Sadness Regulated Differently in Those With Bipolar Disorder, Depression

the Psychiatry Advisor take:

While patients with depression or bipolar disorder can go through bouts of sadness, the areas of the brain regulating emotion act differently in the conditions. And researchers say this discovery could lead to better ways of diagnosing and treating patients with the two conditions.

Eric Ruhe, MD, a psychiatrist at the University of Amsterdam in the Netherlands, and colleagues, conducted functional magnetic resonance imaging of the brains of 42 people with major depression, 35 with bipolar disorder, and 36 healthy controls. None were taking any psychiatric medication.

They were all shown photos of people depicting different emotions. The researchers then asked the participants to either passively experience the images or try to regulate their emotions. They then rated how they felt after viewing the images.

Patients with major depression and bipolar disorder differed in how happy vs. sad emotions were regulated based on activity in the brain’s rostral anterior cingulate, which connects the cognitive and emotional parts of the brain, the researchers reported in JAMA Psychiatry. Depression patients regulated happy and sad emotions poorly compared with the bipolar and healthy patients. And bipolar patients, while performing worse than depressed patients on sad emotion regulation, were rated normal on happy emotion regulation.

Ruhe told LiveScience.com that clinicians often have difficulty telling whether a patient has depression or bipolar disorder. This can be problematic, he added, as antidepressants aren’t usually effective in treating bipolar disorder and may even increase a patient’s risk of having a manic episode.