• Mental Health
    • Anxiety
    • Depression
    • OCD
    • Bipolar Disorder
    • ADHD
    • Addiction
      • What is Addiction?
      • What Are Behavioral Addictions?
      • Addiction vs Dependence
      • Addiction Myths vs Facts
      • Addiction Statistics
      • How to Help a Friend
      • Find an Addiction Specialist
    • Eating Disorders
    • Personality Disorders
      • Obsessive Compulsive Personality Disorder
        • OCD vs. OCPD
    • Trauma
      • Post-Traumatic Stress Disorder
      • Childhood Trauma
    • Sexual Disorders
      • Anorgasmia
      • Female Sexual Arousal Disorder (FSAD)
      • Hypoactive Sexual Desire Disorder (HSDD)
      • Premature Ejaculation (PE)
      • Delayed Ejaculation
    • Schizophrenia
  • Therapy Techniques
    • Online Therapy
      • Best Online Therapy
      • Online Therapy for Teens
      • Best LGBTQ Online Therapy
      • Best Online Therapy for Insurance
    • Psychotherapy
    • Cognitive Behavioral Therapy (CBT)
      • CBT for Anxiety
      • CBT for Social Anxiety
      • CBT for Panic Disorder
      • CBT for Insomnia
      • CBT Online
    • Dialectical Behavior Therapy (DBT)
      • DBT for Teens
    • Acceptance and Commitment Therapy (ACT)
    • Eye Movement Desensitization and Reprocessing (EMDR)
      • EMDR for PTSD
      • EMDR for Anxiety
      • EMDR Online
    • Art Therapy
    • Applied Behavior Analysis (ABA)
    • Exposure and Response Prevention
    • Group Therapy
    • Hypnotherapy
    • Motivational Interviewing
    • Person Centered Therapy
    • Rational Emotive Behavioral Therapy
    • Sex Therapy
  • Types of Therapists
    • Faith-Based & Christian Counselors
    • Life Coaching
    • Family Therapist
      • Child & Teen Counseling
    • Marriage & Couples Counselors
      • Premarital Counseling
    • Psychiatrist
      • Psychology vs. Psychiatry
    • Psychotherapist
    • Grief Counselors
    • Online Therapists
  • Starting Therapy FAQ
    • Does Therapy Work?
      • How to Find a Therapist
      • Helping a Friend or Loved One
    • How to Choose a Therapist
      • Finding a Black Therapist
      • Finding a Latinx Therapist
      • Finding an LGBTQ-Friendly Therapist
      • Finding a Therapist as a Young Adult
      • Finding an Online Therapist
    • Preparing for Your First Session
    • Types of Mental Health Professionals
    • Mental Health Insurance
      • HSAs for Therapy
      • Sliding Scale Therapy Fees
    • Mental Health in the Workplace
      • Asking for a Mental Health Day
      • Taking Time Off for Mental Health
    • Top Mental Health Organizations
      • Mental Health Resources Outside the U.S.
  • About Us
    • About Us
    • Editorial Policy
    • Advertising Policy
    • Privacy Policy
    • Contact Us
    • Write for Us
    • Join the Directory
    • Careers
  • Therapist Directory
    • Find a Therapist
    • Join the Directory
    • Directory Login
  • Mental Health
    • Anxiety
    • Depression
    • OCD
    • Bipolar Disorder
    • ADHD
    • Addiction
      • What is Addiction?
      • What Are Behavioral Addictions?
      • Addiction vs Dependence
      • Addiction Myths vs Facts
      • Addiction Statistics
      • How to Help a Friend
      • Find an Addiction Specialist
    • Eating Disorders
    • Personality Disorders
      • Obsessive Compulsive Personality Disorder
        • OCD vs. OCPD
    • Trauma
      • Post-Traumatic Stress Disorder
      • Childhood Trauma
    • Sexual Disorders
      • Anorgasmia
      • Female Sexual Arousal Disorder (FSAD)
      • Hypoactive Sexual Desire Disorder (HSDD)
      • Premature Ejaculation (PE)
      • Delayed Ejaculation
    • Schizophrenia
  • Therapy Techniques
    • Online Therapy
      • Best Online Therapy
      • Online Therapy for Teens
      • Best LGBTQ Online Therapy
      • Best Online Therapy for Insurance
    • Psychotherapy
    • Cognitive Behavioral Therapy (CBT)
      • CBT for Anxiety
      • CBT for Social Anxiety
      • CBT for Panic Disorder
      • CBT for Insomnia
      • CBT Online
    • Dialectical Behavior Therapy (DBT)
      • DBT for Teens
    • Acceptance and Commitment Therapy (ACT)
    • Eye Movement Desensitization and Reprocessing (EMDR)
      • EMDR for PTSD
      • EMDR for Anxiety
      • EMDR Online
    • Art Therapy
    • Applied Behavior Analysis (ABA)
    • Exposure and Response Prevention
    • Group Therapy
    • Hypnotherapy
    • Motivational Interviewing
    • Person Centered Therapy
    • Rational Emotive Behavioral Therapy
    • Sex Therapy
  • Types of Therapists
    • Faith-Based & Christian Counselors
    • Life Coaching
    • Family Therapist
      • Child & Teen Counseling
    • Marriage & Couples Counselors
      • Premarital Counseling
    • Psychiatrist
      • Psychology vs. Psychiatry
    • Psychotherapist
    • Grief Counselors
    • Online Therapists
  • Starting Therapy FAQ
    • Does Therapy Work?
      • How to Find a Therapist
      • Helping a Friend or Loved One
    • How to Choose a Therapist
      • Finding a Black Therapist
      • Finding a Latinx Therapist
      • Finding an LGBTQ-Friendly Therapist
      • Finding a Therapist as a Young Adult
      • Finding an Online Therapist
    • Preparing for Your First Session
    • Types of Mental Health Professionals
    • Mental Health Insurance
      • HSAs for Therapy
      • Sliding Scale Therapy Fees
    • Mental Health in the Workplace
      • Asking for a Mental Health Day
      • Taking Time Off for Mental Health
    • Top Mental Health Organizations
      • Mental Health Resources Outside the U.S.
  • About Us
    • About Us
    • Editorial Policy
    • Advertising Policy
    • Privacy Policy
    • Contact Us
    • Write for Us
    • Join the Directory
    • Careers
  • Therapist Directory
    • Find a Therapist
    • Join the Directory
    • Directory Login
Skip to content

