Blood tests for bipolar disorder
Can a Blood Test Help Diagnose and Treat Bipolar Disorder?
- Doctors currently diagnose bipolar disorder with a clinical examination.
- Recent studies have explored the levels of brain-derived neurotrophic factor in blood samples in cases of bipolar disorder and major depressive disorder.
- A new blood test could support a clinical diagnosis of bipolar disorder. However, the diagnostic criteria remain unchanged.
Recent studies have given new hope of a potential test to diagnose bipolar disorder based on levels of a molecule in the blood. This research shows promise for future developments, although clinical evaluation will likely remain the cornerstone of diagnosis and treatment in the near future.
Researchers don’t know the root cause of bipolar disorder. It appears to be influenced by a combination of a few factors:
- Genetics. Certain genes may predispose people to bipolar disorder.
Someone is more likely to develop it if they have a close relative with bipolar disorder or depression.
- Brain structure and function. Brain chemicals like norepinephrine, serotonin, and dopamine play a role in many neurological differences, including psychiatric and mood differences. Researchers have also found that the size and structure of some parts of the brain might be slightly different in those with bipolar disorder, according to the National Alliance on Mental Illness.
- Stress. Significant stress can trigger mania in someone with genetic predisposition. A divorce, financial problems, major illness, and the death of a loved one are all examples of stressors that may lead to the onset of bipolar disorder.
As doctors learn more about what causes bipolar disorder, there may be new advances in diagnosis and treatment.
Doctors diagnose bipolar disorder on the basis of a clinical evaluation. It may consist of an interview and discussion about experiences, symptoms, and progression of those over time.
There must be at least one episode of mania or hypomania for a diagnosis of bipolar disorder. Doctors then assess the severity of those episodes to determine the type.
A doctor may also perform a physical exam and run blood work. They do this to rule out other potential causes for symptoms aside from bipolar disorder.
One major challenge for doctors is distinguishing between unipolar and bipolar depression. Unipolar depression is also called major depressive disorder (MDD) and has the same criteria as bipolar depression. History of mania or hypomania along with depression is part of the diagnostic criteria for bipolar disorder, of which there are several types.
Your doctor can’t diagnose bipolar disorder from a brain scan or blood test. However, new research has uncovered a possible link between the expression of a key brain molecule and the diagnosis of mood disorders.
Blood testing as a basis for the diagnosis of bipolar disorder or depression is still in its early stages.
But there has been promising research in the past few years.
Recent studies have explored the role of brain-derived neurotrophic factor (BDNF). This molecule has a big impact on learning and memory. Its expression, however, is complex. Scientists have found links between mood disorders and the levels of proBDNF and mBDNF in the blood.
A 2017 study of 105 participants found levels of mBDNF in the blood of people with bipolar disorder was lower than in those with MDD. Further, the ratio between mBDNF and proBDNF in the bipolar disorder group was also lower than in those with MDD.
The researchers noted this was a promising development, as people with bipolar disorder are often misdiagnosed with MDD. A blood test therefore could help identify those with bipolar disorder experiencing depressive episodes.
A 2021 study of a new assay test showed it’s possible to diagnose low blood mBDNF levels in people with MDD or bipolar disorder within an accuracy rate of 80 to 83 percent.
It may seem like an exciting development that a simple blood test can potentially diagnose bipolar disorder. But when asked if a blood test can provide conclusive evidence of bipolar disorder, Dr. Jeffrey Ditzell, a psychiatrist in private practice in New York City, answers in the negative.
“Not yet. The test assay is currently being used to differentiate proBDNF that is potentially neuroinflammatory, from (mature) mBDNF that is considered neuroprotective,” Ditzell told Healthline.
The test uses a cutoff for serum mBDNF levels of fewer than 12.4 nanograms per milliliter. This represents progress from previous tests, offering support for a clinical diagnosis of MDD or bipolar disorder.
However, Ditzell goes on to say that the blood test is unlikely to shift the diagnostic criteria for bipolar disorder in the near future.
“The BDNF levels can be helpful, but the diagnosis of the condition of bipolar disorder remains a clinical one, and the tests, though supportive, should not be considered as confirmatory, at this time.
”
Treatment for bipolar disorder often involves a combination of medication, psychotherapy, lifestyle changes, social and family support. It can take some time to find the right medication.
