Is Bipolar Disorder a Mental Disorder?

It’s Not Bipolar Disorder, It’s a Brain Disorder


When you hear the term bipolar disorder, what comes to mind? If you’re like most people, you probably think of mental illness. You might imagine someone who, due to a personal weakness, can’t control their mood swings and is wildly imbalanced. You may even think it’s a character flaw that causes them to have trouble with relationships, job performance, and schoolwork.

You’d be wrong.

Bipolar disorder is not a “mental illness”, it’s a brain disorder. It’s rooted in the biological functioning of the 3-pound supercomputer between the ears. Abnormal activity in the brain is associated with the severe ups and downs in mood, energy, and activity levels that are the hallmark signs of bipolar disorder.

Making this discovery changes everything about the way people with bipolar disorder, their families, and the rest of us should think about the condition.

Why A 53-Year-Old Woman Refused to Believe She Had a Problem

Sandy was 53 when her family took her to a hospital for help with her behavior. It wasn’t the first time. Just one month earlier, they had had her committed to another psychiatric hospital for delusional thinking and bizarre behavior—she had actually ripped out all the electrical wiring in her home because she heard voices coming from the walls. In addition to these symptoms, she was barely getting any sleep, her thoughts raced wildly, and she was irritable.

Her doctor diagnosed her with bipolar disorder (a cyclical mood disorder characterized by extreme mood swings from manic episodes to depressive episodes) and placed her on lithium (an anti-manic medication) and an anti-anxiety medication. After responding well, Sandy was sent home. But she didn’t want to believe that anything was wrong with her, and she stopped taking both medications. Her belief was actually supported by some members of her family who openly told her she didn’t need pills and that doctors prescribe them only to force patients into numerous follow-up visits.

Their advice was ill-fated, and within weeks of stopping the treatment, Sandy’s strange behavior returned. This was when her family made the decision to take her to the hospital. Once again, Sandy was extremely paranoid. Believing that everyone was trying to hurt her, she was always looking for ways to escape from the hospital. Her thoughts were delusional—she believed she had special powers and that others were trying to take them from her. At times, she also appeared very “spacy.” Sandy didn’t think there was anything wrong with herself, and her family was at a loss.

What Sandy’s Brain Revealed

In an attempt to understand what was going on with Sandy and to convince her that at least part of her problems were biological, her physician ordered a brain imaging study called SPECT. Normally a very simple procedure, it proved challenging with Sandy and required three separate tries. The first two times she ripped out the intravenous line, saying the clinicians were trying to poison her. The third time was a success because her sister stayed with her and calmed her down by talking her through the experience. The SPECT scans revealed increased activity in her limbic system and patchy increased activity overall. In other words, some areas showed increased activity, and some showed decreased activity. Brain imaging studies show that cyclic mood disorders often correlate with focal areas of increased activity in the limbic system specifically as well as too much activity across the surface of the brain.

Sandy’s Bipolar Brain

Patchy increased activity throughout the cortex.

For Sandy’s family, this was powerful evidence that her problems were biological, not moral. As a result, when she refused medication, they were now willing to encourage her to take it. After she accepted their advice, her behavior normalized again. Once Sandy saw her brain scans, she agreed to follow a treatment plan that included medication.

How Seeing Her Brain Scan Helped Heal Her Symptoms

Seeing her own brain helped Sandy overcome one of the most clinically significant problems in people diagnosed with bipolar disorder. This brain disorder is usually responsive to medication. The problem is that when people with this condition improve, many feel so normal they do not believe they ever had a problem to begin with. It is difficult for them to accept that they have to continue taking medication when they think they no longer have a problem. Yet, prematurely stopping medication actually increases the chances of relapsing.

For Sandy, the brain scans visually demonstrated the biological nature of her mood swings and delusional thinking. Ultimately, this allowed her to understand the need to treat her condition and helped her avoid the relapses she had experienced in the past.

At Amen Clinics, where Sandy was treated, we use brain SPECT imaging as part of an overall evaluation to show our patients the biological nature of “mental health” disorders. Using brain scans helps our physicians more accurately diagnose and treat brain-based conditions, such as bipolar disorder.

