Causes Of Bipolar Disorder And What To Do About It

Medically reviewed by April Justice, LICSW and Dr. Jennie Stanford, MD, FAAFP, DipABOM
Updated December 5, 2024by BetterHelp Editorial Team
Please be advised, the below article might mention trauma-related topics that include suicide, substance use, or abuse which could be triggering to the reader.
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Bipolar disorder is a mental health condition involving severe mood, energy, and behavior shifts. While there is no one cause of the condition, various genetic, biological, and environmental factors may play a role in its development. 

For individuals with bipolar disorder and their loved ones, learning more about these factors may help them understand the condition and identify how to manage symptoms more effectively.

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What is bipolar disorder?

Bipolar disorder is a mental health condition characterized by shifts in mood, changes in behavior, and fluctuations in energy levels. The symptoms of bipolar disorder typically depend on whether an individual is experiencing a manic or depressive episode. Increased energy levels, a sense of euphoria, rapid speech, and a heightened sense of self-esteem may be signs of a manic episode. A depressive episode can feature symptoms like low mood, thoughts of hopelessness, fatigue, and a loss of interest in previously enjoyed activities. 

There are three primary types of bipolar disorder: bipolar I disorder, bipolar II disorder, and cyclothymic disorder. While all three types of bipolar disorder feature changes in mood, behavior, and cognition, the nature of symptoms related to each type can vary significantly. To be diagnosed with bipolar I disorder, an individual must experience a manic episode, which may precede or follow a period of depressive symptoms (though the presence of depression is not necessary for a diagnosis). Individuals with bipolar II disorder experience both depressive and hypomanic episodes, which are less severe than mania. For a diagnosis of cyclothymic disorder, an individual must experience periods of hypomanic and depressive symptoms that do not meet the criteria for episodes of hypomania or depression. 

People with bipolar disorder frequently live with comorbid mental disorders. Potential comorbidities include anxiety disorders, attention-deficit hyperactivity disorder (ADHD), and substance use disorders. If you believe you’re experiencing bipolar disorder symptoms, a healthcare professional can provide you with screenings and determine whether further testing, diagnosis, and treatment are necessary. 

Possible causes of bipolar disorder 

Like many other mental health conditions—for example, anxiety disorders and attention-deficit/hyperactivity disorder—the exact causes of bipolar disorder are unknown. However, several risk factors have been identified as potential sources. Below are some of the various factors that may contribute to the development of bipolar disorder. 

Genetic factors

Bipolar disorder is often considered a genetic mental illness, and research shows that people who have a first-degree relative with the condition have a higher risk of developing it themselves. Research into the genetics of bipolar disorder is ongoing, but some studies suggest that variations in genes may combine to increase the risk of developing bipolar disorder. According to other studies, genetics explain 60% to 85% of all risk of developing bipolar disorder. 

Biological factors

In addition to genetic factors, research suggests that differences in brain structure and functioning may cause the development of bipolar disorder, as there appear to be subtle physical differences in the brains of people with the condition. 

An imbalance of brain chemicals may also contribute, as there is some evidence that a person may develop symptoms of bipolar disorder if they have an imbalance in the levels of one or more neurotransmitters, such as noradrenaline, serotonin, and dopamine, which are some of the chemicals responsible for controlling the brain’s functions.

A few medical conditions have also been closely associated with bipolar disorder. For example, bipolar disorder may occur in connection with metabolic disorders (including hyperlipidemia, diabetes mellitus, and hypertension), thyroid disease, migraine headaches, osteoarthritis, migraine headaches, asthma, kidney disease, or stroke. 

Significant losses or traumatic events

When faced with a significant loss, such as the death of a close family member or other loved one, some people experience shifts in their mood. Depression has been closely associated with the grieving process and is often considered a stage of grief. However, mania or hypomania can also follow a loss for people with bipolar disorders. Major losses and other traumatic events can affect mood, habits, and lifestyle and may incite a manic or depressive episode

Other life stressors

People can develop various health challenges when under extreme stress. Medical conditions like gastrointestinal disorders may emerge as life stressors increase and could indicate a correlation with bipolar disorder. Similarly, stressors can incite the onset or cause worsening of bipolar disorder. A demanding job, a difficult divorce, or taking on too many responsibilities are a few stressors that may contribute to the development of this condition. 

