Causes of Bipolar Disorder - Healthline

Some people may have a genetic risk of developing bipolar disorder. Specific brain changes and environmental factors may trigger the disorder.

Bipolar disorder causes changes in a person's mood and energy. These rapid and intense shifts in emotions can affect their ability to function. Mood episodes are categorized into:

  • manic
  • hypomanic
  • depressive

A distinct change in behavior marks these mood episodes.

No single factor seems to be responsible for the development of bipolar disorder. Researchers continue to try to determine the causes so that more effective treatments can be developed.

What's the genetic aspect of bipolar disorder?

Research in genetics and bipolar disorder is fairly new.

However, according to the American Psychological Association, 80-90% of people with bipolar disorder have a relative with bipolar disorder or depression.

Inherited risk

According to the American Academy of Child & Adolescent Psychiatry, someone with a parent or sibling with bipolar disorder is 4 to 6 times more likely to develop the condition than someone without a family history of it.

A 2016 review of twin studies suggests that there's a heritable component to bipolar disorder. The review noted that the brain structure of a twin with bipolar disorder differs from the brain of the one without bipolar disorder.

Bipolar and schizophrenia overlap

Research from 2021 suggests bipolar disorder and schizophrenia may share a genetic link.

The study authors note that bipolar disorder and schizophrenia are associated with structural abnormalities in the ventromedial prefrontal cortex (vmPFC). The vmPFC is a region of the brain responsible for emotional regulation, self-perception, and decision making.

ADHD overlap

A 2017 study found a genetic correlation between early-onset bipolar disorder and attention deficit hyperactivity disorder (ADHD). Early-onset bipolar disorder occurs before age 21.

Biological abnormalities can affect the brain

Scientists are working to discover how the brains of people with bipolar disorder differ from the brains of people without it. Here are some interesting perspectives.

Brain cells

A lower volume of gray matter in the hippocampus may contribute to certain mental health conditions, including bipolar disorder.

The hippocampus is the part of the brain associated with memory. It also indirectly affects mood and impulses. Gray matter refers to a type of tissue that plays a large role in processing information.

Neurotransmitters

Neurotransmitters are chemicals that help brain cells communicate and regulate mood. Imbalances with neurotransmitters may be linked to bipolar disorder.

Mitochondrial changes

Research suggests that mitochondrial dysfunction may play a role in some mental health conditions, particularly bipolar disorder.

Mitochondria are the energy centers in almost every human cell. If the mitochondrion doesn't function normally, it could lead to a change in patterns of energy production and use. This may explain some of the behavioral symptoms of psychiatric disorders.

Environmental and lifestyle factors

Experts believe that environmental and lifestyle factors play a role in bipolar disorder. These factors include:

  • extreme stress
  • physical or sexual abuse
  • substance misuse
  • death of a family member or loved one
  • physical illness
  • ongoing concerns that affect your daily life, such as money or work problems

These situations can trigger symptoms or affect the development of bipolar disorder, especially for people who may already be at a high genetic risk.

Age, gender, and hormonal factors

Bipolar disorder affects a little more than 2% of the global population.

Age risk

Bipolar disorder usually develops around age 25, or between the ages of 15 and 25. At least half of all cases are diagnosed before the age of 25. But some people do not develop symptoms until they are in their 30s or 40s.

While it's possible for bipolar disorder to develop in children age 6 or younger, the topic is controversial. What may seem like bipolar disorder can be a result of other disorders or traumas.

Sex risk

Bipolar disorder is more common in females than males, according to a 2021 review. The authors note this is true of both bipolar II disorder and bipolar I disorder, which was previously thought to affect males and females equally.

Hormonal risk

Experts suspect that thyroid dysregulation, which can disrupt thyroid hormone levels, may play a role in the progression of bipolar disorder.

The thyroid is a gland in the neck that releases hormones regulating growth and development. People with bipolar disorder often have hypothyroidism, or an underactive thyroid.

What can trigger a manic or depressive episode?

Certain factors can trigger manic or depressive episodes. These factors increase the body's stress level, which is also a trigger. Being familiar with your triggers is one way to keep symptoms from worsening.

While triggers vary from person to person, some common ones include:

  • Stressful life events: These can be positive or negative, such as the birth of a baby, a job promotion, moving to a new house, or the end of a relationship.
  • Disruption in regular sleep patterns: Both decreased and increased sleep can impact your symptoms.
  • Change in routine: A structured routine can help manage stress. Changes to you exercise, diet, or social routines may contribute to worsening symptoms.
  • Too much stimulation: Anything that may overstimulate your nervous system, like loud environments or increased caffeine consumption, may affect your symptoms.
  • Alcohol or substance misuse: Overuse or misuse can lead to ongoing bipolar disorder symptoms, relapses, and hospitalizations.
  • Unmanaged or untreated illness: Managing your condition with modalities, such as therapy, medication, or both, can help lessen or prevent mood episodes

Next steps

With proper diagnosis, treatment, and management, it's possible to lead a fulfilling, happy life with bipolar disorder.

Schedule an appointment with your doctor if you feel you have one or more of the signs of bipolar disorder. They can check your physical health and also ask you some mental health screening questions.

If your doctor doesn't find a physical problem for your symptoms, they may recommend that you see a mental health professional.

Your treatment will depend on your condition. It can vary from medication to therapy. Finding the right treatment can take some time. Talk with your doctor if any medication causes unwanted side effects. There are other options you can try.

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