms. Research indicates that the impact of negative social experiences on those with bipolar disorder can be so significant that it may trigger suicidal thoughts and behaviors.

Don’t ignore the effects of medications: Some medications can increase bipolar symptoms. Scientific findings, for example, reveal that as many as one-third of people with bipolar disorder are susceptible to manic episodes that are triggered by antidepressants.

Other types of medications that may trigger manic symptoms include prescription stimulants commonly used in the treatment of ADD/ADHD. Medications for the treatment of hypothyroidism, as well as appetite suppressants and corticosteroids, may also lead to manic symptoms.

Don’t use alcohol or drugs: Drug and alcohol make bipolar disorder worse. For example, it can extend the duration of manic or depressive episodes, according to a 2015 study. Based on the findings in this research, using cannabis significantly exacerbates manic episodes. In addition, substances and alcohol alter brain function, which can also worsen bipolar disorder.
Don’t drink caffeinated beverages: Consuming caffeine can lead to manic episodes in those with the condition, according to a 2021 study. This study points to the stimulating effects of caffeine as the most likely problem. Stimulants can enhance moods, disrupt sleep, and alter the metabolization of medicines used to treat bipolar disorder.

5 BRAIN-HEALTHY HABITS TO IMPROVE BIPOLAR SYMPTOMS

Knowing what NOT to do is only one of the steps in managing bipolar symptoms. Understanding the lifestyle habits that help balance the brain is key to achieving more stable moods and energy levels. Here are 5 simple ways to boost your brain and achieve greater balance.

Make sleep a priority. Focus on getting 7-8 hours of sleep each night.
Work on your relationships. If your bipolar symptoms cause trouble in your relationships, consider couples counseling or marital therapy. When your significant other understands that some of your behaviors are bipolar symptoms, they are less likely to take it personally.
Know how medications affect you. Make sure to speak with your healthcare provider about all medications and supplements you take. Find out if any of them may impact your symptoms.
Avoid drugs and alcohol. One of the best ways to avoid worsening bipolar disorder is to give up alcohol and drug use.
Eliminate caffeine. Avoiding caffeine can be a powerful strategy to have more balance in your life.

Bipolar disorder and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here. Most people are familiar with the mood swings associated with bipolar disorder (BD), but many are surprised to learn that the condition is also linked to memory loss and other cognitive deficits. Approximately 40-60% of people with the mental health condition experience “neurocognitive impairment,” according to a recent study examining memory loss. In recent years, researchers have sought to more fully understand how the brain, memory, and cognition are impacted in people with bipolar disorder. Here’s what the most recent studies reveal and what individuals with this mental health disorder can do to protect against memory loss, brain fog, and bipolar blackouts. Approximately 40-60% of people with BD experience “neurocognitive impairment,” according to a recent study examining memory loss.

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WHAT IS BIPOLAR DISORDER?

Bipolar disorder is a severe brain disorder that results in pronounced, dramatic changes in an individual’s energy, mood, activity levels, and ability to carry out daily routine tasks. Formerly called manic-depression or manic-depressive disorder, BD involves shifts between “manic” and “depressive” mood states. These mood swings are cyclical with neutral mood states in between. These shifts are much greater than the normal ups and downs that most people experience, and can greatly affect a person’s behavior, personality, emotional regulation, and sleep. Bipolar disorder is one of the leading causes of disability in the world. About 4.4% of the U.S. adult population (roughly 11.3 million people) have BD. While BD most commonly begins in early adulthood, surprisingly, it is also seen in children and teens, as well as middle-aged individuals. There are a wide range of signs of bipolar disorder with different severity levels, all having a major impact on one’s lifestyle, relationships, livelihood, and general ability to function in the world. Bipolar disorder symptoms are most evident during manic and depressive episodes. Manic episodes are characterized by elevated energy levels and increased activity (and sometime irritability) lasting hours, days, weeks, or months. Manic symptoms may include:

Abnormally elevated mood (euphoria)
Grandiose ideas or plans
Racing thoughts
Inflated self-esteem
Lack of judgment leading to risk-taking behavior
Decreased need for sleep
Hypersexuality or hyper-religiosity
Odd or inappropriate social behavior
Delusions or hallucinations

Depressive episodes have a marked downshift in energy and mood, which causes a slowdown in activity, lasting hours, days, weeks, or months. Symptoms may include:

