Bipolar Disorder is a complex condition with multiple contributing factors such as genetic, biological and environmental influences. Bipolar disorder is also called bipolar affective disorder, manic depression and manic depressive disorder. Now, here is an extensive compilation on what causes bipolar disorder.
Genetics' answer to "What Causes Bipolar Disorder?"
Genetic Causes: Biological Parents and Children give insights into What Causes Bipolar Disorder
Genetic Causes: Twins help understand What Causes Bipolar Disorder"
Genetic Causes: Chromosomes and their relevance to What Causes Bipolar Disorder
Genetic Causes: Genetic Mutation's contribution to What Causes Bipolar Disorder
Biology's answer to "What Causes Bipolar Disorder?"
Biological Causes: Abnormal Brain Structure related to What Causes Bipolar Disorder
Biological Causes: Abnormalities in Neurotransmitters help explain What Causes Bipolar Disorder
Biological Causes: Damaged Nerve Cell Receptors take part in What Causes Bipolar Disorder
Biological Causes: Excessive Cortisol contributes to What Causes Bipolar Disorder
Biological Causes: Abnormal Thyroid Gland Function further explains What Causes Bipolar Disorder
Biological Causes: Excessive Calcium in Brain contributing to What Causes Bipolar Disorder
Biological Causes: Disturbed Biorhythm being part of What Causes Bipolar Disorder
Biological Causes: Abnormal Brain Activities being part of What Causes Bipolar Disorder
Environmental Factors explain What Causes Bipolar Disorder
Environmental Causes: Stress and Major Life Event are part of What Causes Bipolar Disorder
Environmental Causes: Separated Identical Twins help further understand What Causes Bipolar Disease
So, What Really Causes Bipolar Disorder? - It's the Combination
Real Cause (Combination): Diathesis-Stress Model
Real Cause (Combination): Kindling Theory
More - All About Bipolar Disorder
What is Bipolar Disorder?
So What Is Bipolar Disorder?
But What Causes Bipolar Disorder? (Brief)
Is Bipolar Disorder Treatable?
Children with Bipolar Disorder: Symptoms and Diagnosis
Symptoms of Mania
Symptoms of Depression
Diagnosis of Bipolar Disorder
Categories of Bipolar Disorder
Mood Swings, a Bipolar Dilemma
Diabetes as a Co-Morbidity of Bipolar Disorder
The Link between Diabetes and Bipolar Disorder
Effects of Treatment
Effective Treatment for Both Diabetes and Bipolar Syndrome
Knowing the Face of Bipolar Disorder: Symptoms of Mania and Depression
Bipolar disorder tends to run in families, reinforcing the belief of genetic predisposition for the condition. This genetic relevance has been researched through multiple family, adoption and twin studies, and it has given a valid explanation of what causes bipolar disorder, as detailed in the following sections.
First-degree family members of bipolar disorder patients are at a considerably higher risk of suffering from the illness than others. For instance, if one biological parent has bipolar disorder, the child already has 15-30% chance of developing the disorder. If the both biological parents have bipolar disorder, then the risk of the child getting it rises to 50-70%.
An identical (monozygotic) twin of a bipolar disorder patient is about three times more likely to have bipolar disorder than a non-identical (fraternal /dizygotic) twin. Put in another perspective, 80% of identical twin bipolar cases occur in the both twins (concordance rate of 80%), where only 16% of non-identical twin bipolar cases occur in the both twins (concordance rate of 16%), further proving the relevance of genetics as the cause of bipolar disorder.
Particular chromosomes, chromosome 6q and 8q21, have been discovered to have genetic abnormalities in patients with bipolar disorder. Although these particular chromosomal regions have been suggested to be related to bipolar disorder, the findings are inconsistent due to the heterogeneity where the chromosomal regions of interest vary in different families. Ongoing studies are discovering that individual genes play only small roles in affecting bipolar disorder. Therefore, despite the strong suggestions, the relevance of chromosomes in what causes bipolar disorder is currently inconclusive requiring further compilation of studies.
Children of old fathers have been linked to a slightly higher chance for bipolar disease, suggesting the relevance of new genetic mutations in what causes bipolar disease.
Brain-imaging tools have revealed that there are abnormalities in some parts of the brains of bipolar disorder patients, such as increased volume of the lateral ventricles and globus pallidus (synonym: paleostriatum) and increased hyperintensities, MRI-revealed high intensity areas typically accompanied by normal aging and psychiatric and neurological disorders such as bipolar disorder.
