Can Bipolar Lead to Schizophrenia?
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Q:  Can Bipolar Lead to Schizophrenia?

I have a brother who was diagnosed with Bipolar in 1995.  He started taking medication for it, but chose alcohol over treatment for bipolar.  I have just recently heard that if a person has been diagnosed with bipolar and they do not take medication to control it, the chemical levels of the brain can damage brain cells which could lead to schizophrenia.  Is this statement true?  He has not taken medication or has not see a doctor for his bipolar for 5-6 years now and we are trying to get him to see a doctor and start taking medication, but he refuses.  We are hoping that this statement is true and we can use it as a means to get him to see a doctor.  Any assistance you can provide to us will be greatly appreciated. 
Thank you.

Dear Sheila -- 
Not sure where you heard that, but I never have -- i.e. that bipolar can "lead to schizophrenia".  Rather, it is true for some people that years without treatment leads to some brain changes:  repeated episodes of depression, for example, are known to be associated in some people with an apparent shrinking of the frontal lobes, and of the hippocampus region on the inside of the temporal lobes (the latter is associated with making new memories).  The frontal lobe shrinkage has been seen in schizophrenia also -- maybe that's the connection that was being drawn in what you heard. 

However, the good news is that recently Dr. Husseini Manji, one of the leading researchers at the National Institutes of Health who has been gracious enough to even write back to people at Bipolar World (and who was recently honored for his work by the International Society for Bipolar Disorders), has been creating evidence that lithium treatment (and perhaps other bipolar medications; haven't gotten that far yet) can actually prevent this kind of brain shrinkage; and perhaps (preliminary results so far) even reverse  it.  (e.g. Manji)

Maybe that will help motivate him?  Careful, I wouldn't count on that.  But I hope it might help, and not make things worse for you even more so, if he chooses not to accept your help. 

Dr. Phelps

Published September, 2003 


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