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Bipolar Disorder is a disease of the brain
(as is Schizophrenia)
Table Contents:

Written by: Dr. E. Fuller Torrey (Note: moodswing.org has added the photos and some of the more recent medical research references in this article)

History of the Scientific View on Bipolar Disorderas a Disease: It has been suspected for over a century that both schizophrenia and manic-depressive disorder (bipolar disorder) are diseases of the brain. In 1837, Dr. W.A.F. Browne, the best-known English psychiatrist of his generation, wrote:

    "Insanity, then, is inordinate or irregular, or impaired action of the mind, of the instincts, sentiments, intellectual, or perceptive powers, depending upon and produced by an organic change in the brain."

In that same year, Dr. Amariah Brigham, one of the founders of American psychiatry, also wrote that insanity "is now considered a physical disorder, a disease of the brain."

It would be 150 years, however, before these statements could be proven. Since the early 1980s, with the availability of brain imaging techniques and other developments in neuroscience, the evidence has become overwhelming that schizophrenia and manic-depressive disorder are diseases of the brain, just as multiple sclerosis, Parkinson’s disease, and Alzheimer’s disease are diseases of the brain. [our emphasis added] The brains of individuals with these diseases are measurably different from individuals who do not have these diseases, both structurally and functionally.

A brief summary of some of the evidence that proves this point follows.

 

Enlaged Ventricles in the Brain: Individuals with bipolar disorder and schizophrenia, including those who have never been treated, typically have enlarged ventricles in the brain, as demonstrated in over 100 studies to date.

above: MRI imaging showing differences in brain ventricle size in twins - one schizophrenic, one not. (image courtesy NIH - Dr. Daniel Weinberger, Clinical Brain Disorders Branch)

Enlarged Amygdala: Individuals with manic-depressive disorder have an enlarged amygdala and increased numbers of white matter hyperintensities.

Neurological Abnormalities: Individuals with manic-depressive disorder and schizophrenia, including those who have never been treated, have more neurological abnormalities, as shown in over 25 studies.

Impaired Cognitive Function: Individuals with schizophrenia and manic-depressive disorder, including those who have never been treated, have more neuropsychological abnormalities that impair their cognitive function, including such things as information processing and verbal memory.

A Sample of Recent Relevant Research:

 

Impaired Awareness of Ilness: Approximately 50 percent of individuals with schizophrenia and manic-depressive disorder, including those who have never been treated, have impaired awareness of their own illness. This has been shown in at least 50 different studies. Such individuals do not realize that they are sick, and they will, therefore, usually not accept treatment voluntarily. Studies suggest that this impaired awareness is probably related to the decreased function of the prefrontal area.

These individuals are thus similar to some patients who have had a stroke and, because of brain damage, are unaware of their disability and deny it. The lack of awareness of illness in individuals with schizophrenia and manic-depressive disorder is the most common reason that they do not take their medication. [as can be seen in the research below, the part of the brain that is resonsible for self-analysis seems to be one of the areas most damaged by schizophrenia; the brain that is damaged, cannot frequently recognize that it is damaged]. This is a problem is because increasingly schizophrenia research is suggesting that the sooner a person with this brain disease is treated, the better the outcome for the person. Delays for treatment result in much worse outcome (see recent research below).

A Sample of Recent Relevant Research:

Additional Information on the Disease Process of Bipolar:

 


 

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