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how does mania or hypomania cause brain damage?


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I'm not sure they have that figured out, but there is a lot of documentation on measurable changes in parts of the brain and loss of grey matter associated with aspects of measurable decline in executive function, memory, cognition and so forth. Query PubMed on "bipolar disorder brain imaging" or "bipolar disorder brain damage" for some of the study abstracts.

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Part of it is probably excitotoxicity - I'm pretty sure that's how psychosis, at least, causes brain damage. Excessive signalling by glutamate and by other excitatory neurotransmitters can lead to huge calcium influxes into the cell, which can trigger internal self-destruct systems.

There is a study supporting that idea here. It's probably more complicated than that, but that might be part of it. Particularly because excessive glutamatergic signalling has been found to be associated with mania (reference)

While mania is not a drug, it does result in measurable changes in your brain's activity and signalling, usually in terms of overactivity, and that's toxic.

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Drugs are not the only way to damage a brain's neuro-circuitry. My understanding is they are finding damage in the parietal lobes (atrophy? I am not going to look it up and link, so take it with a handful of salt), among other things. Here is a link about damage to the frontal lobes, though.

They also find irregularities in white matter, which they suspect is demylienation(sp?). And there is a decrease in glial cells (which are some kind of neural tissue) over time.

Also, I am inferring this, so I am not 100% sure this is true, but there are noted differences in blood oxygenation (that part is true, it is the next part I am not sure of); I know in my husband with epilepsy has hypoxia damage on his frontal lobes, and whenever he is in the ER, they are very concerned about his blood oxygen level, so I am guessing it is a concern for us as well.

ETA: There are new types of neuro-imaging (or at least new to me), so they are going to start being able to make more detailed observations.

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  • 4 weeks later...

I don't recall seeing an explanation yet for the cause of brain atrophy in bipolar disorder. And, I'm too lazy to do the deep digging tonight.

Obviously this goes to the core of the illness itself. Since, if they understood this they would either know the cause or be very close too it.

Still we can see other neurological diseases that damage the brain and CNS: Multiple Sclerosis, Huntingtons Chorea (Woody Guthrie), Alzheimers, and most recently in the news, the brain atrophy in football players.

Two things though have been proven by research in the last five years: For bipolar disorder and schizophrenia, the earlier treatment with medication is started and sustained the better the disease outcome!!! :) That's good news. Something we know we can do and that works. a.m.

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