Can a Bipolar Brain Scan Help in Diagnosis?

Published: May 11, 2023
Published: 05/11/2023
Headshot of Dianne Grande, Ph.D.
Written by:

Dianne Grande

Ph.D.
Headshot of Rajy Abulhosn, MD
Reviewed by:

Rajy Abulhosn

MD
  • Can Brain Scans be Used to Diagnose Bipolar Disorder?Can Brain Scans Diagnose Bipolar Disorder?
  • Brain Scans of a Bipolar Brain vs. Normal BrainBipolar Vs. Normal Brain Scans
  • When Are Brain Scans Used in Diagnosing Bipolar Disorder?When Brain Scans Are Used to Diagnose
  • What is the Future of Brain Scans and Bipolar Disorder?Future of Brain Scans & Bipolar
  • Final ThoughtsConclusion
  • Additional ResourcesResources
  • Can a Bipolar Brain Scan Help in Diagnosis? InfographicsInfographics
Headshot of Dianne Grande, Ph.D.
Written by:

Dianne Grande

Ph.D.
Headshot of Rajy Abulhosn, MD
Reviewed by:

Rajy Abulhosn

MD

Brain scans are used to study the differences in brain structure and functioning of those with bipolar disorder. These differences include changes in gray matter volume, white matter integrity, visual processing, and amygdala activation. Findings are based upon CAT scans, MRIs, and MRS scans. While no brain scan currently in use can definitively diagnose someone with bipolar, scans are helpful in ruling out other diagnoses and in research.

Online Psychiatry and Medication Management Covered By Insurance

Talkiatry offers psychiatric appointments with real doctors, with first appointment in days. They’re in-network with every major insurer and offer medication management. Take the assessment and meet your new psychiatrist.

Choosing Therapy is compensated for marketing by Talkiatry.

Free Assessment

Can Brain Scans be Used to Diagnose Bipolar Disorder?