From this perspective, the idea of a blood test for bipolar disorder can offer some hope. The 2021 study found mBDNF levels were higher in those taking antidepressants. This suggests that perhaps a blood test can assess the effectiveness of some medications.
When asked if people with bipolar disorder undergoing treatment should ask for this kind of blood testing, Ditzell explains that the tests need further development.
“I don’t think we are there yet, but may hopefully be there in the future,” said Ditzell. “I would not rush out to ask for such a test, as it currently is of limited diagnostic value and may well be cost-prohibitive.”
Blood analysis of mBDNF levels can potentially help people with bipolar disorder and doctors achieve proper diagnosis and effective treatment.
As this research is in its early stages, it is likely clinical evaluation will remain the basis for bipolar disorder identification and treatment for the time being.
Can a Blood Test Help Diagnose and Treat Bipolar Disorder?
- Doctors currently diagnose bipolar disorder with a clinical examination.
- Recent studies have explored the levels of brain-derived neurotrophic factor in blood samples in cases of bipolar disorder and major depressive disorder.
- A new blood test could support a clinical diagnosis of bipolar disorder. However, the diagnostic criteria remain unchanged.
Recent studies have given new hope of a potential test to diagnose bipolar disorder based on levels of a molecule in the blood. This research shows promise for future developments, although clinical evaluation will likely remain the cornerstone of diagnosis and treatment in the near future.
Researchers don’t know the root cause of bipolar disorder.
It appears to be influenced by a combination of a few factors:
- Genetics. Certain genes may predispose people to bipolar disorder. Someone is more likely to develop it if they have a close relative with bipolar disorder or depression.
- Brain structure and function. Brain chemicals like norepinephrine, serotonin, and dopamine play a role in many neurological differences, including psychiatric and mood differences. Researchers have also found that the size and structure of some parts of the brain might be slightly different in those with bipolar disorder, according to the National Alliance on Mental Illness.
- Stress. Significant stress can trigger mania in someone with genetic predisposition. A divorce, financial problems, major illness, and the death of a loved one are all examples of stressors that may lead to the onset of bipolar disorder.
As doctors learn more about what causes bipolar disorder, there may be new advances in diagnosis and treatment.
Doctors diagnose bipolar disorder on the basis of a clinical evaluation. It may consist of an interview and discussion about experiences, symptoms, and progression of those over time. There must be at least one episode of mania or hypomania for a diagnosis of bipolar disorder. Doctors then assess the severity of those episodes to determine the type.
A doctor may also perform a physical exam and run blood work. They do this to rule out other potential causes for symptoms aside from bipolar disorder.
One major challenge for doctors is distinguishing between unipolar and bipolar depression. Unipolar depression is also called major depressive disorder (MDD) and has the same criteria as bipolar depression. History of mania or hypomania along with depression is part of the diagnostic criteria for bipolar disorder, of which there are several types.
Your doctor can’t diagnose bipolar disorder from a brain scan or blood test. However, new research has uncovered a possible link between the expression of a key brain molecule and the diagnosis of mood disorders.
Blood testing as a basis for the diagnosis of bipolar disorder or depression is still in its early stages. But there has been promising research in the past few years.
Recent studies have explored the role of brain-derived neurotrophic factor (BDNF). This molecule has a big impact on learning and memory. Its expression, however, is complex. Scientists have found links between mood disorders and the levels of proBDNF and mBDNF in the blood.
A 2017 study of 105 participants found levels of mBDNF in the blood of people with bipolar disorder was lower than in those with MDD. Further, the ratio between mBDNF and proBDNF in the bipolar disorder group was also lower than in those with MDD.
The researchers noted this was a promising development, as people with bipolar disorder are often misdiagnosed with MDD. A blood test therefore could help identify those with bipolar disorder experiencing depressive episodes.
A 2021 study of a new assay test showed it’s possible to diagnose low blood mBDNF levels in people with MDD or bipolar disorder within an accuracy rate of 80 to 83 percent.
It may seem like an exciting development that a simple blood test can potentially diagnose bipolar disorder. But when asked if a blood test can provide conclusive evidence of bipolar disorder, Dr. Jeffrey Ditzell, a psychiatrist in private practice in New York City, answers in the negative.
“Not yet. The test assay is currently being used to differentiate proBDNF that is potentially neuroinflammatory, from (mature) mBDNF that is considered neuroprotective,” Ditzell told Healthline.