If you or a loved one is experiencing symptoms of bipolar disorder or has been diagnosed with the condition and treatment isn’t working, getting an accurate diagnosis is critical to finding the relief you want from your symptoms. To find out how we can help you or a loved one, call to speak to a specialist at 888-288-9834 or schedule a visit.



  1. I was interested in your post about bi polar disorder being a brain problem. Back in the 1950s there was a lot of work done on the balance of potassium and calcium in the brain, and it’s causing manic depression. Recently this doesn’t seem to have been remembered as the serotonin myth took over and maybe seemed like a better new science in recent years. But research at Oxford University into sodium channels and potassium channels, is now showing interesting results on their effects in neurology and cyclical behaviour. My father, as a little boy, for some unknown reason used to eat handfuls of salt. He developed mentally normally till in his 30s when he had a pericardiectomy for removal of a calcium layer which had built up round his heart and was strangling it. His was one of the first successful operations for this. However his manic depression episodes began after this (maybe precipitated by stress or relief that he had come through the operation, most people died after this ground breaking open heart surgery in 1930s and 1940s), but he couldn’t have Lithium as it is contra-indicated in heart problems. Thinking there may be others like him, and knowing that Largactil actually worsened his attacks, would now be the time to look with new eyes again at the calcium/potassium balance in such sufferers, especially if SPECT scans could show this?

    Comment by Heather Roberts — November 6, 2019 @ 4:02 AM

  2. Was there any discussion of possible environmental exposure which has been causing these symptoms? Especially the psychosis and mood disorder.? I’ve seen similar patients with these and other neurological symptoms caused by chronic accumulation of mold mycotoxins. I know Amen clinic does consider this as well but was not mentioned in this patient as a potential cause. This is a hidden condition as most patients at present with this condition have no awareness of exposure and may be related to an older home with chronic mold accumulation in carpets and walls. It is not visible and may takes several years of exposure before symptoms appear in genetically susceptible patients.
    I strongly recommend this patient have a urine mycotoxins test or the blood tests recommended by Shoemaker protocol.
    Also note this patient likely improved while in hospital in part because of being away from mold location/exposure site. I hope she continues to do well but if she returned to living where she had the delusions there is likely a high risk of relapse
    Good luck (that’s the advice given by Ritchie Shoemaker to patients with the mold toxicity denial of illness/foggy brain illness). The fact that you got the patient to take the scan is certainly an accomplishment, I know Amen clinic uses other appearances on the scan to diagnose mold exposure toxicity- This scan needs to be added to potential mold toxicity

    Comment by Duard D Birkhofer MD — November 6, 2019 @ 5:29 AM

  3. I find your question interesting as my Mom was diagnosed with Hypoparathyroidism and suffers from calcification of the brain as a result. I wondered the same, would a spec scan assist in helping a person with significant calcification finding a medication that would help.

    Comment by Carol Grigg — November 6, 2019 @ 6:31 AM

  4. I took lithium: :it has been over 30 years ago: but all I remember is that it made me totally dysfunctional. I would sleep almost 24/7 and it didn’t matter if I took more or less of the drug I would still sleep. This did not go away even after 8 months. I was not able to do housework care for my 6 year old son have any kind of social life etc. It was a horrible experience. There was none of this my symptoms are gone I do not need this medication any more. It was more like an ongoing punishment. I finally left the “treatment” and said I have a life to live. I went back to work. Looking back on my situation I did have periods of highs. I had triggers. Most of the time I barely functioned and could not get out of bed in the morning. My highs and lows were never to the point that I required hospitalization and I know that is not true for many people with this. Also I believe Lithium may help some people, it just was not the drug for me and maybe others.

    Comment by Adelia Hitt — November 6, 2019 @ 7:04 AM

  5. Thank you, as a Chaplain, I have often wondered why some folks and families respond the way they do and make us the bad guys…repeatedly.