Although brain scans are not currently a reliable tool for diagnosing bipolar, they do have the potential to be a useful tool in the future. Brain scans have the potential to show physical differentiation in brain structure when behaviors can’t paint the complete picture. A study completed in 2020 used a combination of structural and functional MRI imaging techniques to effectively identify patients with bipolar at an accuracy of 87.5%.4

A doctor might recommend a brain scan for someone with bipolar symptoms in order to identify and rule out other conditions. Misdiagnoses might occur if there are any coexisting psychiatric or medical conditions, or due to lapses in history-taking.

Although uncommon, other conditions which might mimic symptoms of bipolar include brain trauma, tumor, Multiple Sclerosis, or stroke.1 More often, people with depression or borderline personality disorder are misdiagnosed as having bipolar disorder.2, 3 Diagnostic criteria for both Borderline and Bipolar include mood shifts as well as significant impulsive behavior. The possibility of MRI assisting in bipolar diagnosis could be beneficial in situations such as borderline personality disorder or depression, where the symptoms can mimic bipolar disorder.

Brain Scans of a Bipolar Brain vs. Normal Brain

Several differences exist between the bipolar brain and the normal brain. Knowing when these differences begin to develop or are at risk of developing can help with early detection and prevention. A recent study looked at MRIs of adolescents at high risk for bipolar and compared those to brain scans of adolescents at normal risk. Over a 2-year span, the youth at high risk showed a decrease in connectivity between areas of the brain involved in emotional processing, while the normal risk scans showed an increase in connectivity.5, 6

Physical abnormalities and differences in brain functions within bipolar disorder include:

  • Amygdala activation: Using functional MRIs, researchers found lower levels of amygdala activation in Bipolar individuals when not in an acutely depressed mood compared to depressed patients.7
  • Visual Cortices: Using MRI scans of bipolar vs normal brains, results showed that the bipolar brains responded in the same way to visual stimuli as the normal brains, when they were not in a manic or depressed mood.  When in a manic or depressed mood, the visual cortices of the Bipolar brains showed less activity than the normal brains.8
  • Subcortical volume, cortical thickness, and white matter integrity: A large scale study using multimodal brain MRIs found consistent patterns of lower subcortical volume, lower cortical thickness, and disrupted white matter integrity in patients with Bipolar. Results were not dependent on being in a depressed or manic mood.9, 11
  • Cortical gray matter: MRI scans showed that gray matter was thinner in frontal, temporal, and parietal regions of the brain in Bipolar individuals. These are brain areas that are critical in the control of emotion and inhibition. Results were not dependent on mood state.9, 10
  • Subcortical volume: Based upon functional MRI scans, a review article reported widespread patterns of pathology in the subcortical limbic structures, including amygdala and ventral striatum. These findings were not dependent on mood state.12

Help For Bipolar Disorder

Talk Therapy – Get help from a licensed therapist that has expertise with bipolar. Betterhelp offers online therapy starting at $60 per week. Get matched With A Therapist


Virtual Psychiatry – Get help from a real doctor that takes your insurance. Talkiatry offers medication management and online visits with expert psychiatrists. Take the online assessment and have your first appointment in days. Free Assessment

Choosing Therapy partners with leading mental health companies and is compensated for marketing by BetterHelp and Talkiatry.

When Are Brain Scans Used in Diagnosing Bipolar Disorder?

Doctors generally do not recommend brain scans to diagnose bipolar disorder. Medical doctors and mental health professionals usually rely on questions about current and past symptoms in order to make the diagnosis. A physician might order blood tests and/or brain scans to check for the presence of other conditions which can cause similar symptoms. For example, a brain scan might be ordered to rule out tumor or stroke as a cause of the symptoms.

The other main reason for ordering a scan of a possible bipolar brain is to be part of research for accurate diagnosis.  Studies of the structural and functional differences between a bipolar vs normal brain are ongoing. It is hoped that this type of research will at some point provide information that allows for the definitive diagnosis of bipolar based upon brain scans.