Specific neurotransmitters have been strongly tied to bipolar disorder along with other mood disorders. They are dopamine, serotonin and norepinephrine. Abnormally low or high levels of these neurotransmitters have been observed in bipolar disorder patients. Also, imbalance of these neurotransmitters has been correlated to the cause of bipolar disorder. Based on these findings, drug treatments that alter the amounts and balance of these transmitters have been successfully used to relieve bipolar disorder, advancing our understanding of what causes bipolar disorder.
Also, abnormalities in hypothalamic-pituitary-adrenal axis (HPA axis) exist in stress-triggered bipolar disorder cases. HPA axis (synonyms: HPTA axis, limbic-hypothalamic-pituitary-adrenal/LHPA axis, hypothalamic-pituitary-adrenal-gonadotropic axis) is a complex interaction system that controls stress, mood and emotions, among other things such as digestion, immune system, sexuality and energy usage.
Nerve cell receptor's ability to receive signals from neurons may become damaged, causing bipolar disorder.
Excessive secretion of cortisol has been observed in the patients with bipolar disorder. Cortisol (synonym: hydrocortisone) is an anti-stress and anti-inflammatory steroid hormone.
Abnormal thyroid gland function has been observed in the patients with bipolar disorder. Monitoring thyroid levels is important because excessive or lacking amounts of thyroid hormone causes mood and energy fluctuations. Many bipolar disorder patients experience rapid episode cycling due to thyroid gland problem, and therefore they must additionally take thyroid pills as well as medications for bipolar disorder. Also, lithium treatment causes low thyroid levels in some patients, resulting in the need for thyroid supplements.
Excessive flow of calcium into brain cells also has been observed in bipolar disorder patients.
Disturbance in circadian rhythms (synonym: body clock) and melatonin activity are also observed in bipolar disorder patients.
Abnormally high or low brain activities have been associated with bipolar disorder. These include abnormally hyper brain activities related to emotion and movement coordination and abnormally calm brain activities related to concentration, attention, inhibition and judgment.
Environmental factors such as recent stressful life events may trigger one's first bipolar disorder episode, either manic (high mood disorder) or depressive (low mood disorder). These stressful events include death in the family, end of relationships, divorce of parents, a loved one having terminal illness, and moving to a new neighborhood, which can be especially stressful to a child. A manic or depressive mood then starts. Once the initial onset of mood disorder occurs, recurrence tends to occur more easily, eventually fully developing into bipolar disorder.
Separated identical twin bipolar disorder cases further implicate environment as a strong factor that causes bipolar disorder. Despite sharing identical genetic materials, identical twins that were separated early in life into different environments show lower concordance rate than those who were raised in the same environment, proving that the environments have influenced the onset of bipolar disorder.
The best explanation of what causes bipolar disorder is the combination of genetic/biological predisposition and the environmental trigger, which are often termed as the "Diathesis-Stress Model" and the "kindling theory".
Diathesis-Stress Model says that a person can inherit a certain diathesis (predisposition to a disorder), and the disorder may or may not occur depending on what stress the person suffers in life.
Also, researchers have formulated a "kindling" theory stating that people who are genetically and anatomically predisposed to bipolar disorder have lower-than-usual threshold of mood changes after they experience a series of traumatic events that can lead to self-starting recurring mood episodes, eventually developing into bipolar disorder.
If you're an avid Hollywood fan, you might have known that Catherine Zeta-Jones has checked herself into a mental health facility. Her diagnosis? Bipolar Disorder. Because of this, a few people now are wondering about this mental condition. Zeta-Jones then should be thanked for achieving what most mental health advocates struggle in getting: attention for this poorly understood but potentially devastating and surprisingly common illness.
You see, bipolar disorder, also called manic depression, actually affects 5.7 million adult Americans every year according to the National Institute of Mental Health (NIMH). That‘s roughly 2.6 % of the U.S. population. Men and women of any race have equal chances of developing it although some studies suggest that people with creative talent are more likely to have some form of bipolar disorder. In fact, Van Gogh, Tchaikovsky, and Hemingway are believed to have suffered from it.
Sad part is, bipolar disorder symptoms are often dismissed that many sufferers are not diagnosed, and therefore do not receive timely treatment. Bipolar disorder patients are often told "snap out of it", "You just have the blues" or that they're temperamental, moody, or just weird. As a result, majority of the patients have to bear their symptoms in escalating degrees for as long as 10 years before they are found out to have bipolar disorder. Worst, only one in four of them is diagnosed accurately.