The test uses a cutoff for serum mBDNF levels of fewer than 12.4 nanograms per milliliter. This represents progress from previous tests, offering support for a clinical diagnosis of MDD or bipolar disorder.
However, Ditzell goes on to say that the blood test is unlikely to shift the diagnostic criteria for bipolar disorder in the near future.
“The BDNF levels can be helpful, but the diagnosis of the condition of bipolar disorder remains a clinical one, and the tests, though supportive, should not be considered as confirmatory, at this time.
”
Treatment for bipolar disorder often involves a combination of medication, psychotherapy, lifestyle changes, social and family support. It can take some time to find the right medication.
From this perspective, the idea of a blood test for bipolar disorder can offer some hope. The 2021 study found mBDNF levels were higher in those taking antidepressants. This suggests that perhaps a blood test can assess the effectiveness of some medications.
When asked if people with bipolar disorder undergoing treatment should ask for this kind of blood testing, Ditzell explains that the tests need further development.
“I don’t think we are there yet, but may hopefully be there in the future,” said Ditzell. “I would not rush out to ask for such a test, as it currently is of limited diagnostic value and may well be cost-prohibitive.”
Blood analysis of mBDNF levels can potentially help people with bipolar disorder and doctors achieve proper diagnosis and effective treatment.
As this research is in its early stages, it is likely clinical evaluation will remain the basis for bipolar disorder identification and treatment for the time being.
New blood test can diagnose depression and bipolar disorder
A newly developed system for monitoring blood biomarkers associated with mood disorders could lead to new ways to diagnose and treat depression and bipolar disorder. Although depression has been known for centuries and affects hundreds of millions of people around the world, traditional diagnosis still depends on the clinical assessments of physicians, psychologists and psychiatrists. At the same time, blood tests can serve as the basis for such health assessments to check whether symptoms of depression are related to other factors, but are not used in clinical practice to objectively and independently diagnose the condition itself. A new study suggests that blood testing could be a practical option for diagnosing and treating depression and bipolar disorder in the future.
In the course of the work, the scientists identified 26 biomarkers - measurable and natural indicators - in the blood of patients that are variously associated with the frequency of mood disorders, including depression, bipolar disorder and mania.
Scientists have developed a new blood test that can help diagnose levels of depression.
What are depression and other affective disorders?
According to Stanford University neuroendocrinologist Robert Sapolsky, if you want to delve into the basis of medical human suffering, there is nothing stronger than depression. Depression can be described as a state in which sunrise and fragrant morning coffee do not bring a person any pleasure. “Depression,” says Sapolsky, “is the worst disease you can catch. It cripples people and breaks destinies.”
The World Health Organization (WHO) predicts that by 2025, depression will be second only to diabetes and related obesity. Right now, as I write this, there are more than 264 million people worldwide suffering from the symptoms of this disease, from all age groups. 
Although it may seem counterintuitive to many, depression is actually a biochemical disorder in genetics and behavioral traits that makes it literally impossible for a person to enjoy sunsets (again, let me paraphrase Sapolsky). It sounds rather complicated, and alas, depression really is. You can learn more about how to diagnose and treat it in this article.
A recent study showed that bipolar disorder can be seen at the cellular level.
But despite the insidiousness of depression, a huge number of people around the world also experience other equally unpleasant affective disorders (the general name for a group of mental disorders associated with mood disorders). One of these is known as bipolar disorder or manic-depressive psychosis; manifests itself in the form of affective states: manic (or hypomanic) and depressive (or subdepressive), and sometimes mixed. Doctors call these states episodes or phases of the disorder, which periodically replace each other (practically without the influence of external circumstances).
Read also: How do doctors diagnose depression and is there a faster way?
As with depression, diagnosing bipolar disorder is not an easy task. To date, the diagnosis of depression or bipolar disorder is based on a combination of factors and patient complaints. At the same time, for effective treatment of affective disorders, early diagnosis is required . Given that the number of people with a variety of mood disorders is growing around the world (in many ways this was facilitated by the COVID-19 pandemic), new diagnostic methods would be a real breakthrough.
How to diagnose depression by a blood test?
Today, blood biomarkers are becoming important tools in diagnosing mood disorders, especially when a subjective assessment of a person or a healthcare professional's clinical impression of their condition is not always reliable. Neuroscientist and psychiatrist Alexander Niculescu of Indiana University believes that today "blood tests can open the door to accurate, personalized drug selection and objective monitoring of response to treatment.