One of the challenges in diagnosing bipolar is being able to distinguish between one of the four types of bipolar vs. a unipolar depression. There is overlap between the symptoms of bipolar and the symptoms of unipolar depression. However, to be diagnosed with bipolar, the person must have a history of at least one episode of mania or hypomania. At the present time, there is no brain scan that is definitively used to diagnose any of these forms of bipolar.

The main types of bipolar disorder include:

  • Bipolar I disorder: The person must have had at least one manic episode, and also has had depressive episodes. If a person with bipolar I reports only their symptoms of depression and doesn’t disclose symptoms of mania (irritability, elevated energy level, impulsiveness), they might be misdiagnosed as having depression.
  • Bipolar II disorder: The person alternates between episodes of severe depression and hypomania but has never had a full manic episode. A person with bipolar II might not recognize the symptoms of hypomania due to their shorter duration or intensity compared to mania. They might also be diagnosed as depressed.
  • Cyclothymic disorder: The person has had both mild depression and hypomanic episodes for at least 2 years. Since neither the depressed nor the hypomanic states are as severe as full manic or depressed episodes, the person with cyclothymic disorder might not acknowledge their shifts in mood between highs and lows.
  • “Other specified” and “unspecified”: The person has had hypomanic episodes that don’t meet the full criteria for other bipolar types, with explanation that is either specific or vague. This diagnosis can easily be missed due to the lack of clear symptoms of mania or hypomania.

With continued research, bipolar brain scans may become useful for differentiating between the different types of bipolar disorder. This would have implications for treatment since medication regimens differ among the four types of bipolar. For example, in one study, scans of bipolar I brains showed abnormalities in function and structure of brain areas involved in emotion regulation. These abnormalities were not seen in the scans of bipolar II brains. The results suggested basic differences in these two types of bipolar disorder.13

Reasons for misdiagnosis include the presence of coexisting conditions, lapses in history-taking, and similarity to other mental health conditions such as depression and borderline personality disorder.2, 3 Misdiagnosis can lead to many individuals not receiving a diagnosis for bipolar disorder into their adulthood and inadequate or insufficient treatment. Research into the structural and functional differences between bipolar brains and normal brains is extremely important for early detection and treatment.

Clinical Trials

If someone is interested in getting a brain scan but their medical provider doesn’t think it’s necessary for diagnosis, they might still participate in a clinical trial for research purposes. Ongoing national clinical trials for bipolar research can be found at www.clinicaltrials.gov.14 Also, the National Institute of Mental Health provides information about clinical trials.15 If interested, you might talk to your doctor or mental health provider about participating in a clinical trial.

What is the Future of Brain Scans and Bipolar Disorder?

While brain scans are not yet used for diagnosis of bipolar, they do hold a lot of promise for future use in both diagnosis and treatment. By continuing to improve mapping of affected brain areas in bipolar individuals, researchers will learn more about where in the brain to look for treatment effects. For example, studies have shown that treatment with lithium was associated with less thinning of gray matter, as compared to treatment with antipsychotics or anti-epileptics.10

Another direction of research is the use of novel imaging techniques which allow for looking at different regions of the brain in unique ways. Neurologists and neurosurgeons are teaming up to study the option of specific surgery to affect activity in the white matter of the brain.16 This could provide another option for bipolar patients whose symptoms are treatment-resistant.

Improved diagnosis also allows for more specified therapy for bipolar disorder. As an example, cognitive behavioral therapy (CBT) is effective for bipolar, while dialectical behavior therapy (DBT) is the preferred therapy for borderline personality disorder. Medication regimens for bipolar differ in important ways from medication for depression, making accurate diagnosis critical for treatment planning.

Final Thoughts

In the future, brain scans may allow for the confident diagnosis of bipolar disorder and for ruling out another type of bipolar or another mental health disorder which can cause similar symptoms. Someone struggling with treatment-resistant bipolar might talk with their doctor about participating in a clinical trial for research into making diagnosis more accurate as well as optimizing treatment for bipolar. Bipolar is a complex disorder which requires accurate diagnosis for determining the optimal treatment approach.

Additional Resources

Education is just the first step on our path to improved mental health and emotional wellness. To help our readers take the next step in their journey, Choosing Therapy has partnered with leaders in mental health and wellness. Choosing Therapy may be compensated for marketing by the companies mentioned below.