    Comment by Susan Burton — November 6, 2019 @ 9:34 AM

  6. I am hugely interested in learning about Bipolar. I was diagnosed with Bipolar 1 with Depression about 5 years ago. But as far as my parents say, I have had bipolar for years and years. I was in an Auto accident in 1996, injuring frontal lobe (right side) . I was 23 years old. Coma for 9 days. I know I have never been the same after that.

    I already had a history of sexual, emotional, drug exposure and mental trauma by age 4.

    It just seems to me that whatever struggles I had by age 23 they got 100% worse and were not getting better. I am on medication and feel stable if the vibe is always positive!!! I just want to be able to understand my Brain and know if I’m stable enough to work? MY BIPOLAR IS SO UNCERTAIN AND I JUST WANT THE PROOF OF KNOWING WHATS WRONG WITH ME. PlLEASE PLEASE CAN YOU PLEASE HELP ME FIND OUT IF THIS IS HELPABLE. Much Respect for all you do

    Comment by Jennifer Freeman — November 6, 2019 @ 10:20 AM

  7. I have word retrieval issues also amongst living with Bipolar, Depression, Anxiety, OCD, PTSD, Agoraphobia, and Binge Eating. Sorry I have short term memory which gets worse with age I guess but I think my long term has gone too and I’m so confused feeling all the time. Almost like Deja Vu feeling but I know I wasn’t there because I don’t leave the house. I am very tired of feeling like I don’t want to live another day everyday it’s so exhausting this feeling and emotions that come with it. For me to Cry and replay my emotions to myself everyday is the utmost ridiculous action I have to mumble out loud day in and day out that I just can’t do anymore. When is enough. I’m 46 years old. I’m tired

    Please Help Me help myself

    PS Memory problems so bad especially short term, and I can’t remember a lot of my long term either. I take like 5 different meds and and 2 to 3 of them twice a day.

    Comment by Jennifer Freeman — November 6, 2019 @ 10:41 AM

  8. Jennifer,
    My heart breaks for you! I had one of my family who was just experiencing a lot of anxiety go to Dr. Amen’s clinic and I was beyond happy…happy really doesn’t describe it…with how it help her. If you haven’t been to his clinic, find a way to go. I believe it could be life changing. If you lack enough funds to put the cash out, let them know that as well. They may have some good Samaritans that help cover costs or…who knows. I truly believe it can dramatically change your life.

    Comment by Sandra Franzen — November 6, 2019 @ 8:06 PM

  9. I am totally an advocate of what Dr. Amen has accomplished with his clinics. I have several family and even employees that I think could benefit from your service. I have been trying to get my sister to bring her I believe 60 year old daughter, living at home, and abusive frequently to her Mom especially, to bring her to your clinic. She, I believe, might be a challenge, BUT rehab’s don’t work and her Mom and Dad are in their 80’s and if they are gone, she will be in the streets.
    I brought my granddaughter, Laila Stelling, probably about 2 years ago. I would like to bring her future husband who Is a wonderful guy but has, as a child been trieated for ADHD I think and I truly think it would benefit him as well. The two of them are good together, but I think they’d be even better if I could send him.
    I am so thankful there is a resourse like your clinics where the “Truth be told, it can change your life”
    Always Wishing You the Best,
    Sandy Franzen

    Comment by Sandra Franzen — November 6, 2019 @ 8:13 PM

  10. I have similiar issues to Jennifer my doctor calls it pseudodementia.

    Comment by Sunny — November 7, 2019 @ 3:03 AM

  11. There is research that vitamin K can regular calcium to deposit on the bones instead of arteries…

    Comment by Ingrid — November 7, 2019 @ 6:54 AM

  12. Dr Amen What about vitamin K to decrease calcium deposits in the brain? What about gut health as well as detoxifying the liver to decrease ammonia brain toxicity. I have a strong believe in cleaning the body and provide it with proper nutrients we can get the body to function normally without drugs. The alternative clinic in Arizona does this successfully.

    Comment by Ingrid — November 7, 2019 @ 7:44 AM

  13. This article, using terms like ‘brain disorder which can be treated’ seems to ignore neuroplasticity and the cause and effect possible with intention, action, feeling, thought etc. I managed to cure my very entrenched bipolar patterns by examining my mind and thoughts preceding my peaks and troughs, where I saw a pattern almost by accident. I’m really surprised to see the ‘broken brain theory’ being used here.