"
Niculescu has been researching this area for several years and is developing tests based on blood biomarkers to help predict the risk of suicide attempts in patients with depression, diagnose severe pain and measure stress levels in patients with PTSD. In the new four-year study, scientists worked with hundreds of patients at the Richard Rudebusch Medical Center in Indianapolis, conducting a series of tests to identify and confirm biomarkers of gene expression in the blood that may be associated with mood disorders.
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In the future, it will be possible to diagnose depression and bipolar disorder with a blood test.
When visiting patients with depression who agreed to participate in the study, their mood (from low to high) was monitored at each session, and blood samples were also taken.
By comparing gene expression and protein expression patterns against a massive database (collected from 1,600 human genetics studies), the team was able to identify a number of biomarkers associated with mood disorders.
According to the authors of a study published in the scientific journal Molecular Psychiatry, 12 biomarkers found provide a particularly strong link to depression, with six of them associated with bipolar disorder and two biomarkers that could indicate mania. Remarkably, the new approach not only detects patients' susceptibility to depression and other mood disorders, but can also help identify specific medications that may best improve their condition.
A newly developed blood biomarker monitoring system could help millions of people around the world in the future.
"Of the top biomarker genes associated with mood disorders, eight are associated with circadian rhythms, which may help provide a molecular basis for explaining links between conditions such as depression and factors such as sleep disorders," the study authors note.
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Although the described blood test is currently a scientific proof of concept, when such a test will become available for general use is not yet known. The authors of the study hope their findings will reassure the psychiatric community that precision medicine has a place in the diagnosis and treatment of depression.
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Depression and bipolar disorder suggested to be diagnosed by a blood test
US scientists conducted a large-scale study of blood samples of patients seeking medical help with symptoms of depression or mania and analyzed data in the literature. The authors were able to identify 23 biomarkers in the blood of people, which, perhaps in the future, will make it possible to more accurately diagnose depression and bipolar disorder, distinguish between these two conditions and select therapy that is more effective for a particular patient. Work published at Molecular Psychiatry .
According to statistics, one out of four people experiences affective disorders (mood disorders) at least once in their life. In particular, depression is one of the most common causes of decreased performance in people aged 15-44 years. Mood disorders do not yet have objective diagnostic methods, and such disorders are often stigmatized in society, and patients often do not seek help. Because of this, it is sometimes impossible to diagnose or correctly diagnose mood disorders: for example, instead of bipolar disorder, patients are diagnosed with depression. As a result, people who need help do not receive optimal treatment.
Biomarkers of diseases in the blood - a promising indicator for the objective diagnosis of such diseases. The definition of depression or bipolar disorder by blood tests, in theory, can help not only with an accurate diagnosis, but also with the selection of the most effective therapy for each individual patient.
Previously, a team of scientists from Indiana University led by Alexander Niculescu described those markers of gene expression in human blood that indicate an increased likelihood of suicidal outcome.
In the new study, the researchers were looking for genes that could be over-expressed or under-expressed in a person with mood disorders, specifically depression and bipolar disorder.
For several years, scientists have worked with 44 people who sought medical help with manifestations of affective disorders. Each of these people visited the specialist up to six times, with three to six months between visits. The condition of the patients was assessed according to the criteria existing in medical practice, and blood samples were taken from them to search for biomarkers. There was also an independent group of patients whose biological samples and case histories were used by scientists to test potential biomarkers, and a test sample for which the authors tried to predict the condition only from their blood tests. At the same time, the researchers sought to find a connection not only between depression and biomarkers, but also between fluctuations between periods of depression and mania and blood counts: this is very important for an accurate diagnosis of bipolar disorder.
As a result of the analysis of the obtained samples, the authors of the work identified 23 potential genes, the reduced or increased expression rates of which may indicate affective disorders in patients. These genes play a role in the regulation of circadian rhythms, cell differentiation, and signaling between cells. The scientists tested the obtained data for reproducibility and for the ability to predict the condition of patients.
Not all of these biomarkers were equally accurate in predicting depression or mania in different groups of patients. For example, prediction accuracy was 10 to 20 percent higher for women than for men. The authors of the work suggest that this may be due to any biological characteristics associated with sex, and due to the fact that men do not accurately describe their symptoms to specialists or seek medical help less often. The latter only strengthens the need for an objective way to diagnose mood disorders.
Researchers also suggest that the association of the level of expression of certain genes with affective disorders suggests the creation of new drugs.