How dangerous is this? Bipolar disorder, when left undiagnosed and therefore untreated, renders its victim incapable of functioning normally. It makes everyday tasks such as sleeping, going to school or work, and relating to people difficult or downright impossible. In fact, the World Health Organization ranked bipolar disorder as the sixth leading cause of disability in the world. But that's not all; without adequate social support and medical attention, one out of five bipolar disorder patients commit suicide.
Bipolar disorder is one of mental illnesses under a category called mood disorders. It is characterized by episodes of extreme levels of emotional states. This is not the usual sad and happy moments which we all experience because these symptoms are often severe, prolonged, and happening in senseless cycles that impair normal daily functioning. NIMH says you can tell if a person is having a bipolar episode if he exhibits mood episodes several times a day and nearly every day for one to two weeks. Below are these mood episodes experienced in Bipolar Disorder:
1. Mania - At times, a patient is on a "high". He's hyperactive. He hardly sleeps, talks too fast, and jumps at one thought to another. He's easily irritated, aggressive and impatient. He makes rash decisions, cannot concentrate, goes on shopping sprees, engages in impulsive sex, drives recklessly, and has unrealistic beliefs in his capabilities.
2. Depression - Sometimes a patient is at a "low". He's not interested in performing his daily activities, even those that he used to enjoy. He feels guilty, anxious, sad, empty, and worthless, and tired. He sleeps too much or can't sleep. He either hates to eat or he overeats. He doesn't like to have sex. He has trouble focusing and remembering and he contemplates suicide.
In some instances, Bipolar disorder patients even experience hallucinations and delusions which frequently lead to misdiagnosis of Schizophrenia. To ease their symptoms, many patients turn to alcohol and drugs which worsen their episodes and make their condition harder to diagnose.
As for Catherine Zeta-Jones' symptoms, she is said to have Bipolar II Disorder, one of four classifications of bipolar disorder. The other three types are Bipolar I Disorder, Bipolar Disorder Not Otherwise Specified (BP-NOS), and Cyclothymia.
- A Bipolar II patient shifts from severe depression to mild manic state called hypomania.
- Bipolar II episodes are less severe than those of a Bipolar I sufferer who swings from severe mania to severe depression and is usually suicidal.
- A BP-NOS patient on the other hand has symptoms but can't be categorized into Bipolar I or II.
- Cyclothymia is the mildest form of bipolar disorder with mild bipolar episodes spread over two years.
Experts agree that not just one but a number of factors may be involved in the development of bipolar disorder. These are the following:
1. Genetics. If a person has a close relative that has bipolar disorder, it doesn't mean that he automatically has it too. However, his risk is considerably higher. For instance, if only one of his parents has bipolar disorder, he has 15-30% chance of developing the disease. If both parents have it, then his risk of getting it climbs to 50-70%.
2. Brain Structure. Current brain-imaging tools revealed to researchers that there are abnormalities in some parts of the brains of bipolar disorder patients. They also have reduced brain volume compared to healthy individuals. Some authorities also suggest that imbalance of neurotransmitters in the brain impair the brain's mood-regulating system.
3. Environment. Recent stressful life events may trigger one's first bipolar disorder episode, either manic or depressive. These include death in the family, end of relationships, divorce of parents, a loved one having terminal illness, and so forth.
Researchers came out with a "kindling" theory that says people who are genetically and anatomically predisposed to bipolar disorder lower their threshold of mood changes if they experience a series of traumatic events. A manic or depressive mood then starts and becomes recurrent fully developing into bipolar disorder.
Bipolar disorder cannot be cured. However, medications such as mood stabilizers are prescribed by doctors to enable the patient to control his symptoms. The patient also undergoes counseling or psychotherapy. Usually, even family members who will be his primary caregivers will go through counseling.
Psychiatric medications have many known side effects and not all bipolar disorder sufferers have similar responses to a drug. Sometimes, several drugs are tried before the most effective medication is determined. It is therefore imperative for patients to keep a chart of their symptoms, sleep patterns, medications, and life events. This will help their doctors monitor if their treatments are working. If a patient's symptoms or side effects worsen, his doctor may adjust or alter his treatment.
Bipolar disorder is an illness that lasts a lifetime and may be recurrent. However, as long as there is effective maintenance treatment plan, good relationship with doctors, a healthy lifestyle, and more importantly, understanding and care from family and friends, individuals with bipolar disorder may be able to manage their symptoms and lead fulfilling lives.
In fact, Catherine Zeta-Jones is also proving this as true; she's been reported to be out of the mental treatment center and is ready to start working on her two new films.