    Comment by Maree Andrews — November 7, 2019 @ 2:22 PM

  14. I am confused by the proposal that because Bipolar brains show an abnormal activity pattern that it is not a mental illness but a brain disease. I believe mental illness affects the brain functioning and could be characterized as “brain disease.” If it is not a mental illness, what is?

    Comment by Jeanne — November 7, 2019 @ 6:19 PM

  15. You and I have a lot in common. I was in a car accident and have tbi and it kicked in a full blown case of bipolar that was always probably lingering around anyway. I was never the same after the accident. One day you will be able to love the new you and the amen clinic is your ticket. Good luck. God bless you

    Comment by Lisa — November 10, 2019 @ 6:44 PM

  16. My grand son has Bipolar disorder. He has tried several different drugs Lithium and several others.He wants to commit suicide at times.I am afraid he will what can I do to help him.

    Comment by Reba Childers — November 30, 2019 @ 10:40 PM

  17. Hello Reba, thank you for reaching out. We’d be happy to contact you directly to discuss further. We look forward to speaking with you.

    Comment by Amen Clinics — December 2, 2019 @ 1:51 PM

  18. Hi
    I am a Certified Banting Coach aka
    ” Keto ”
    ” Low Carb High Fat Coach or
    ” Atkins way of living.
    I am amazed at how many so called “incurable diseases” are put into remission or reversed by getting into the Keto Zone. Can bi-polar be put in remission by a Ketogenetic way of living/eating? I would appreciate any testimonies.

    Comment by Yorke Rodda — December 14, 2019 @ 3:08 AM

  19. My sister takes some 40 drugs. Her neurologist believes she is over medicated. She has bipolar, sleeping disorders, neuropathy, is a T1Diabetic and has gained 70 pounds (yet says she barely eats). She has been tested for seizures but medication did not change her “episodes” so the neurologist believes she is over medicated. Her memory is awful. She also had ECT treatment in her 30’s. She refuses to live anywhere but alone with her cat. We believe she needs an alternate setting where she is looked after. She is 53, can only work part time, hates her ongoing and mounting health issues, wants support but limits our involvement. She is becoming a burden on the brother who lives the closest to her (45 minutes away). She has a Life Alert and he is her contact person. She falls frequently and injured herself. I suspect a bone scan may reveal a loss in bone density. I have tried coaching her in proper nutrition, however her funds are limited to afford supplements and healthy food and her lack of brain function makes it difficult for her to follow a recipe. She also has executive function disorder so her decision making skills are lacking. If there is anything you can do for someone who is fairly destitute, I would greatly appreciate a response. I am enrolled in your Brain Health Coach program in Amen University.

    Comment by Tamara Miller — April 25, 2022 @ 3:46 AM

  20. Hello Tamara, thank you for reaching out and sharing about your sister. We’d be happy to contact you directly with additional information or resources that may assist you.

    Comment by Amen Clinics — April 25, 2022 @ 6:37 PM

  21. I’m disappointed not to see you share here about dierary or nutritional lithium, like you have available in supplements. Low dose dietary or supplemented lithium is neuro-protective and neuro- regenerative. See Dr. James Greenblatt work. While the prescription form- Lithium Carbonate- is a large molecule that’s not readily bioavailable so doctors push high doses and do serum level testing for toxicity. But still, it can have bad side effects from too much lithium and possibly from the carbonate. So why not promote dietary sources (thyme, nutmeg, pistachios, organic potatoes, cabbage, spring water, Trace Mineral drops) and Nutritional Lithium, like your Lithium Orotate supplement that is bioavailable at a low dose? The current science is we all need 1mg a day, some may need more and Omega 3 compliments the lithium. This article is about brain scans and devoid of healthy solutions? Dietary nutritional lithium (((not the prescription kind))) has been shown to help in TBI, add, bipolar, dementia, autism. Anyways, I was so happy to see it in your supplements, but this article is again, disappointing.

    Comment by Tammy — April 26, 2022 @ 9:40 AM

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