The consensus among mental health experts is that Bipolar Disorder has a genetic basis, but many other factors are involved. Having a family history of bipolar only contributes a small portion of the risk of developing it. Both environmental and situational factors play a prominent role in whether or not someone’s genetic predisposition can trigger the development of bipolar disorder.
What Is Bipolar Disorder?
Bipolar Disorder is a severe mood disorder, sometimes referred to as manic depression, that includes extreme mood swings that happen in cycles. Cycles of high or low mood may last from several days to weeks. There are three distinct types of bipolar disorder: Bipolar I, Bipolar II, and Cyclothymic Disorder. Each bipolar type has different signs and symptoms, which lead to alternating cycles related to its mood swings. Depending upon the type, symptoms of bipolar disorder include manic episodes, hypomanic episodes, or major depressive episodes.
Manic Episodes might be characterized by:1
- Elevated, expansive, or irritable mood with high energy daily for at least one week
- Inflated self-esteem
- Decreased need for sleep
- Pressured speech
- Racing thoughts
- Agitation or excess activity without a specific goal
- Impulsivity, such as buying sprees or sexual indiscretions<
- Significantly impaired daily functioning at work, school, or in social situations
- Brief Psychotic Disorders, such as hallucinations or delusions
Hypomanic Episodes might be characterized by symptoms listed for manic episodes but include:
- Elevated, expansive, or irritable mood each day for at least four days
- No marked impairments in daily functioning
- No psychotic experiences
Major Depressive Episodes might be characterized by:
- Depressed mood, nearly every day and for most of the day
- Loss of interest or enjoyment of most activities
- Significant weight gain or weight loss without dieting
- Significant increase or decrease in appetite
- Sleeping too little or too much each day
- Slowed down movements that others can observe
- Daily tiredness or loss of energy
- Poor feelings of self-worth, excessive guilt, or self-loathing
- Difficulty concentrating or making decisions
- Passive suicidal ideation, with or without a specific plan
Is Bipolar Disorder Hereditary?
There is some data to suggest that family history makes it more likely to develop bipolar disorder, but the causes of this disorder aren’t fully understood. Researchers who have studied the genetic basis of bipolar disorder agree that this is a complex disorder with multiple factors as causes. Many genes are associated with the development of bipolar disorder, but no single gene is seen as an undeniable risk factor. Specialists agree that, most likely, several of the associated genes interact with each other to result in an elevated risk.2
How Often Does Bipolar Disorder Run in Families?
The most substantial evidence for a genetic cause of bipolar disorder comes from studies of identical twins. If a person has an identical twin with bipolar disorder, their risk of developing it is as high as 80%.3
Identical twins have the same genes and therefore have the same genes acting in combination.
If someone has a sibling, child, or parent with bipolar disorder (like a bipolar mother), their risk is ten times higher than that of the general population.3
However, their overall risk is only 5-10%. Some common genes only contribute to a small risk of bipolar disorder. Most people with a genetic predisposition to it do not end up developing bipolar disorder. Additionally, those with only a distant relative with bipolar disorder, such as an uncle, cousin, or grandparent, are less likely to develop it than people with a closer relative who have the condition.
Does Brain Structure Play a Role?
Studies have shown an association between brain structure and bipolar disorder, particularly bipolar I disorder, which includes manic episodes.4,5
These associations may be due to the effect of bipolar disorder on the brain’s structure rather than indicating brain structure as a cause of the disorder. Study results consistently showed an association between reduced brain volume and frequency of manic episodes.
Environmental Triggers for Developing Bipolar Disorder
Multiple risk factors for the development of bipolar disorder are currently studied. Some of these are also risk factors for other mental health problems, suggesting a possible common cause. If there are conditions in the family such as depression or schizophrenia, the risk of another family member having bipolar disorder is higher than baseline. However, the evidence is unclear as to which factors are causes of specific disorders. It is important to remember that every person’s interactions of risk factors with genetic and environmental factors will differ.
Various environmental factors or life events might trigger an episode of mania or hypomania in an individual with some genetic risk. These triggers can affect the body’s stress response by raising blood levels of cortisol. If cortisol levels remain high over time, all organ systems, including the nervous system, will be affected.
Environmental Triggers that may interact with biological factors include:6,7
- Use of substances
- Underlying health conditions
- Changes in diet or sleep
- Sudden extreme stress
- Persistent chronic stress
- Adverse childhood experiences, particularly emotional abuse
- Growing up in a densely populated urban environment
- Personal history of criminal behavior
Readers should also note that many people with bipolar are wrongly diagnosed with another disorder when they first seek treatment. For example, if they are depressed when seeking help for the first time, they may not show any symptoms of manic or hypomanic moods. In those instances, they might be wrongly diagnosed with Major Depression Disorder. It is also common for bipolar symptoms to be confused with other disorders such as ADHD, OCD, or schizophrenia. The incorrect past diagnosis may create the association (not causation) between these mental health disorders and bipolar.
Will I Pass Down Bipolar to My Child?
Although heredity does play a part in whether someone develops bipolar, it is only one part among many. A person with bipolar will not necessarily pass it down to their children. Factors including the child’s physical health, environmental stressors, adverse events during their lifetime, and their use of substances throughout their life will have a more considerable impact.
Parents may still be concerned about whether their child inherits a predisposition for developing mental illness. It can be helpful to note symptoms of bipolar disorder in children so the parent may seek an evaluation and ensure that the child gets the proper care.
Treatment for Bipolar Disorder
The standard bipolar treatments involve both medication and psychotherapy. bipolar medication usually involves mood stabilizers, such as Lithium and Depakote, which treat and prevent the highs and lows of mood cycles. Certain anti-seizure drugs may be prescribed and directed at evening out mood to avoid extreme symptoms. The third class of medication for bipolar is anti-psychotics. These might be prescribed for use alone or with mood stabilizers. Traditional antidepressants can trigger a manic episode for people with bipolar and, therefore, must be closely monitored by a physician if taken.8
Psychotherapy is an essential part of the treatment for bipolar because it helps the person cope with stress and manage relationship issues. Several types of therapy are effective in treating symptoms of bipolar and assisting the person in functioning at their best. The most commonly used therapy for bipolar is Cognitive-Behavioral Therapy, Dialectical Behavior Therapy, and Family-Focused Therapy.9
Treatment involves several stages: assessment and pre-stabilization, stabilization with medication, and finally, post-stabilization.
When to Seek Therapy
It’s critical to find a therapist who has experience working with bipolar because it is a complex disorder. People with bipolar may have difficulty accepting the reality of how much harm their manic episodes have caused in their life. They may fear the loss of high-energy periods and wonder whether life would be dull without those experiences. Family members might also need special attention to the problems and frustrations that they have experienced. An experienced therapist can help the person, and family members work through these difficulties. There are online tips for finding a therapist, finding an online therapist, and Choosing Therapy’s online directory.
Although there is evidence of a genetic factor in developing bipolar, many other factors also affect whether a person will develop it. Regardless of whether or not specialists can identify the particular genes to watch out for, promising treatment options are available to prevent bipolar disorder from considerably affecting someone’s life. A person with bipolar can become stabilized and live a creative and productive life.