Most parents with children who suffer from bipolar disorder find themselves at their wits end as to how to help their child cope with the condition. While bipolar disorder may affect your child's emotions, it can be controlled and the child can live a normal life. This article focuses on the main symptoms and diagnosis of the condition.
Bipolar disorder, commonly known in medical circles as manic-depressive illness, is a condition, actually more of a brain disorder, that disrupts a child's interpretation of their emotions. Studies of children with the condition have found that they tend to be moody, extremely happy at times or, in some cases, a combination of both. These children often have difficulties in certain areas of their childhood. This includes school and schoolwork, as well as relationships with family and friends. This may be due to their frequent mood swings, which may last up to a week.
The National Institute of Mental Health categorized the symptoms into two main groups: mania and depression.
Children with bipolar disorder may exhibit different signs of mania. These include having an unusual happiness that makes the child look silly, short fiery tempers, constant need to attempt risky things, inattentiveness, as well as talking very fast on a mixed topic of subjects.
Bipolar children often have bouts of depression which, as mentioned, may last for a week sometimes. These symptoms, although commonly noticed, may not necessarily point to the child having the condition. The symptoms include prevalent sadness, frequent pain such as headaches and stomachaches, and preoccupation with death or suicide.
Medical researchers have been unable to find any blood or brain indicators that reveal that a child has bipolar disorder. The currently used method to diagnose the condition involves a comprehensive review of the child's family mental health history, the sleep patterns, and energy levels.
Children with Bipolar I Disorder often have manic moods/symptoms that last up to seven days. The moods can be mixed with depressive and manic moods and the mixed episodes can last up to two weeks.
Those with Bipolar II Disorder often have depressive moods as the main characteristic. Although they may at times experience manic moods, these are not full blown. These moods may last up to four days.
Cylothymic Disorder is a mild form of bipolar disorder that affects the child for a period of around one year. It is mainly characterized by mania with slight depression.
Lastly, Bipolar Disorder (Not Otherwise Specified) refers to the form of the condition that does not fall into any of the other three categories.
Mood Swing, we all have it to some extent - the sudden mood changes, when an anxious situation triggers us to react extremely in either elation or depression. This is a condition termed as bipolar disorder or manic-depressive illness.
Throughout life, stressful situations may trigger this disorder to manifest as early as the adolescence stage or teenage years. It can affect a person's emotional functioning and eventually those around him, lasting for weeks and even months at a time.
Bipolar disorder involves an alternate between a roller-coaster of mood elation ("highs") identified as mania and depression ("lows"). It may vary from one individual to another and can be changing in intensity depending on an individual's capacity to handle emotions. These emotional patterns are sometimes unnoticeable, but when the mood swings alter a person's normal behavior, judgment and thinking, then it could be time to seek treatment.
In most instances, the common signs and symptoms of mania or manic phase include poor judgment, hyperactivity, euphoria, exaggerated optimism, severely high self-esteem, sleep deprivation, racing thoughts, rapid speech, agitation, easy distractibility, reckless and risk taking behaviors, and aggressiveness.
On the other hand, the depressive phase may manifest symptoms as disturbed sleep, loss of appetite, feelings of hopelessness and helplessness, severe anxiety or paranoia, intense sadness, easy fatigability, general loss of interest in activities of daily life, poor concentration, easily irritated, indeterminate pain, and suicidal thoughts.
Most experts explain that bipolar disorder may be triggered by factors such as genetics (being prone to getting the illness when it runs in the family) as well as environmental where stress and sudden change play a major role. The exact etiology of this illness, however, still remains a mystery, although evidence implies that individuals who suffer from bipolar disorder experience changes in the chemical messengers between nerve cells inside the brain.
Most often, these individuals inherit their parents' genetic abnormality in terms of neurotransmitters that regulate these chemical messengers, although this is not conclusive. Some experts also say that drug, alcohol and/or substance abuse and severe traumatic experience set off episodes of bipolar disorder.
Bipolar Disorder is more popularly known as a Manic Depressive Syndrome. It is characterized by unusual shifting of moods, as well as activity and energy levels. This type of depression is not to be taken lightly as a severe case of manic depression can lead to suicide. Usually, there are a number of medical conditions that co-exist with bipolar disorder, one of which is diabetes. Currently, with the advent of technology and medicine, bipolar disorder is treatable and diabetes can be controlled.
Currently, there have been no other causes discovered for bipolar disorder except genetics. Heredity has been the only observed cause for this type of depression. Diabetes is just one among several medical conditions that can occur in a person with bipolar disorder.
