Bipolar is a Progressive, Organic Brain Disease. Medication Helps Stop Damage to Brain.


Sarah Troy writes:

I am not a doctor. I have bipolar disorder. My responses are based on my own experience, reading and research.

QUESTION: “I know bipolars begin to experience cognitive damage with each untreated manic episode but do BPs on medication also experience this cognitive damage?”

Yes. Bipolar is a progressive, organic brain disease.

Bipolar is a major mental disease (or disorder). Research on the major mental disorders, such a bipolar, schizophrenia, major depression, and Alzheimer’s disease, shows: A) Deterioration of the brain occurs slowly over the lifespan in each of these disorders. B.) This deterioration is both structural and functional. C) There are differences between how the brain looks in each of these disorders. In other words, the brain of a bipolar has structural and functional deterioration that is different from the brain of a major depressive disorder. D) In each of these disorders, we know that active phases of the disease, or “episodes,” accelerates brain deterioration.

In bipolar, the “episode” used as the marker for brain deterioration is the hypomanic or manic episode. So, one thing observed in bipolars is that as they age (due to the underlying organic deterioration) “episodes” of hypomania or mania gradually become more intense and frequent, with a fewer number of years between episodes. This pattern of deterioration occurs in all bipolars, whether they are un-medicated, under-medicated, or medicated.

There is simply no “cure” for bipolar.

Does medication slow the progressive nature of the disease? Yes, because effective treatments (medications) for bipolar decrease the intensity or frequency of hypomania or mania, or increase the number of years between episodes.

Therefore, a bipolar who is effectively (adequately) medicated will experience less brain deterioration over time than a bipolar who is under-medicated or un-medicated.

Do we know more about lithium than other bipolar meds? Yes. Because lithium has been studied the longest, we know more about it than any other bipolar medication. Research shows effective treatment with lithium can, in some people, help the brain to heal the damage done by “episodes.” Can other bipolar meds do this? We just don’t know. More research is needed.

How much of a difference is there between the brains of effectively (adequately) medicated bipolars and the brains of un-medicated or under-medicated bipolars? A lot. It has been established for a while that the brains of untreated Schizophrenics deteriorate similarly to the brains of Alzheimer patients over time. Now, the newer research is showing that the brains of untreated bipolars deteriorate like the brains of untreated schizophrenics over time. Hence, the brains of untreated bipolars have been compared to the brains of Alzheimer’s patients over time. bipolar-brain-imaging.html – Accelerated shrinking of grey matter of brain disease.htm#enlargedventricles – Disease process of Bipolar and Schizophrenia brain-science/spect-image-gallery/spect-atlas/images-of- bipolar-disorder-and- schizophrenia/ – Images of Bipolar disorder and Schizophrenia ~thompson/projects.html – Current neuroscience projects

48 thoughts on “Bipolar is a Progressive, Organic Brain Disease. Medication Helps Stop Damage to Brain.

  1. Well, I’m glad I’m taking lithium, but this is daunting information! I wonder what long-term use of my MAOI (monoamine oxidase inhibitor) and Seroquel do to my weary brain!?!?

    I also wonder about the power of the placebo effect, in other words, if we think our bipolar brains won’t deteriorate that much over time, will our attitude have any bearing on our brains’ healing capacity? Probably not, but then again…who really knows?

    Liked by 3 people

  2. Thank you so much for this post, which I reblogged. I look forward to research on other mood stabilizing medications including valproic acid, which I take. I also take the SSRI escitalopram, as I have bipolar type II and was diagnosed and treated as dysthymic for two decades before my bipolar diagnosis.

    Liked by 2 people

  3. Reblogged this on my SAHM thing… and commented:
    I feel like I didn’t really know this, even though I probably should have. And I probably shouldn’t have read it on a day that I’m overtired, and already feeling depression creeping up on me. In other news, I’m feeling pretty weird about the crazy gunman incident that happened in a Sydney cafe these past 24 hours. Just…can’t wrap my head around that one. My heart goes out to the loved ones of the innocents who lost their lives.

    Liked by 1 person

  4. This is extremely disturbing, I do wonder about the comprehensive research though and the misdiagnosis of bipolar patients as a variable. Would be interesting to know if the lamictal I’m on protects the brain. Surprising that my psychiatrist and other doctors never gave a mention to the deterioration.


  5. Thank you for this post. It was extremely educational for me. I am always looking for research into bipolar disorder. I was diagnosed 4 years ago, although I have had bipolar for most of my lifetime. I just went misdiagnosed.

    Liked by 1 person

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    Liked by 1 person

  8. So just a few days ago I began looking into what being bipolar is, and the symptoms were eerily accurate to things I’ve experienced since I was 11 or so. So obviously I took dozens of tests to see if I am bipolar and I’ve gotten positive results every time, however none of these tests were professional. But that’s besides the point, my maniac episodes are only a few months apart, (each of which are severe), not years, what does this mean?

