Growing Up Hilt

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Risk Factors for Developing Bipolar Disorder

One systematic review of the available data suggests there are no significant differences between ethnicities or genders regarding bipolar disorder diagnosis.

Bipolar Disorder and Heredity

The biggest risk factor for bipolar disorder is having family members with the disease. The importance of family history suggests that bipolar disorder has a strong hereditary component. In other words, bipolar disorder can run in families.

One genetic variant in the section of DNA that codes for brain-derived neurotrophic factor (BDNF) has been repeatedly shown to have a strong association with bipolar disorder. BDNF is important to cell survival, nerve growth, communication, and memory. BDNF levels have even been shown to rise and fall as a person transitions in and out of depressive or manic states.

Bipolar Disorder and Environmental Factors

Genes alone don’t explain why some people get bipolar disorder and others don’t. Environment can also play a big role. For instance, early life stress has also been shown to contribute to the development of bipolar disorder. Some researchers believe that stress makes it easier for a depressive episode to be triggered.

Genes and environment also interact in complicated ways. One study found that there is a combined effect of childhood sexual abuse and a mutation in a gene that codes for toll-like receptors, an important component of the immune system. Specifically, the study demonstrated that this combination was more likely to result in an early onset of bipolar disorder. A similar relationship has been observed between the BDNF gene mutation, childhood sexual abuse, and the onset of bipolar disorder.

Bipolar Disorder Symptoms

Symptoms of bipolar disorder range from the lows of depressive symptoms to the highs of manic symptoms. These symptoms differ from person to person and episode to episode.

Symptoms associated with the depressive side of bipolar disorder include:

• Depressed mood
• Low interest in activities once enjoyed
• Low energy or fatigue
• Weight loss
• Poor sleep (insomnia or sleeping too much)
• Feelings of worthlessness or guilt
• Thinking about or planning suicide

Symptoms associated with the manic side of bipolar disorder include:

• High energy
• Decreased need for sleep
• Talkativeness
• Exaggerated feelings of importance
• Racing thoughts
• Poor decision-making
• Delusions
• Hallucinations
• Psychosis (a “break” from reality)

The type of bipolar disorder a person has is defined by the symptoms they experience.

Types of Bipolar Disorder

There are three types of bipolar disorder:

• Bipolar type 1 — The most extreme form of bipolar disorder, type 1 indicates individuals have experienced at least one manic episode in addition to the lows of depression.
• Bipolar type 2 — Individuals with this form of bipolar disorder only experience hypomania and not true mania. Therefore, this type is defined by alternating hypomanic and depressive episodes.
• Cyclothymic disorder (cyclothymia) — This type is also defined by highs and lows, but they are not as high as hypomania or as low as that experienced in the depression episodes of bipolar types 1 and 2. Cyclothymic disorder was recently reclassified as a type of bipolar disorder.

Read more about types of bipolar disorder.

Diagnosing Bipolar Disorder

Bipolar disorder is diagnosed based on the newest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American Psychiatric Association. According to some experts, the current edition of the DSM does a better job than previous editions in recognizing cases of bipolar disorder. However, bipolar disorder remains underdiagnosed in the general population. It is often confused with major depression.

Remember, a diagnosis can only be made by a psychiatrist or clinical psychologist through a mental health assessment. A doctor may perform a physical examination to rule out other potential causes (such as thyroid disorder), but a referral to psychiatric services is usually required for a proper diagnosis.

Treating Bipolar Disorder

Although bipolar disorder can’t yet be cured, treatments for bipolar disorder can help manage symptoms of the disorder. Many people with bipolar disorder take a combination of medications to help manage lows and highs. These medications may include:

• Mood stabilizers (anticonvulsants) — Drugs that are used for seizures, at the right doses, can also be used for bipolar disorder to stabilize mood swings. Some of these drugs include Lamictal (lamotrigine) and Depakote (divalproex sodium). Lithium is an older drug, but it is still used today.
• Antidepressants — Although antidepressants don’t work for everyone, they can help some people manage their depression.
• Antipsychotics — These drugs can help manage episodes of mania and psychosis, delusional thinking, and other symptoms associated with mania.

In addition to prescription drugs, psychotherapy is often a helpful treatment option for learning to manage symptoms. For instance, cognitive behavioral therapy has been shown to be helpful for symptoms associated with bipolar disorder.

Read more about treatments for bipolar disorder.

Talk With Others Who Understand

MyDepressionTeam is the social network for people with depression and their loved ones. On MyDepressionTeam, more than 13,000 members diagnosed with bipolar disorder come together to ask questions, give advice, and share their stories with others who understand life with depression and bipolar disorder.

Are you living with bipolar disorder? Share your experience in the comments below, or start a conversation by posting on your Activities page.