Is Bipolar Genetic? How To Know If You May Be Genetically At Risk

Medically reviewed by Julie Dodson, MA, LCSW and Majesty Purvis, LCMHC
Updated October 29, 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.
Support is available 24/7. Please also see our Get Help Now page for more immediate resources.

Bipolar disorder is a mood disorder that affects about one in 40 adults in the US, and it’s the sixth-leading cause of disability worldwide. Though it is a chronic and potentially severe mental illness, bipolar disorder is generally treatable. However, when untreated, it can significantly impact a person’s daily functioning and well-being. That’s why understanding the causes and risk factors for developing bipolar disorder—including genetics—can be important, so you can take preventative measures and learn to recognize symptoms if they do arise. 

Getty
Learn about bipolar disorder and genetics

What is bipolar disorder?

Bipolar disorder is typically characterized by extreme mood swings between an “up” or manic state and a “down” or depressive state. These moods are commonly referred to as episodes. The frequency of these shifts and the intensity of the episodes are what determine which type of bipolar disorder an individual has. There are three primary types of bipolar disorder: bipolar I disorder, bipolar II disorder, and cyclothymic disorder. 

Bipolar disorder I is characterized by mania that lasts a week or longer and may require the individual to be hospitalized. Individuals with bipolar disorder type I may or may not have also experienced a major depressive episode. Bipolar disorder II involves shifts between hypomanic episodes, which are less severe periods of mania, and depressive episodes. Unlike with bipolar disorder type I, individuals with type II must experience both a high and low period. The cyclothymic disorder involves mood shifts whose severity or duration don’t meet the criteria for bipolar disorder I or II.

Symptoms of bipolar disorder

The primary symptoms of bipolar disorder are the shifts between manic and depressive states.

Symptoms of a manic episode may include:

  • Feeling restless

  • Feeling very happy or euphoric

  • Feeling agitated or irritable

  • Having racing thoughts

  • Being unrealistic about one’s abilities

  • Talking quickly

  • Being jumpy

  • Taking excessive risks

  • Displaying poor judgment

  • Being impulsive

  • In extreme cases, symptoms of psychosis such as hallucinations or delusion

Symptoms of a depressive episode may include:

  • Feeling fatigued

  • Feeling sad, hopeless, or helpless

  • Isolating oneself from friends and family

  • Experiencing changes in appetite resulting in weight gain or loss

  • Having difficulty making decisions

  • Having a hard time focusing

  • Losing interest in usual activities or hobbies

  • Talking slowly

  • Having thoughts or behaviors of self-harm or suicide

iStock

Genetic factors increase the risk of developing bipolar disorder

Like many psychiatric disorders, bipolar disorder is thought to have a significant genetic basis. Experts in the genetics of bipolar disorder have found that several different genes likely play a role in the development of the condition. Below, we’re discussing the extent to which genetic factors (and other risk factors) contribute to bipolar disorder.  

Is bipolar disorder genetic?

As a 2020 paper on the topic states, “The cause of bipolar disorder (BD) is still unknown. However, it has been established that the dynamic interplay between genetic, neurochemical, and environmental factors plays a role in the onset and progression of BD”.

Is bipolar genetic, or can environmental factors cause this mental health disorder?

Scientists believe that bipolar disorder has a genetic component. However, there are studies suggesting that a person can develop bipolar disorder due to environmental factors. In other words, both genetic and environmental factors can contribute to a given individual’s risk of developing bipolar disorder. Let’s take a closer look at each of these.

Bipolar disorder has a genetic component 

Bipolar disorder is considered one of the most heritable mental disorders. Studies suggest that if an individual has a first-degree relative (a biological parent or sibling) who has bipolar disorder, they have a 15–30% chance of developing it themselves. If they have two first-degree relatives with the disorder, they have up to a 75% chance of developing it themselves. So while having family members with bipolar disorder doesn’t guarantee that you’ll develop the disorder as well, it likely increases the chances.'

AKAP11: A definitive risk gene

It is thought that numerous gene variants contribute to the development of bipolar disorder—each in a small way. Researchers haven't yet found a single, specific genetic marker that is always present in people with bipolar disorder. However, multiple genes—and numerous genetic variants within them—have been linked to the condition. In a genome-wide association study, researchers identified 64 genomic loci, which included 161 genes, that were connected to bipolar disorder. While no single gene may be responsible for the disorder’s development, certain genes have been more strongly implicated. In a 2022 study, which included details from approximately 14,000 individuals with bipolar disorder and a similar number of healthy controls, researchers concluded that AKAP11 is “a definitive risk gene”.  