Studies have shown that people who have bipolar disorder have an increased risk of developing diabetes after a period of time. The percentage of patients with diabetes mellitus (Type 1 Diabetes) was higher in those who had manic-depressive disorder than those patients who did not suffer from the disorder. Because the two medical conditions almost always develop in the same patient, researchers have hypothesized that diabetes and a bipolar disorder overlap in terms of pathogenesis (the method of which a disease is caused).
Studies have shown that treating bipolar disorder can increase the risk of acquiring diabetes. It was found that patients taking antipsychotic drugs for the treatment of bipolar syndrome increased their risk of developing diabetes. Reports also showed that diabetes developed in patients who gained weight, were hypertensive and had substance abuse issues. Substance abuse often happens to patients with bipolar disorders but the exact cause for this is not known. As for cases of readmission to medical facilities, there were fewer patients who came back because of their diabetes as compared to those who had to be readmitted because of bipolar syndrome.
Medical researchers have suggested that in treating both conditions, a patient would require a team that is knowledgeable in several medical disciplines. It is also strongly advised that people who have both of these conditions change their diet to healthier eating and exercise regularly in order to prevent the worsening of both conditions.
Those patients who are already on the brink of developing diabetes are strongly urged to change their diet and start regular exercise. Since substance abuse is relatively common in manic-depressive patients, taking in substances such as alcohol is strongly discouraged.
Bipolar Disorder is a mood disorder which is characterized by episodes of depression and mania or mild non-psychotic excitement. This definition is also the explanation why it is also being called as the Manic Depressive Disorder. It causes mood swings from low depressions to high mania.
There is neither exact cause for the disorder nor an exact way of determining the condition. There may be a genetic link because most people who suffer from the condition have relatives in the same shoes or are suffering from depression. It is also associated with imbalance in brain chemicals, hormonal deficiencies, triggered by sleep deprivation, hypothyroidism, and the use of antidepressants.
Each subtype of bipolar disorder has different patterns of symptoms. Bipolar I Disorder includes mood swings that cause difficulty in the job, school or relationships. Bipolar II Disorder is less severe than the previous type and is characterized by elevated moods, irritability, and some changes in daily functioning. Persons with Bipolar II suffer from hypomania, which is less severe than mania and it lasts shorter than the depression. Cyclothymia is a mild form of the manic depressive disorder where depression and hypomania can be disruptive but the highs and lows are not as severe as the other two types.
Although the symptoms of the disorder may vary from person to person and some may find the manic phase more troublesome and some find the depression phase worse, there are a lot of common symptoms in a phase. Symptoms of the manic phase of bipolar disorder include euphoria, extreme optimism, inflated self-esteem, poor judgment, rapid speech, racing thoughts, aggressive behavior, agitation or irritation, increased physical activity, risky behavior, spending sprees or unwise financial choices, increased drive to perform or achieve goals, increased sex drive, decreased need for sleep, inability to concentrate, careless or dangerous use of drugs or alcohol, frequent absences from work or school, delusions or a break from reality, and poor performance at work or school.
The depressive phase of bipolar disorder displays the following symptoms: sadness, hopelessness, suicidal thoughts or behaviors, anxiety, guilty feelings, sleep problems, fatigue, loss of interest in daily activities, problems concentrating, irritability, chronic pain without a known cause, frequent absences from school or work, and poor performance at work or school.
Other symptoms of this condition include seasonal changes in the mood, which is also called seasonal affective disorder (SAD). Some people enter the manic phase during spring or summer and then get depressed during fall or winter. Another symptom is the rapid cycling bipolar disorder. This is having four or more mood swings in a year and for some people, mood shifts happen in a matter of hours.
Psychosis or the detachment from reality is the result of severe episodes of either mania or depression. Psychosis inhibits symptoms which are delusions and hallucinations. In some cases, the first sign of bipolar disorder is a psychotic break. For children and adolescents who have bipolar disorder, the symptoms can include explosive temper, rapid mood shifts, reckless behavior, and aggression. Younger children also display intense periods of giddiness and silliness, long bouts of crying and outbursts of explosive anger, plus a changing sleeping pattern.
It is very important to approach and ask for help from mental health providers like psychiatrists and psychologists when there are symptoms of bipolar disorder. They help through counseling and prescriptions to control the symptoms. The diagnosis of the disorder starts from a thorough review of medical history including the symptoms and a complete physical examination and mental health exam. Assessment tests are also conducted to make sure that the symptoms are not caused by treatable medical conditions.