Talk Therapy 

Online-Therapy.com – Get support and guidance from a licensed therapist. Online-Therapy.com provides 45 minute weekly video sessions and unlimited text messaging with your therapist for only $64/week. Get started  Get Started

Virtual Psychiatry

Talkiatry Get help from a real doctor that takes your insurance. Talkiatry offers medication management and online visits with expert psychiatrists. Take the online assessment and have your first appointment in days. Free Assessment

Starting Therapy Newsletter

A free newsletter for those interested in learning about therapy and how to get the most benefits out of therapy. Get helpful tips and the latest information. Sign Up

DBT Skills Course

Jones Mindful Living Dialectical Behavior Therapy (DBT) is a popular treatment for BPD. Learn DBT skills with live weekly classes and online video courses for only $19 per month. Free One Week Trial

Choosing Therapy Directory 

You can search for therapists by specialty,  experience, insurance, or price, and location. Find a therapist today.

Choosing Therapy partners with leading mental health companies and is compensated for marketing by Jones Mindful Living, Online-Therapy.com, and Talkiatry.

For Further Reading

  • Best Bipolar Disorder Youtube Channels  
  • Best Books about Bipolar Disorder
  • Depression and Bipolar Support Alliance
  • Bipolar Disorder Statistics and Resources
  • Clinical Trials Database

Can a Bipolar Brain Scan Help in Diagnosis? Infographics

Can Brain Scans Be Used to Diagnose Bipolar Disorder  Brain Scans of a Bipolar Brain vs. Normal Brain  What is the Future of Brain Scans and Bipolar Disorder

15 sources

Choosing Therapy strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.

  • Mind Diagnostics (2022,October). Bipolar brain scans: What science tells us about bipolar disorder. Retrieved from:https://www.mind-diagnostics.org/blog/bipolar-disorder/bipolar-brain-scans-what-science-tells-us-about-bipolar-disorder

  • NIH: National Library of Medicine (2005, February). A different depression: Clinical distinctions between bipolar and unipolar depression. Retrieved from:A different depression: clinical distinctions between bipolar and unipolar depression – PubMed (nih.gov)

  • BMC Psychiatry (2020, October). Identification of bipolar disorder using a combination of multimodality magnetic resonance imaging and machine learning techniques. Retrieved from: Identification of bipolar disorder using a combination of multimodality magnetic resonance imaging and machine learning techniques | BMC Psychiatry | Full Text (biomedcentral.com)

  • American Journal of Psychiatry (2022, March). Longitudinal changes in structural connectivity in young people at high genetic risk for bipolar disorder. Retrieved from:Longitudinal Changes in Structural Connectivity in Young People at High Genetic Risk for Bipolar Disorder | American Journal of Psychiatry (psychiatryonline.org)

  • University of Newcastle, Australia (2022, March). Evidence of those at risk of bipolar disorder captured with MRI scans. Retrieved from:https://www.newcastle.edu.au/newsroom/featured/evidence-of-brain-changes-in-those-at-risk-of-bipolar-disorder

  • ScienceDirect (2019, April). Amygdala activation and connectivity to emotional processing distinguishes asymptomatic patients with bipolar disorders and unipolar depression. Retrieved from: https://www.sciencedirect.com/science/article/abs/pii/S2451902218302362

  • SpringerLink Brain Imaging and Behavior (2017, July). Impaired sensory processing measured by functional MRI manic and depressed mood states. Retrieved from: Impaired sensory processing measured by functional MRI in Bipolar disorder manic and depressed mood states | SpringerLink

  • NIH: National Library of Medicine (2017, May). Cortical abnormalities in bipolar disorder: an MRI analysis of 6503 individuals from the ENIGMA bipolar disorder working group. Retrieved from: Cortical abnormalities in bipolar disorder: an MRI analysis of 6503 individuals from the ENIGMA Bipolar Disorder Working Group – PMC (nih.gov)

  • Technology Networks: Neuroscience News & Research (2017, May). Retrieved from: https://www.technologynetworks.com/neuroscience/news/mri-study-of-bipolar-sufferers-reveals-structural-differences-288248