Substance use

Substance misuse may increase the risk of bipolar disorder or cause an episode. Researchers have noted that bipolar disorder and alcohol use disorder often occur together, and alcohol can often cause mania or severe depression. 

There has also been research into whether caffeine consumption impacts the course of bipolar disorder, but the research has not been conclusive.

Pre-existing mental health concerns

Research suggests a connection between certain mental health conditions and bipolar disorder. Bipolar disorder is thought to co-occur with attention-deficit hyperactivity disorder (ADHD), anxiety disorders, and substance use disorders, among other conditions. 

Studies show that the existence of attention-deficit hyperactivity disorder may be a risk factor for bipolar disorder. Studies indicate that 10% of people with attention-deficit/hyperactivity disorder live with comorbid bipolar disorder. Some experts have suggested that attention-deficit hyperactivity disorder is a prodrome of bipolar disorder, meaning a diagnosis serves as an early indicator. 

Bipolar disorder and anxiety are also commonly co-occurring conditions. In individuals with an anxiety disorder, bipolar disorder is nine times more likely to develop than in the general population. Additionally, as discussed in the above section, substance use disorders are closely connected to bipolar disorder. There is also evidence that a significant proportion of people who experience substance-induced psychosis will eventually develop bipolar disorder. 

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Can you prevent bipolar disorder?

There is no definitive way to prevent bipolar disorder. However, there are ways to keep the condition from worsening, and treatments are available for bipolar disorder to manage the condition. Treatment for bipolar disorder often includes a combination of approaches, such as talk therapy, medication, and healthy lifestyle choices.

Because bipolar disorder is usually a lifelong condition, long-term treatment approaches are often necessary. In therapy, individuals can treat bipolar disorder by learning about the sources of their depressive and manic symptoms, working through the emotional challenges of the condition, and addressing potential comorbidities, such as attention-deficit hyperactivity disorder (ADHD). Commonly prescribed medications include mood stabilizers, antipsychotics, and antidepressants. In some cases, brain stimulation therapies (e.g., electroconvulsive therapy) may be utilized. 

Healthy lifestyle habits that may help individuals manage the condition alongside professional treatment may include: 

  • Exercising regularly

  • Eating nutritious food

  • Reducing alcohol consumption

  • Getting adequate sleep

  • Reducing life stressors

  • Learning relaxation techniques to cope with unavoidable stressors

If you want to explore medication for bipolar disorder, talk to your doctor to examine your options and determine what might work best for you. In addition, consult a doctor before starting, changing, or stopping a medication. Medication is not a cure-all treatment for bipolar disorder, and everyone reacts differently to medical treatments. Often, a combination treatment approach is helpful, as therapy can guide individuals in learning lifelong coping mechanisms. 

The BetterHelp platform is not intended to provide any information regarding which drugs, medication, or medical treatment may be appropriate for you. The content provides generalized information that is not specific to one individual. You should not take any action without consulting a qualified medical professional.

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Support options 

Therapy is another treatment option for people with bipolar disorder, regardless of the subtype or cause. Talk therapy may help you develop coping strategies, make lifestyle changes, learn relaxation techniques, process a significant loss, and work through concerns that may be causing you distress. You can seek help from a therapist in person near you or connect with a licensed therapist online through a platform like BetterHelp

Different people may have different preferences, but for some people with bipolar disorder, the symptoms that can arise during depressive episodes may make it difficult to leave the house for therapy. With online therapy, you can have sessions from the comfort of your home, which may be more convenient. In addition, online platforms may offer unique features, such as worksheets or group sessions, which can be included in a weekly or monthly subscription cost. 

Research has demonstrated the effectiveness of online therapy for bipolar disorder, with one such study providing evidence of the efficacy of internet-based psychoeducation interventions for bipolar disorder in reducing depressive symptoms. Another study found that 95% of participants with bipolar disorder reported improved quality of life after treatment.

Takeaway

There is no one cause of bipolar disorder, but research suggests that a combination of genetic, biological, and environmental factors may play a role. Treatment for bipolar disorder often includes a combination of approaches, such as talk therapy, medication, and healthy lifestyle choices. 

If you are interested in seeking therapy but depressive symptoms are making it difficult to commute to an appointment, online therapy may be a convenient alternative, as it allows you to have sessions from the comfort of your home.

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