Stigma surrounding mental illness is luckily becoming a thing of the past, and scientists, more than ever, are trying to discover practical ways to treat mental health issues. According to a new study published in the World Journal of Biological Psychiatry, an electrocardiogram, or an EKG, might be able to tell the difference between depression and bipolar disorder, and it could make diagnosis much easier.
The study's participants included 67 adults diagnosed with major depression, and 37 adults with bipolar disorder. Dr. Angelos Halaris, a professor at Loyola Medicine’s psychiatry and behavioral neurosciences department, the study's main author, and his colleagues performed a fifteen minute EKG test on each of the patients, and then converted the test into information about heart rate variability, which is the variation in time and pace between heartbeats. After analyzing the data collected, the researchers found that those who had been diagnosed with major depression had much higher respiratory sinus arrhythmia (RSA) at the start of the study than the research subjects who were diagnosed with bipolar disorder. On the other hand, the EKG test also revealed the people with bipolar disorder had higher blood levels of inflammation and immune system biomarkers, which can flare in response to stress caused by chronic conditions like bipolar disorder. These small indicators can aid doctors in more accurately — and swiftly — diagnosing bipolar disorder or major depression.
Though these finding will need further confirmation through other studies, Dr. Halaris told the American Association for the Advancement of Science that “having a noninvasive, easy-to-use and affordable test to differentiate between major depression and bipolar disorder would be a major breakthrough in both psychiatric and primary care practices.”
So what is the difference between these two mental illnesses, and why does it matter anyway? The National Alliance of Mental Illness defines bipolar disorder as “a mental illness that causes dramatic shifts in a person’s mood, energy and ability to think clearly. People with bipolar disorder experience high and low moods — known as mania and depression — which differ from the typical ups-and-downs most people experience.” Comparably, major depression is characterized by just a whole lot of lows, with no major mood fluctuations. Despite similarities between these two mental health issues, they are medically treated differently, and misdiagnosis could lead to some serious consequences. Bipolar disorder — especially Bipolar II Disorder — is commonly misdiagnosed as major depression when patients are experiencing a depressive episode. Both disorders can be treated with antidepressants, but medicated people with bipolar disorder also need a mood stabilizer to ensure the antidepressant doesn’t propel them into a manic episode. Thus, running an EKG test that determines the correct diagnosis in a matter of minutes could save psychiatrists and their patients much trial and error, limiting the potential of misdiagnosis.
You may not think this study is a big deal, but mental illness impacts more people around you than you probably realize. Bipolar disorder affects around 2.6 percent of American adults annually, while major depression affects around 6.7 percent. That may seem like a small percentage of the population, but major depression is the leading worldwide cause of disability, and bipolar disorder falls in sixth place. Moreover, mental illnesses such as major depression and bipolar disorder are more likely to adversely impact women, but women are also less likely to be listened to about medical problems due to, you know, sexism. The research Dr. Halaris and his colleagues discovered could help medically validate the symptoms that people report, which in turn could make it easier to receive proper mental health treatment.
Though this study’s findings may take a while to come to fruition, and to become common practice, it is a huge stride in the right direction for both people with major depression and those with bipolar disorder. Diagnosing these mental health issues with accuracy is key to treating them and helps in harm reduction. If a fifteen minute test can do this, that could change the course for patients with bipolar disorder or major depression.