Exploring The Link Between Bipolar Disorder And Genetics
Over time, researchers have uncovered evidence indicating that many mental health conditions and challenges may have a genetic component. In other words, if someone in your biological family—including in previous generations—had or has a certain mental illness, you may be at increased risk for developing the same one. That said, mental health is complex. In most cases, genetics aren’t the only factor in whether someone may be at risk for presenting with a certain issue. With bipolar disorder in particular, it’s thought that both genetics and other factors may play a role in why some individuals may experience it and others may not. Read on to learn more about the hereditary link in particular.
What is bipolar disorder?
Bipolar disorder, previously called manic depression or manic-depressive illness, is a mental health condition that’s estimated to affect around one in 40 US adults. A potentially severe mental illness, bipolar disorder can cause extreme shifts in mood, cognition, and behavior. The primary symptoms of bipolar disorder usually include periods of elevated mood, energy, and activity levels (known as manic or hypomanic episodes) and periods of depressed mood and decreased energy (known as depressive episodes). Bipolar disorder typically develops during adolescence or early adulthood, though it can also occur in childhood in rare cases.
There are three primary types of bipolar disorder: bipolar I disorder, bipolar II disorder, and cyclothymic disorder. To be diagnosed with bipolar disorder type I, an individual must have experienced at least one manic episode. For a diagnosis of bipolar disorder type II, at least one major depressive episode and one hypomanic episode must have occurred. Cyclothymic disorder may be diagnosed when an individual experiences periods of depressive and hypomanic symptoms that do not meet the criteria for episodes of major depression or hypomania.
Note that manic or hypomanic episodes both have similar characteristics, but hypomanic episodes are typically milder, shorter in duration, and do not cause functional impairment. Symptoms of both include:
An exaggerated sense of well-being and self-confidence (euphoria)
Decreased need for sleep
Increased energy and activity levels
Racing thoughts and rapid speech
Impulsive or risky behavior, such as excessive spending or irresponsible sexual behavior
Common symptoms of depressive episodes include:
Persistent feelings of sadness or emptiness
Loss of interest in previously enjoyed activities
Decreased energy and activity levels
Difficulty concentrating or making decisions
Changes in appetite and sleep patterns
Feelings of worthlessness or guilt
While manic and depressive symptoms of bipolar disorder typically arise during distinct phases, they can also co-occur, during periods called mixed episodes. In cases of severe bipolar disorder, some people experience psychotic symptoms, which can include hallucinations, delusions, and disorganized thought. Note that the signs and symptoms of bipolar disorder might vary from person to person and may also change over time. If you or a family member is experiencing symptoms of mania, hypomania, or major depression, seeking help from a healthcare professional is typically recommended; bipolar disorder can be a serious condition, though it is treatable.
Genetic factors increase the risk of developing bipolar disorder
Individuals who have a close relative with bipolar disorder are at increased risk of experiencing the condition themselves. Bipolar disorder is considered one of the most heritable psychiatric disorders, which means that differences in genetic factors account for a significant amount of variation in the disorder. Studies on the genetics of bipolar disorder suggest that the heritability is approximately 79-93%. While genetics play a role in the development of this condition, they are not thought to be the sole determinant.
As with many mental disorders, it is thought that many genes play a role in bipolar disorder, each potentially contributing in a small way. According to the National Institute of Mental Health, “no one gene can cause the disorder”. Thus far, experts have identified multiple genes in which mutations may help cause bipolar disorder. For example, researchers have found that gene variants that impact the function of the protein CPG2 can increase the chances of bipolar disorder developing during a person’s life, as can genetic variations in TRANK1, a recently identified susceptibility gene. Additionally, specific groups of genes have been linked with certain features of bipolar disorder. For example, the chromosomal regions 13q31 and 22q12 have been implicated in symptoms of psychosis.
As more research is conducted, future directions become clearer, and human genome studies continue to advance, we may learn more about the exact genetic variants that are associated with bipolar disorder.
