Bipolar Disorder

Unlike traditional psychiatry, which rarely looks at the brain, Amen Clinics uses brain imaging technology to identify brain patterns associated with bipolar disorder.

What Is Bipolar Disorder?

Bipolar spectrum disorder (BSD), previously known as manic-depressive illness, is a brain disorder that results in significant and severe changes in mood, energy, activity levels and ability to carry out routine tasks. These shifts are more severe than the normal ups and downs that most people experience. According to the World Economic Forum, bipolar disorder ranks sixth on the list of the world’s leading causes of disability.

Who has Bipolar Disorder?

Nearly 6 million adults in America are affected by bipolar disorder, which can also affect children and adolescents. The onset of the disorder most commonly begins in young adulthood (late teens to mid-20s), but it can also start in childhood or as late as in a person’s 50s.

Men and women are equally likely to develop the disorder, which tends to run in families. People with a parent or sibling with the condition are more likely to develop it. This indicates there may be a genetic factor involved. However, it’s important to know that having a family member with the condition does not mean that you will get it too. In addition, remember that your genetics are not your destiny. A growing body of evidence shows that your lifestyle habits can either turn on or turn off your genes.

What are the Core Symptoms?

Because bipolar disorder involves both manic episodes and depressive episodes that shift in a cyclical pattern, people with the condition typically experience a broad range of symptoms. Manic episodes are characterized by many things, including decreased need for sleep, grandiose ideas or racing thoughts. Depressive episodes are characterized by loss of interest in usually pleasurable activities to even thoughts of death or suicide. See below for more details about these two types of episodes.

What Causes Bipolar Disorder?

Experts have yet to discover the exact causes of bipolar disorder, but they have identified several risk factors for the condition. As you saw above, having one or more family members with bipolar disorder increases the risk. So does a history of emotional trauma, high stress, or substance abuse. In addition, bipolar disorder is associated with changes in the structure and function of the brain (see below for more on this).

Left untreated, bipolar disorder can cause major problems in life, including:

  • Self-esteem issues
  • Relationship problems
  • Job performance issues
  • Poor school performance
  • Substance abuse
  • 39% hospitalization rate (more than any other mental health condition)
  • A decrease of over 9 years in life expectancy
  • 15 times more likely to attempt suicide than general population

Why Choose Amen Clinics for Bipolar Disorder Treatment?

Bipolar disorder is often misdiagnosed as depression, ADD/ADHD, or even schizophrenia because some of the symptoms are very similar. Making the distinction between bipolar disorder and other conditions is critical because following the wrong treatment plan can make symptoms much worse. For example, when someone with bipolar disorder is misdiagnosed with ADD/ADHD and given stimulant medication, it can dramatically exacerbate symptoms and cycling. At Amen Clinics, we use brain imaging as part of a comprehensive evaluation to help distinguish between bipolar disorder, ADD/ADHD, depression, schizophrenia, and other conditions. This means you’ll get a more effective treatment plan.

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Bipolar Brains Work Differently

In brain SPECT images of people with bipolar disorder, we see heightened activity in the limbic system which includes the amygdala, the hippocampus, and the cingulate gyrus. This system controls emotion, memory, motivation, fear, and sensory information. Abnormalities in this region can impact one’s emotional and sensory states negatively impacting their daily lives. By knowing which area of the brain is most impacted, we can customize a treatment plan and approach to calm areas of the brain working too hard and stimulate areas of the brain not working hard enough.

Healthy Brain Scan

Bipolar Disorder Brain Scan

SPECT (single photon emission computed tomography) is a nuclear medicine study that evaluates blood flow and activity in the brain. Basically, it shows three things: healthy activity, too little activity, or too much activity. A healthy “active” scan shows the most active parts of the brain with blue representing the average activity and red (or sometimes red and white) representing the most active parts of the brain. In the healthy scan on the left, the most active area is in the cerebellum, at the back/bottom part of the brain. In the scan on the right from a person with bipolar disorder, there is overactivity in many areas of the brain.

Cyclic mood disorders, such as bipolar disorder, often correlate with focal areas of increased activity in the limbic system as well as too much activity across the surface of the brain. SPECT brain scans also show that many people who are diagnosed with bipolar disorder actually have a traumatic brain injury that has never been properly diagnosed and treated. For these people, healing the underlying TBI can be very helpful in alleviating symptoms associated with bipolar disorder.

Ready to learn more? Speak to a care coordinator today!

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Types of Bipolar Episodes

Bipolar Disorder features both manic episodes and depressive episodes that shift in a cyclical pattern, people with the condition typically experience a broad range of symptoms.

Type 1: Manic Episodes

Manic episodes are characterized by an emotional state that is elevated, expansive, energized, or euphoric. These feelings can cause people become highly active, and in some cases, irritable. Manic episodes can last hours, days, weeks, or months.

Manic episodes are characterized by:

  • Abnormally elevated mood
  • Inflated self-esteem
  • Decreased need for sleep
  • Increase in goal-oriented activity
  • Grandiose notions, ideas, or plans
  • Increased talking or pressured speech
  • Racing thoughts
  • Inability to “turn off the mind”
  • Poor judgment that leads to risk-taking behavior
  • Hypersexuality or hyperreligiosity
  • Excessive appetite
  • Inappropriate social behavior
  • Irritability or aggression
  • Delusions or hallucinations

Type 2: Depressive Episodes

Depressive episodes are characterized by a marked downshift in energy levels and moods, causing people to experience a slowdown in activity. These depressive episodes can last hours, days, weeks, or months.

Depressive episodes are characterized by:

  • Persistent sad or negative mood
  • Loss of interest in usually pleasurable activities
  • Feelings of guilt, worthlessness, helplessness, and hopelessness
  • Sleeping too much or too little, or waking up too early
  • Decreased energy, fatigue, or feeling “slowed down”
  • Difficulty concentrating
  • Thoughts of death or suicide, or suicide attempts


“You are not stuck with the brain you have.”

– Daniel G. Amen, M.D.


Different Types of Bipolar Disorder

Bipolar disorder is not a simple or single condition. There are at least 4 types of the condition, including:

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


The distinction between the types is related to the severity of the symptoms. For example, bipolar I disorder is considered the most severe form of the condition.


“When Your Brain Works Right, You Work Right.”

– Daniel G. Amen, M.D.


Bipolar Disorder Testimonial

Loni's Heartbreaking Story

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