A SCREENING test for bipolar disorder is one step closer after Australian researchers helped identify "markers" of increased risk in the close relatives of those with the condition.
The discovery has raised hopes for early intervention and a more "assertive package of treatment" at the first sign of bipolar disorder.
Sisters Tamara and Brydie Tancred, from the northern NSW Hunter region, have always understood they had a higher risk of developing bipolar disorder given both their father, and their uncle, were diagnosed with the condition.
But it was about a year after their uncle took his own life in 2006 that the young sisters decided to take part in research they hoped would help improve outcomes for those living with bipolar disorder, and their families.
"I was about 11," Brydie Tancred, 28, said.
"Our uncle had recently passed away and I think because of our understanding and knowledge of mental health, even as a child, it felt like a really proactive way of doing something to help change that for future families, or people who may also be experiencing mental health conditions."
Now, the results of that study have been published in The American Journal of Psychiatry, with researchers from UNSW Sydney, the Hunter Medical Research Institute (HMRI), the University of Newcastle identifying differences - over time - in the brain's communication networks in young adults at high genetic risk of developing bipolar disorder. Researchers used diffusion-weighted magnetic imaging technology to scan the brains of 183 individuals over a two-year period, monitoring for progressive changes in the brain. It has offered insight into what is happening in the brains of young people as they grow, while highlighting the importance of early intervention for bipolar disorder.
"I love that the study identified that the younger you support people at higher risk, the higher chance they have of living a normal life and possibility never developing bipolar," Ms Tancred said.
The sisters explained that while their father had proactively managed his condition with medication and regular appointments with his doctor, their uncle had disliked the medication and had a "harder struggle".
"He lost friends, his job... He was such an amazing, funny person," she said.
He was 40 when he died.
"Way too young," Tamara Tancred said.
"As a family we are trying to do what we can to shed light on anything that might lead to improvements for people who live with this," she said. "You do sometimes wonder if you'll develop it too.
"But our parents have always been super open with us about mental health, so as much as I know I have a higher risk of developing bipolar disorder, I've always known that even if I do, I have different support systems available and medications and I know I'll be able to lead a relatively normal life."
Ms Tancred said her uncle and father were diagnosed with bipolar disorder when they were 21 and 22.
"Back then people didn't know much about it, or that environmental factors could have a big impact," she said.
"So if there was a screening test that could give people a heads up I think it would give them a better framework and ensure that from a young age they were taking the right treatments and ensuring their mental health was in great shape for leading a healthy and happy life."
People with a parent or sibling with bipolar disorder are 10 times more likely to develop the condition.
Professor Michael Breakspear, who led the research at HMRI and the University of Newcastle, said this research was helping to work out who was more likely to develop the condition, and why, before they developed disabling and distressing symptoms of the disorder.
"With breast cancer, people might go and get a mastectomy or get regular mammograms if they know they are at high risk," he said.
"But for bipolar disorder, we don't do anything. We just wait for people to get ill and come in and see a doctor.
"The general path at the moment is you get depressed, you see your GP, you may or may not get an anti-depressant, and you may or may not go and see a psychologist.
"But if we think you have bipolar disorder and you develop depression - there's a whole set of different treatments we should be doing.
"So we are trying to develop screening tests to help people who are at the highest risk of developing bipolar disorder, and at the first sign of a mood episode, we would then offer them a much more assertive package of treatment."
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