Gene variants that affect brain function

Many gene variants that have been identified are thought to exert influence on brain function. In a study published in the journal Archives of General Psychiatry (Arch Gen Psychiatry), researchers found that variations in the CACNA1C gene may help explain cognitive impairments in bipolar disorder. Additionally, researchers in a whole-genome study and meta-analysis identified variations in several protein-encoding genes that contribute to brain structure and function.  

As we continue to identify common genetic markers in bipolar disorder, we can learn more about the role specific genes play in the manifestation of symptoms in a person’s life. Future directions may include more large-scale human genome studies and other collaborative efforts to accumulate details. In a summary of the above-mentioned genome-wide association study, the National Institute of Mental Health stated that identification of the location of specific genes “will continue to increase rapidly with the addition of new cohorts”.

The environmental component of bipolar disorder

It’s thought that environmental factors also play a role in an individual’s likelihood of developing bipolar disorder. It may be that elements of their upbringing could predispose them to be at risk for a mental health condition like this later in life. Or/in addition, difficult, stressful, and/or traumatic life events may have the potential to trigger the expression of a gene that relates to this disorder. Environmental factors or events that have been found to increase risk include: 

Environmental risk factors

  • Abuse

  • Other trauma

  • High-stress events like divorce or the loss of a loved one

  • Significant levels of chronic stress

  • Certain medications

Getty
Learn about bipolar disorder and genetics

The role of alcohol in the risk of developing bipolar disorder

It’s also worth noting that some research relates substance use disorders—especially those involving alcohol—to bipolar disorder. First, bipolar and substance use disorders are often comorbid, meaning that it’s not uncommon for a single individual to experience both concurrently. While excessive or problematic alcohol consumption may be a coping mechanism some turn to in an attempt to manage symptoms, research suggests a potential genetic link as well. Further research is needed to understand the exact relationship between these two disorders, but limiting or avoiding alcohol may be helpful for those who have or are at risk for developing bipolar disorder.

How to know if you may be genetically at risk for bipolar disorder

If you know of a biological first-degree relative of yours who has bipolar disorder, you may be at increased risk of developing it too, as described above. If you’re not connected with or aware of the health history of every member of your biological family, tracking down this information can be useful. In cases where this is not possible, some people wonder whether at-home genetic tests may help them understand if they may have a family history of a disorder like this. However, since researchers have yet to isolate the exact gene(s) associated with bipolar disorder, such tests are unlikely to be accurate.

Helpful lifestyle changes if you are at risk of developing bipolar disorder

If you have or suspect you may have a family history of this disorder, it can be helpful to speak to your doctor about what you can do. They may evaluate you for symptoms of bipolar disorder now, help you understand what to look for in the future, and give you tips on lifestyle changes you can make to help prevent onset if you are at risk. These changes may include:

How therapy can help people with bipolar disorder or other mental health conditions

If you have been diagnosed with bipolar disorder, meeting with a therapist regularly is likely part of your treatment plan. If you’re showing symptoms of bipolar disorder or another mental health condition, meeting with a healthcare professional for evaluation is recommended. If you’re concerned about your risk of developing bipolar disorder or another mental health condition, taking care of your mental health now can be a helpful preventative measure. Therapy is one way to do this. With the help of a trained therapist, you can address any past traumas, get help processing your emotions, and learn about self-care strategies you can try to maintain positive mental health.

Online therapy

Attending traditional, in-person therapy sessions with a therapist is not possible for everyone. Some don’t have providers in their area, can’t easily travel to appointments due to a health condition or disability, or can’t receive care for financial reasons. In cases like these, online therapy can represent a viable alternative. With an online therapy platform like BetterHelp, you can meet with a licensed therapist from the comfort of your home or anywhere you have an internet connection, and for a cost that’s comparable to most insurance co-pays. Research suggests that online therapy can offer similar benefits to in-person therapy in many cases, so the format you choose is generally up to you.

Takeaway

While the exact causes and risk factors of bipolar disorder are still being studied, research so far points to both genetic and environmental components. If you believe you may be at risk of, or already experiencing, symptoms of a mental health condition like bipolar disorder, it’s typically recommended that you meet with a healthcare professional for evaluation and treatment options.
Find support for bipolar disorder symptoms
The information on this page is not intended to be a substitution for diagnosis, treatment, or informed professional advice. You should not take any action or avoid taking any action without consulting with a qualified mental health professional. For more information, please read our terms of use.
Get the support you need from one of our therapistsGet started