What causes Bipolar Disorder? by Robyn Tamanaha, LMFT

What is it?

The bipolar disorders occur along a spectrum, which is based upon the intensity of the symptoms, how long the symptoms last, and how much they interfere with major areas of a person’s life. The experience of the disorders can include episodes of depression, mania, and hypomania, as well as mixed episodes. The individual can also experience periods without an episode. Want to know more? CLICK HERE to read my blog What are the different types of Bipolar Disorders

What causes it?

As research on bipolar disorder continues, there is no one single cause, but the manifestation of bipolar episodes seems to be a combination of three factors: genetics, biology, and stress.

Genetics:

One factor in the manifestation of bipolar episodes is family history. For many diagnoses, having a relative with a particular diagnosis increases the chances of you potentially experiencing the same diagnosis. In the case of bipolar disorder, if one individual in a family has bipolar disorder, the chances of a first degree relative also having it is around 9% (Miklowitz, 2019). There has been a lot of research on twins and bipolar disorder; specifically, the likelihood that an individual will experience bipolar disorder if their twin does. Some studies have found that the likelihood of one identical twin having bipolar disorder (if the other twin has it) can be up to 48% (Miklowitz, 2019).

Biology:

A second factor is biological vulnerability. The human brain is complex, with many chemicals, pathways, and structures that all play vital roles in the overall functioning and regulation of the human being. In individuals with bipolar disorder, it was found that there are issues with two particular functions of the brain: 1) How chemicals are regulated, and 2) The area of the brain that regulates emotion and sleep (Miklowitz, 2019).

Stress:

So, let’s say that there's an individual that has genetic factors and some biological vulnerability. How would a bipolar mood episode manifest? The answer in many cases: stress. Stressors can include major life changes or adjustments, major changes in sleep, and conflicts in relationships with family, friends, or partner(s).

What does this mean?

There is no single cause of bipolar disorder, but the fact that stressors play a factor in the manifestation of bipolar episodes gives credit to two psychotherapy treatments for bipolar disorder: Interpersonal and Social Rhythm Therapy (IPSRT) and stress management. Interpersonal and Social Rhythm Therapy (IPSRT) was developed by Ellen Frank (2007) based upon data that showed that daily rhythms and changes in the individuals’ role or relationships influence mood. IPSRT treatment includes 1) regulating sleep, eating, and daily activities because this helps to manage the diagnosis, 2) processing and addressing relationships and past experiences or changes, and 3) discussion around how the individual feels about having the diagnosis. The second treatment is stress management, which can be included in IPSRT; however, it can also be its own focus to include daily stress, work stress, and even lifestyle. In bipolar disorder, managing stress helps to manage the episodes and symptoms.

How can therapy help?

As you can see, bipolar disorder is complex and the strategies to manage it are multi-layered. Individuals with bipolar disorder can be successful and have a fulfilling life, and therapy can help the individual achieve these. A therapist who is experienced or specialized in bipolar disorder, and who is knowledgeable with the treatments for it, is important. When it comes to bipolar disorder, it’s important to see someone who is a specialist, not a generalist.

References:

Frank, E. (2007). Treating bipolar disorder: A clinician's guide to interpersonal and social rhythm therapy. Guilford.

Miklowitz, D. J. (2019). The bipolar disorder survival guide what you and your family need to know. Guilford Pubn.

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Disclaimer: This information is being provided to you for educational and informational purposes only. The topics being discussed are meant as a self-help tool for you own use. It is not psychotherapy or counseling. This information is to be used based on your own judgment. If you need to speak with a professional, you should find one local to you and contact them directly.

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