Sad or negative moods
Loss of interest in activities that once were pleasurable
Feelings of guilt, helplessness, and hopelessness
Decreased energy, fatigue
Sleeping too much or too little or waking too early
Trouble concentrating
Suicidal thoughts or behavior

Bipolar disorder symptoms can look different from person to person, and they might even differ from one mood episode to the next. There are 4 distinct types of bipolar disorder:

Bipolar I disorder – manic episodes lasting at least 7 days or severe manic symptoms requiring hospital care. Often distinct depressive episodes occur as well, lasting at least 2 weeks. It’s also possible to have mood disturbance with mixed features.
Bipolar II disorder – depressive and hypomanic (less severe manic) episodes, but less intense episodes than with bipolar 1 disorder.
Cyclothymic disorder – recurrent depressive and hypomanic symptoms, but not intense or long enough to qualify as depressive or manic episodes.
Bipolar disorder otherwise not specified – bipolar symptoms that do not fall in the other types.

When BD goes untreated, it can truly be devastating to one’s quality of life, negatively impacting school/work life, self-esteem, and relationships. It also increases the risk of substance abuse, suicide, and hospitalizations, as well as shortens life expectancy. There’s no exact cause of BD, but genetic risk, high stress, substance abuse, trauma, and changes in brain structure and function may be contributing factors.

BIPOLAR DISORDER AND MEMORY LOSS

Not all people with BD experience memory loss, but many do. Oftentimes, during manic or depressive episodes, individuals with BD remain conscious but experience lapses of memory. Some experts attribute the memory loss to the rapid volatility of the extreme mood states. These memory-related effects are called “brain fog” or “bipolar blackouts.” Researchers have noted that, in general, BD individuals show impaired performance on tests measuring attention, executive function, and memory. These cognitive and memory loss issues are both transitory (occurring during the manic or depressive episodes of the illness) and persistent (even in periods of remission). Deficits have been observed in both short-term memory loss (forgetting things recently heard, seen, or done) and long-term memory (failing to remember things known in the past) in BD patients. Unfortunately, this can negatively impact personal relationships and work performance. A March 2022 study noted cognitive issues, including memory loss, as a reason for individuals with BD being less likely to be employed than the general population. While every BD mood state has been shown to have memory issues and compromised cognition, a study that compared BD individuals with healthy controls found that manic episodes had more pronounced deficits. BD patients in manic mood states had greater difficulty with verbal and working memory (affecting both short-term and long-term memory), executive function, and problem solving. Also, individuals with more severe BD had greater cognitive impairment.

BRAIN CHANGES IN BIPOLAR DISORDER

Changes in the brains of people with BD have also been noted by experts. In a 2020 review of MRI imaging of people with BD, researchers observed small but significant differences in the volumes of brain structures. They included the following regions:

Hippocampus, responsible for new learning, memory formation (short- and long-term), and emotion.
Prefrontal Cortex, responsible for judgment, forethought, planning, working memory, and impulse control.
Anterior Cingulate Cortex, responsible for shifting attention, error detection, and processing fear memory.
Thalamus, responsible for relaying motor and sensory signals, regulating sleep and wakefulness, consciousness, and learning and memory.

In addition to these reductions, a 2021 longitudinal study noted cortical thinning in the frontal cortex for those who experienced persistent manic episodes. A type of mental atrophy, cortical thinning is associated with aging and neurodegenerative disorders such as dementia. Interestingly, a history of bipolar disorder is linked to a significantly higher risk of dementia in older adults, research shows. It’s still not clear what is driving these BD-related brain changes. Experts hypothesize medication use, genetic factors, and the occurrence of mood episodes likely play a contributing role, according to a 2023 review study.

WAYS TO PROTECT AGAINST BIPOLAR MEMORY LOSS

Getting professional help and proper treatment is essential to minimize the frequency of episodes, which are associated with greater cognitive deficits. That includes embracing healthy lifestyle habits such as stress reduction (exercise and meditation), good sleep hygiene, nutritional supplementation, and a brain-healthy diet. Additionally, experts recommend the following strategies for supporting well-being and minimizing episodes:

Having a structured daily routine with actions you repeat
Eliminating alcohol or any recreational drug use
Simplifying your schedule, slowly adding activities over time in a sustainable manner
Seeing a qualified therapist regularly to promote emotional regulation
Identifying triggers so that you can reach out for support before an episode occurs
Consistently writing down “to-dos” to ensure you stay organized personally and professionally
Relying on a calendar every day to keep appointments and give yourself reminders

Bipolar disorder, memory loss, and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.

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