Causes Of Bipolar Disorder And What To Do About It

By: Sarah Fader

Updated June 02, 2020

Medically Reviewed By: Amanda Andrews

No exact and definite causes of bipolar disorder have been discovered yet. No test tells any more than that you might be genetically predisposed to getting it. It doesn't show up in a blood test or on a brain scan. However, researchers continue to explore the possibilities. As of now, the results of numerous studies suggest that there might be genetic, biological, and environmental factors behind the onset of the disease as well as its relapse after treatment.


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The goal of the research, of course, is to come up with better treatments and possibly someday prevent bipolar disorder before it starts. In the meantime, knowing more about the potential causes of bipolar disorder may help you come to terms with having it. Understanding what causes bipolar to relapse or get worse is undeniably valuable, because the more you know, the better decisions you can make about your care and lifestyle right now.

Possible Genetic Causes of Bipolar Disorder

Over the historical course of bipolar research, scientists have mostly concluded that bipolar disorder is an inherited disease. The data shows that the following aspects of bipolar run in families:

  • Same history of psychiatric hospitalizations
  • Bipolar and obsessive-compulsive disorder occurring together in individuals
  • Same approximate age of onset
  • Same approximate number of episodes characterized by mania
  • Same approximate frequency of manic episodes
  • When one twin has bipolar disorder, the other twin has a 70% chance of having it.
  • With one parent having bipolar, the chances of the child having it goes up 10-15%, but with both parents having it, the child's chances are 30-40%.

With these familial similarities in mind, scientists have been looking for exact genetic markers that always show up when someone has bipolar disorder. A genetic marker is simply a gene that has a known location on DNA and can be used to identify inheritable traits. While no specific gene stands out so far as the one that always causes bipolar, the following genomic variants each have been identified in groups of people who have the disease.

  • CACNA1C - SNP at rs1006737 - The CACNA1C affects the calcium channel. It is a large gene that has many variants, but the rs1006737 has been associated with bipolar disorder. The results did not hold up under repeated studies. A note of interest: other studies have shown that genetic variants that affect activity within the calcium channel are associated with psychiatric disorders.
  • NCAN - neurocan - NCAN is another large gene. It affects a large secreted protein found in certain parts of the brain. It is involved in several tasks at the cellular level. While scientists have studied this gene about bipolar and other psychiatric disorders, they haven't identified any clear correlation.
  • ODZ4 - rs12576775 - The rs12576775 variant of the ODZ4 gene has shown promise as an identifying factor for bipolar disorder. However, the variant is also present in several other disorders, including autism spectrum, ADHD, major depression, and schizophrenia. More studies are needed to find out what the factors are that make the difference between all these disorders.

Currently, tests available online are promoted as answers to the question of whether you have bipolar. At this time, there is no scientific evidence that these tests do any such thing. They do identify whether you have a specific gene, but that gene may or may not find expression in bipolar or any other psychiatric disorder.


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Possible Biological Bipolar Disorder Causes

Scientists who study the biological causes of psychiatric disorders assume that they are caused not only by genetic variations but also by brain chemistry and structure. In short, they see the biological roots of the disease as a genetic predisposition as acted on by the forces of nature. It's still unclear how much is determined by the genes and how much by what happens to the person through their lifetime. However, researchers have identified the following associations between biological differences and the presence of bipolar disorder.

Neurotransmitter Dysfunction

Neurotransmitters are the chemical substances that carry messages within the brain. They include serotonin and norepinephrine, among others. When these neurotransmitters aren't functioning properly, they can lead to the onset of bipolar disorder.

Onset or Flare of Certain Medical Conditions

A few medical conditions have been closely associated with bipolar disorder. People who have these conditions are much more likely to be diagnosed with bipolar disorder. For example, bipolar seems to precede or occur simultaneously with multiple sclerosis in a significant percentage of people with MS. Another disorder that seems to be preceded by bipolar disorder is Cushing's syndrome. Cushing's is a metabolic disorder that also features high blood pressure and obesity.

Hormonal Changes

Hormonal changes, such as those following pregnancy may also be associated with the onset of bipolar disorder.

