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(9) Bipolar Disorder

What causes bipolar disorder?

The causes of bipolar disorder are not easily defined. When speaking of cause, it is typical to think in terms of infections of the lungs causing pneumonia or of cigarette smoking causing lung cancer.

 

In actuality, most medical conditions cannot be so easily defined as having clearly linked causes. In fact, it took many years of statistical analysis before scientists could demonstrate a clear causal link between cigarette smoking and lung cancer. Even today, people argue, “My grandmother smoked her entire life and died at the ripe old age of 90 from natural causes.

How can cigarettes possibly cause cancer?” The reality is that cigarette smoking is only one portion, albeit a big one, of the causal puzzles that when pieced together leads to lung cancer. This is true of most diseases today. Instead, when physicians talk about cause, they are really talking about risk factors that influence the odds of developing a particular illness. For example, depression, a complex illness, is more like an illness with multiple causes that influence the odds of someone developing it.

Bipolar disorder is more apt to run in families than major depressive disorder, but it also is not 100% heritable. It may occur in someone with no family history for the illness, or it may not occur in someone with extensive family history for the illness.

The odds of having any mood disorder are impacted by a variety of sources inside and outside of a person. This variety constitutes what is called the biopsychic social model, which is typically employed. In this model, clinicians consider biological, psychological, and social factors that may contribute to the onset of a mood disorder. This model influences most diseases of lifestyle. Take heart disease, for example.

Applying the biopsychosocial model to heart disease demonstrates biological risk factors of family history, the presence of high blood pressure and high cholesterol, and atherosclerosis; psychological risk factors of type A personality and/or an inability to handle stressful events; and social risk factors of smoking, diet, and activity level.

Biologically, bipolar disorder is associated with changes in various neurotransmitter levels and activity, commonly referred to as a chemical imbalance in the brain. Additionally, bipolar disorder typically runs in families, suggesting a genetic, or heritable, aspect to the illness. Psychologically, certain personality types are more prone to having less robust coping styles under stress. People who have low self-esteem and a pessimistic outlook are at higher risk for depression.

Other psychological disorders, such as anxiety, psychotic, or substance abuse disorders, increase the odds of developing bipolar illness in a susceptible individual.

Socially, the onset of bipolar illness is linked to stressful life events, usually entailing loss, such as of a spouse, child, job, or financial security. A mood disorder however, can also be linked to events generally considered to be uplifting rather than stressful, although from the body’s reaction, they are stressful.

These events can include marriage, the birth of a child, a job change or promotion, or a move to a new neighborhood or home.

Leslie’s comments:

I remember my symptoms appearing when I was a teenager and, although I didn’t link it until more recently, I am quite sure that an ongoing episode of sexual abuse during that time had a lot to do with developing the disorder. I’m also convinced that there is a genetic link because my uncle struggles with the disorder as well.

Terms:

Chemical imbalance - a common vernacular for what is thought to be occurring in the brain in patients suffering from mental illness.

Psychotropic - usually referring to pharmacological agents (medications) that, as a result of their physiological effects on the brain, lead to direct psychological effects.

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