    Liked by 1 person

  9. It seems like i could have written this post myself. I’m bipolar 1 and have suspeced that my severe mania-mixed-depressed episodes have been leaving lasting damage. That’s been the main drive for me to find an effective medication cocktail to prevent it from happening. I’ve started reading the literature and the impression I get is that severe episodes create damage akin to accelerated aging in the brain. Mostly irreversible, but future damage can be mitigated by avoiding the onset of mania. I know mentally I don’t function at as high a level as I used to but it’s good to know there us a way to at lest slow the damage.

    Liked by 1 person

  10. Hi following a closed head injury at the age of 31 3 months later I was mis- diagnosed a “congenital defect” and put on lithium. This was because of the Meglamaniac Consultant Psychiatrist who has since been in Court for sexually abusing patents. approx 30 months after injury I felt an odd sesation in my head,”I now understand it to be Neuro passage ways reopening after Brain swelling effects going. 19 years I argued that I was okay, I stopped Lithium that was wrecking “my” system. I have been examined by a Neuropsychiatrist who states that I have no Neuropsychiatric or Psychiatric syndrome as well as a Professor of Psychiatry who states that I was Organic bipolar for the first 2 years. I have been off Lithium and no other med for almost 7 years without any problem. Will the NHS say sorry, huh no chance, I lost my wife and children during this horiffic time, 2 of the my 3 children now in their twenties are ok, but my ex wife and one of my children will not speak to me, and I do not blame them, but it was the Lithium that rocked “my” boat. I have so much more to say but I will leave it at that.

    Liked by 1 person

  11. Hi! No complaints regarding the post itself. Just problems with the language used in the post.

    The constant reference to individuals with bipolar disorder as “bipolars” is very linguistically dangerous and stigmatizing because: (a) I AM NOT bipolar, I have bipolar; my diagnosis does not define me; and, very much so in the same vein as the first point, (b) the reference of those who have bipolar as “bipolars” is extremely dehumanizing. If Johnny broke his leg, would you go around saying “Look, it’s broken Johnny!” No.

    I know this comment is nitpicky. And I know the post was three years ago. But we’re all here for the same reason–To help those with mental health issues best cope with their illness and get better! And unfortunately one of the greatest barriers to effective care is the stigma of mental illness. It starts with us and the language we use. This stigmatizing language is hardly intentional. But we ought to make a conscious effort to do better (: Thank you!

    Liked by 1 person

  12. Yes I agree with you about that. I never call myself or anyone else bipolar, I always say someone with bipolar. Funny the author says bipolar and schizophrenics but say brains with Alzheimer’s and the author had bipolar. Despite that it had valuable information. But good that you pointed out how not to address someone with bipolar d/o.


    • I’m so glad Lucas noticed this as well and even happier to know that you were quoting someone else verbatim. I constantly tell myself, “I have bipolar, bipolar is not who I am.” Maybe one day I’ll truly believe it.

      Liked by 1 person

  13. I have read recent studies that suggest that using lithium early with the first onset of symptoms appears to help, but not if started in the mid to late stages of the BP disease. I feel this may be because lithium is a naturally occurring salt in the human body and early on it may correct a deficiency before the eventual brain damage occurs and is not reversible. BP is thought to be an inflammatory brain disease and I see no evidence that other medications actually stop the inflammatory disease process but rather get the symptoms under control. For lack of a better analogy its like saying I’m bleeding because I cut myself and the bandage I put on it actually afterword stopped me from cutting myself. No but it does stop the bleeding.There is no proof that the symptoms cause brain damage but rather the brain damage causes the symptoms. Other meds do not inhibit the progressive brain damage that causes the symptoms to begin with. I had white matter hyperintensities and brain shrinking in my late 40’s and other symptoms of inflammatory disease which are possible bio-markers of BD. I have found that NAC (N-Acetyl Cysteine) and fish oil have helped immensely, especially with anxiety and clarity of thought. I believe people should take their meds and educate themselves, as a huge problem with this disease is insight into self. Don’t drink alcohol and be as healthy as possible. I also believe that big pharma would like us all to see no other way to treat it.

    Liked by 2 people

    • Thank you for your lovely comment! I wrote you a looong answer and somehow it disappeared! So here I go again. Firstly I do believe that Lithium works no matter when you take it, st the beginning, middle, or in advanced illness, but because so much brain damage has occurred as the disease progresses, Lithium works less and less well. I also believe that BD is an immune illness, it has so many markers of inflammation! Also, I don’t think we know why it progresses but I guess it is like any other neurodegenerative illness like schizophrenia or Alzheimer’s. And I too have white spots all over my brain as migraine suffered do and I have had migraines since I was 13 years of age. Fascinating! Also please have a look at another of my blogposts, the link is below.
      And please feel free to keep commenting. Thank you.

      Liked by 1 person

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