Not everyone with a family history of the disorder will necessarily develop it, though; and people without a family history might still develop bipolar disorder. Environmental factors like stress, trauma, and other challenging life experiences may also contribute to the risk of developing the condition.
Other factors that may contribute to bipolar disorder
Environmental and lifestyle factors might also play a significant role in both the development and course of bipolar disorder. For instance, stress and trauma might trigger the onset of symptoms or exacerbate existing symptoms.
That’s why practicing self-care is recommended for everyone and can be especially helpful for those who have or may be at risk for developing this disorder. This could include habits such as:
Exercise, which research suggests may help those with bipolar disorder manage or improve depressive symptoms
Meditation, which one study found helped “alleviate guilt, depressed mood, and helplessness/hopelessness” in individuals with bipolar disorder
A healthy diet, which researchers in 2015 found may positively influence several biological processes that are typically dysregulated in those with bipolar disorder, and because this disorder has “a high comorbidity with several physical diseases”
However, it’s important to note that if you have or know you’re at higher risk for developing bipolar disorder, you should speak with a healthcare provider before making any significant lifestyle changes. If you’re currently on medication or other treatments for bipolar disorder or another mental health condition, it’s recommended that you don’t stop or alter this regimen without consulting with a qualified healthcare professional first.
Treatment options for those who develop bipolar disorder
There is currently no cure for bipolar disorder, but it’s considered to be a highly treatable condition. With appropriate, ongoing treatment, most people with this disorder can live functional, fulfilling, autonomous lives. Such treatment usually consists of some combination of medication and psychotherapy. Medication is often used to help manage symptoms, such as mood swings. A therapeutic approach such as cognitive behavioral therapy (CBT) can help an individual identify and change negative thought patterns. Or, interpersonal and social rhythm therapy (IPSRT) can assist them in establishing and maintaining a healthy routine. Other types of therapy that may be helpful for individuals with bipolar disorder include family-focused therapy, in which other family members participate in the therapeutic process, and psychodynamic therapy.
The most effective treatment plan for bipolar disorder will be individualized to the needs and circumstances of the individual. A healthcare team, which may include a primary care provider, psychiatrist, and therapist, will often be assembled to work with the individual to develop and implement a treatment plan that considers their specific needs and goals. It’s usually ideal for the client to be an active participant in their treatment and to communicate with their healthcare team regularly about their progress and any concerns they may have.
How online therapy can help
If you’re looking for a virtual therapist to add to your care team, you might consider trying a virtual therapy platform like BetterHelp. It can match you with a licensed therapist in a matter of days, and you can then meet with them via phone, video call, and/or in-app messaging from the comfort of your home or anywhere else you have an internet connection. For those who are looking for a more available or affordable therapy format, such online methods may be worth considering—especially since research suggests that they can be as effective as traditional in-person formats in many cases.
Takeaway
Does bipolar disorder come from a person’s mother or father?
While the results of some past research have suggested that a child is more likely to develop bipolar disorder if their father has it rather than their mother, contemporary evidence suggests that the effect of maternal and paternal transmission is similar. If one parent has bipolar disorder, no matter which one, a child is more likely to develop the condition themselves.
Which type of bipolar disorder is hereditary?
Bipolar I, bipolar II, and cyclothymic disorder all have some genetic risk factors contributing to their transmission. A child whose parents have any of those conditions is at a higher risk of developing it themselves. However, evidence suggests that bipolar I, which is also considered the most severe type of bipolar disorder, is more heritable than the other conditions. This means that the risk of a child developing bipolar disorder is likely highest if they have a parent diagnosed with bipolar I, although environmental risk factors also play a significant role.
What triggers bipolar disorder?
The mood fluctuations of bipolar disorder may sometimes seem unpredictable, but a crucial part of managing the disorder is learning to identify signs of an impending mood shift. Learning to steer clear of specific triggers that exacerbate the risk of manic or depressive episodes is also vital. While these triggers vary from person to person, research has identified some common patterns.