  • Wiley Online Library (2020, July). What we learn about bipolar disorder from large-scale neuroimaging: Findings and future directions from the ENIGMA bipolar working group. Retrieved from: What we learn about bipolar disorder from large‐scale neuroimaging: Findings and future directions from the ENIGMA Bipolar Disorder Working Group – Ching – 2022 – Human Brain Mapping – Wiley Online Library

  • NIH: National Library of Medicine (2008, October). Cognitive neuroscience and brain imaging in bipolar disorder. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/18689286/

  • NIH: National Library of Medicine (2015, August). Emotion regulation deficits in euthymic bipolar I versus bipolar II disorder: a functional and diffusion-tensor imaging study. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/25771686/

  • NIH: National Library of Medicine (2023). Clinical trials. Retrieved from: https://www.clinicaltrials.gov/ct2/results?term=bipolar&recr=Open&rslt=&type=&cond=&intr=&outc=&lead=&spons=&id=&state1=&cntry1=&state2=&cntry2=&state3=&cntry3=&locn=&gndr=&fund=0&rcv_s=&rcv_e=&lup_s=&lup_e=

  • NIH: National Institute of Mental Health (2021, May). Clinical trials – Information for participants. Retrieved from: https://www.nimh.nih.gov/health/trials

  • University Hospitals (2021, January). Mapping brain circuitry in bipolar disorder. Retrieved from: https://www.uhhospitals.org/for-clinicians/articles-and-news/articles/2021/01/mapping-brain-circuitry-in-bipolar-disorder

Recent Articles

Cognitive Behavioral Therapy for Bipolar Disorder
Cognitive Behavioral Therapy (CBT) for Bipolar Disorder
With an educated and experienced therapist, cognitive behavioral therapy can address bipolar episodes efficiently as part of a comprehensive...
';
Klarity ADHD Review 2023: Cost, Pros & Cons, & Who It’s Right For
Klarity Health is an online medication management platform for individuals with ADHD, anxiety, depression, and insomnia.
';
Depression Movies
15 Eye-Opening & Inspiring Movies About Depression
We asked some of our resident therapists to see what movies they think do a good job of portraying...
';
Depression blogs
Best Depression Blogs for This Year
We collected a list of depression blogs that might fit the needs of anyone searching for more answers and...
';
Bipolar Disorder in Children and Teens
Bipolar Disorder in Children & Teens
Childhood bipolar disorder, or pediatric bipolar disorder, is a mental health condition characterized by extreme mood swings, including manic...
';
Symptoms of Bipolar Mania
Symptoms of Bipolar Mania
Though bipolar mania varies by individual, common symptoms include elevated mood, increased energy and activity levels, decreased need for...
';
Headshot of Dianne Grande, Ph.D.
Written by:

Dianne Grande

Ph.D.
Headshot of Rajy Abulhosn, MD
Reviewed by:

Rajy Abulhosn

MD
  • Can Brain Scans be Used to Diagnose Bipolar Disorder?Can Brain Scans Diagnose Bipolar Disorder?
  • Brain Scans of a Bipolar Brain vs. Normal BrainBipolar Vs. Normal Brain Scans
  • When Are Brain Scans Used in Diagnosing Bipolar Disorder?When Brain Scans Are Used to Diagnose
  • What is the Future of Brain Scans and Bipolar Disorder?Future of Brain Scans & Bipolar
  • Final ThoughtsConclusion
  • Additional ResourcesResources
  • Can a Bipolar Brain Scan Help in Diagnosis? InfographicsInfographics
Call for immediate help
Emergency: 911
Suicide Hotline: 988
See more Crisis Hotlines
  • About Us
  • Contact Us
  • Write for Us
  • Careers
  • Editorial Policy
  • Advertising Policy
  • Privacy Policy
  • Terms of Service
  • No Surprises Act
For immediate help call:
Medical Emergency:
911
Suicide Hotline:
988
Click For More Crisis Hotlines
For immediate help call:
Medical Emergency:
911
Suicide Hotline:
811
See more Crisis Hotlines
here
logo
This site complies with the HONcode standard for trustworthy health information:
verify here.
This website is certified by Health On the Net Foundation. Click to verify.
Choosing Therapy Logo