Environmental Causes/Triggers for Onset and Relapse

With the genetic and biological causes of bipolar in place, a trigger is usually the tipping point between predisposition and having the disorder. The triggers known at this point come from the environment and the lifestyle choices each person makes.

Alcohol or Drug Use

Alcohol and drug use are not what causes bipolar disorder, but they can cause a relapse or make the condition worse. Depressions are usually much more severe for those who use these substances. Drug use can trigger a depression or manic episode as well.

Major Losses

When faced with a major loss, many people have problems with their mood. Depression has been so closely associated with the grieving process that Marian Kubler-Ross identified it as one of the 5 Stages of Grief. However, mania, too, can follow a loss as the person tries frantically to replace what they no longer have. Grieving can cause people to change their habits and alter their lifestyle in ways that make them more vulnerable to bipolar as well as a variety of other medical and psychiatric conditions.

Other Life Stressors

People often develop a variety of health problems when they're under extreme stress. Medical conditions such as gastrointestinal disorders may come along soon after life stressors increase dramatically. In the same way, stressors can trigger the onset, relapse, or worsening of bipolar disorder. A stressful job, dealing with a bitter divorce, or taking on too many responsibilities are just a few of the stressors that can bring on this psychiatric condition.

Stopping Bipolar Meds

If you're already on bipolar meds or any other psychiatric meds, a relapse is more likely if you quit taking those meds or reduce them without consulting with your psychiatrist. It takes careful planning and precise execution to reduce or discontinue medications without triggering a depressive or manic episode. Certainly, it's fine to suggest to your doctor that you no longer need as much if any of the med. It's perfectly okay to request their help with getting off the prescription drug. However, if you stop without the help of your doctor, you're likely to have mental health problems.

Medication Triggers

Changes in medication for psychiatric or medical conditions can trigger bipolar episodes. Some of the drugs that can trigger manic episodes are:

  • Street drugs, including cocaine, Ecstasy, and amphetamines
  • Appetite suppressants
  • Cold medicines
  • Thyroid medications
  • Corticosteroids such as prednisone
  • Excessive use of caffeine


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If you have bipolar disorder, it's crucial that your psychiatrist avoids prescribing you antidepressants that tend to trigger manic episodes. Fortunately, there are several that do help alleviate depression without elevating the mood too much. They include Wellbutrin, Symbyax, Zoloft, Prozac, and Cymbalta.

Can Bipolar Disorder Be Prevented?

Until scientists have identified the exact causes of bipolar disorder, it's unlikely that anyone will be able to avoid the possibility of having it. However, there are some things you can do to decrease the chances that environmental triggers will lead to the onset of bipolar. You can minimize your risk factors for bipolar by making healthy lifestyle choices, avoiding substance abuse, and seeking professional help before a loss or stressor begins to affect your mental health.

Make Healthy Lifestyle Choices

If you're truly committed to doing everything you can to prevent onset, relapse or worsening of bipolar disorder, consider making these lifestyle changes:

  • Avoid alcohol and street drugs.
  • Avoid caffeine, nicotine and other over-the-counter stimulants.
  • Exercise at least 30 minutes per day.
  • Eat healthy meals and snacks at regular times each day.
  • Get enough sleep at your normal sleeping time, avoiding naps.
  • Inform all your doctors about all your prescription meds
  • Take bipolar medications exactly as directed by your psychiatrist.
  • Eliminate unnecessary life stressors.
  • Learn relaxation techniques to help deal with unavoidable stressors.

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Seek Professional Help in Times of Crisis

Because stress and loss can be triggers for bipolar disorder, dealing with the serious issues in your life can decrease your chances of immediate onset. A counselor can help you gain perspective and insight, learn coping skills, and practice healthier patterns of thought and behavior.

Therapists are available for online counseling at BetterHelp.com. They can help you deal with a crisis or loss, make lifestyle changes, learn relaxation techniques, and work through the problems that are putting your life out of balance. The scientific exploration of bipolar disorder causes is fascinating to follow. In the meantime, even if you don't know what causes bipolar disorder, a counselor can help you regain and maintain your mental health now and in the future.


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