Can Bipolar Disorder Cause Brain Damage?

doctor talking to a patient

Nortonrsx / Getty Images

Bipolar disorder is a mental health condition characterized by swings between depressive and manic behavior.  If you or someone you know has been diagnosed with bipolar disorder, you might wonder how the condition affects your brain.

In short, bipolar disorder can affect your brain. For instance, bipolar disorder is linked to lower amounts of grey matter in the brain.

This article discusses whether or not bipolar disorder can cause brain damage and how bipolar disorder impacts the brain.

How Bipolar Disorder Affects the Brain

Bipolar disorder can cause changes in the brain, specifically in the following areas:

  • Prefrontal cortex: The prefrontal cortex is responsible for our cognitive control functions like paying attention, controlling impulses, problem-solving, and comprehension. Studies have found subjects with bipolar disorder to have decreased grey matter in the prefrontal cortex and an overall decreased prefrontal cortical volume.
  • Subcortical structures: The subcortical areas of the brain are where our brain processes its more primitive functions, like hormone production, emotion, and memory. Those with bipolar disorder may experience dysfunction in their subcortical structures, leading to challenges in regulating mood.
  • Medial temporal structures: Medial temporal structures are prone to decreased grey or white matter in those living with bipolar disorder. In turn, this can lead to memory disruption.

Can Bipolar Disorder Cause Brain Damage?

There is so much that has yet to be discovered about bipolar disorder. That being said, imaging studies have provided plenty of information on how this disease impacts the brain. In particular, a recent study shows that the grey matter in those with bipolar disorder is significantly impacted. 

Grey Matter in the Brain

Grey matter is the outer layer of brain tissue. It is filled with neuronal cell bodies. These cells are what give the tissue a grey hue. The neuronal cell bodies are also the materials that make up your cerebral cortex.

Research on Grey Matter

A recent journal article noted that brain scans were examined to determine grey matter thickness. There were 6,500 brain scans, and 1,800 of that total were brain scans of people with bipolar disorder. This study discovered that those with bipolar disorder have significantly less grey matter in both spheres of the frontal, temporal, and parietal lobes than in people without bipolar disorder.

Low Amounts of Grey Matter in People With Bipolar Disorder

While this loss of grey matter is concerning, researchers also found in those same brain scans that those who were treating their bipolar disorder with lithium had more grey matter than those who were on other types of bipolar medication. It is believed this is due to the impact lithium has on tissue growth in the brain.

So yes, bipolar disorder can cause brain damage, and this has been proven through research using brain imaging. However, there is also compelling evidence that lithium isn’t the only effective treatment for the symptoms of bipolar disorder. It may also help with the decrease of grey matter deterioration, leading to decreased brain damage.

Bipolar Disorder Treatment

Bipolar can be effectively managed with the right treatment protocol. Professionals recommend a combination of medication, psychotherapy, and lifestyle changes.

Medication offerings include mood stabilizers, anticonvulsants, and antipsychotics. Psychotherapycan help those experiencing this disease minimize their response to triggers, develop coping tools, and enhance personal relationships.

Lifestyle changes include following a daily routine, setting a sleep schedule, exercising regularly, and eating well.

How Bipolar Disorder Medication Can Affect the Brain's Grey Matter

It has been established that decreased grey matter in the brain can be problematic, with studies noting its profound impact on overall functioning in those with bipolar disorder.

Here are a few areas that can be significantly disrupted by a decrease in grey matter thickness in the brain:

Grey matter isn't just impacted in those living with bipolar disorder. For instance, those with schizophrenia or major depressive disorder are also prone to having low amounts of grey matter. While this may feel devastating for some to hear, it is important to know that decreased grey matter thickness can be reversed.

Lithium's Effect on Grey Matter

Some bipolar medication can support the increase of grey matter thickness. Lithium is often prescribed to those living with this mood disorder, and it has been found to increase grey matter thickness throughout the impacted areas of the brain. This means lithium doesn't only have the capacity to decrease symptoms, it can also target the root cause of many bipolar symptoms. While this is promising, not all bipolar medication has this effect.

Other Medications

Anticonvulsants and antipsychotics are often prescribed to those living with bipolar disorder. These medications have not been proven to increase grey matter thickness in the brain. In fact, these medications have been linked to decreased grey matter thickness.

Despite this, the most important aspect of bipolar medication is if it works for the person experiencing the disorder. Keeping this in mind, it is important to focus on which medication makes you feel your best.

A Word From Verywell

Living with bipolar disorder can be hard. It is an often stigmatized and misunderstood disease, one that impacts the body and mind. However, it is possible to lead a healthy and fulfilled life even while experiencing this disorder. Be sure to team up with a licensed mental health provider for individualized care. Also, consider seeking out a support group with others who are also living with bipolar disorder. If you find yourself struggling with thoughts of harming yourself, call 988 for immediate mental health crisis support.

5 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. National Institute of Mental Health (NIMH). Bipolar disorder.

  2. Beyer JL, Kuchibhatla M, Payne ME, MacFall J, Cassidy F, Krishnan KRR. Gray and white matter brain volumes in older adults with bipolar disorder. Int J Geriatr Psychiatry. 2009;24(12):1445-1452. doi: 10.1002/gps.2285

  3. Strakowski SM, DelBello MP, Adler CM. The functional neuroanatomy of bipolar disorder: a review of neuroimaging findings. Mol Psychiatry. 2005;10(1):105-116. doi: 10.1038/sj.mp.4001585

  4. Mercadante AA, Tadi P. Neuroanatomy, gray matter. Treasure Island, FL. StatPearls Publishing; 2022.

  5. Hibar DP, Westlye LT, Doan NT, et al. Cortical abnormalities in bipolar disorder: an MRI analysis of 6503 individuals from the ENIGMA Bipolar Disorder Working Group. Mol Psychiatry. 2018;23(4):932-942. doi: 10.1038/mp.2017.73

By Julia Childs Heyl
Julia Childs Heyl, MSW, is a clinical social worker and writer. As a writer, she focuses on mental health disparities and uses critical race theory as her preferred theoretical framework. In her clinical work, she specializes in treating people of color experiencing anxiety, depression, and trauma through depth therapy and EMDR (eye movement desensitization and reprocessing) trauma therapy.