Evidence suggests that improperly balanced antidepressant medication is likely a trigger for a manic episode, emphasizing that medical management should be handled by a clinician experienced in treating mood disorders. Additional triggers for manic episodes may include caffeine, seasonal factors, hormonal shifts, and infections. For depressive episodes, typical triggers include fasting, sleep disturbances, and experiencing stressful events. It is possible that traumatic head injuries may also induce or exacerbate bipolar symptoms.
Can I pass bipolar disorder to my child?
Bipolar disorder is highly heritable, meaning it often appears in children of those who have the condition. It is impossible to say whether someone will develop bipolar disorder based on genetics alone, but researchers recently identified a genetic biomarker that can predict the risk of a person developing bipolar disorder. The gene, dubbed AKAP11, is associated with a high risk of developing both bipolar disorder and schizophrenia.
Clinicians will likely be able to screen for AKAP11 in the near future to aid in diagnosing bipolar disorder. However, it is important to remember that bipolar disorder is caused by a combination of genetic variations and environmental factors; just because someone tests positive for the marker gene or has a parent with bipolar does not guarantee they will develop the disorder. Evidence suggests that only 5 - 10% of people with first-degree family with bipolar disorder will develop the condition.
Who is most at risk for bipolar disorder?
The reasons a person develops bipolar disorder are not completely known, but both environmental and genetic variables likely cause it. Those with certain genetic markers and a first-degree family who has been diagnosed with the condition are thought to be at the highest risk, but there are other factors not related to genetics that may also contribute to the disorder.
Evidence suggests that those who experienced maltreatment as a child are at higher risk of developing bipolar disorder. Traumatic events in childhood are known to increase the risk of developing bipolar disorder, but scientists are unsure why. One theory asserts that traumatic events are linked to higher levels of emotional dysregulation, and children exposed to such an environment may develop maladaptive emotional regulation as a result.
Should people with bipolar disorder have kids?
People with bipolar disorder can have children, but they should consider what potential risks may be posed to their future child. Genetically, the child is at a higher risk of developing bipolar disorder than the general population, but genes are only a part of how bipolar develops. There is no guarantee that the child of someone with bipolar disorder will develop the condition themselves. In fact, evidence suggests that a child with a parent who has bipolar disorder has only a 5 - 10% chance of being diagnosed with bipolar disorder in their lifetime.
How can you tell if someone has bipolar disorder?
The only way to be certain that a person has bipolar disorder is for them to discuss their diagnosis with you. Many of the common symptoms of bipolar disorder, such as mood swings, euphoria, irritability, and impulsiveness, can be attributed to other mental health conditions as well. It is also possible that someone has no diagnosable condition and may simply behave in a manner to which you are not accustomed. It is important not to jump to conclusions or make assumptions about a person's pathologies.
Does bipolar disorder get worse with age?
There is evidence to suggest that some of the symptoms of bipolar disorder, especially the depressive illness symptoms, can worsen with age. However, it is important to remember that worsening of symptoms does not occur for everybody, and well-managed bipolar disorder can remain in remission for years. Likely, the most significant disease risk associated with worsening symptoms comes from poor management of the disorder. Those who experience the greatest relief from symptoms as they age likely adhere to medication routines, learn coping skills, and take active steps to improve their mental health overall.
Can bipolar disorder be cured?
Bipolar disorder is a chronic condition that cannot be cured, but it can be treated. With proper management, it is possible to go for long periods between bipolar episodes. In some cases, people can prolong their remission indefinitely. Evidence suggests that approximately 10% of people diagnosed with bipolar disorder have only one episode in their lifetimes. Others may have only two or three. A person’s risk of bipolar symptoms worsening is usually highest when a person disregards their condition, avoids treatment, or turns to substance abuse to cope.
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