Table of ContentsView AllTable of ContentsCausesRisk FactorsBrain DifferencesWorsening SymptomsOther ComplicationsNext in Bipolar Disorder GuideHow to Diagnose Bipolar Disorder
Table of ContentsView All
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Table of Contents
Causes
Risk Factors
Brain Differences
Worsening Symptoms
Other Complications
Next in Bipolar Disorder Guide
There isn’t a single or exact known cause ofbipolar disorder. However, research has identified several suspected causes and risk factors that help explain why someone may develop bipolar disorder. These include genetics or family history of bipolar disorder, environmental factors, and brain structural and functioning differences.
This article details the suspected causes of bipolar disorder, risk factors to be aware of, and known brain differences. It also covers what causes worsening symptoms in people with bipolar disorder and other variables that can cause complications.
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Bipolar Disorder Causes
Genetics Plays a Role
Bipolar disorder can be considered a high degree of genetic heritability, meaning it is often passed down from parent to child. While several different factors influence someone’s likelihood of developing bipolar disorder, research indicates the lifetime risk of developing bipolar disorder is eight times more likely if you have an immediate family member (first-degree) with the disorder.The risk increases further if you have two parents with bipolar disorder.
Many genes are involved in bipolar disorder, and no single gene is the cause.
Childhood Trauma Contributes to Risk
Childhood trauma or maltreatment in childhood is an environmental risk factor linked to the later development of mental illness, including bipolar disorder. Research has shown a significant association between bipolar disorder and previous physical, sexual, and emotional abuse, as well as physical and emotional neglect.
Does Childhood Trauma Cause Bipolar Disorder?While there is a link betweenchildhood trauma or maltreatmentand bipolar disorder, the exact nature of how or why this happens is still unclear and is the focus of ongoing research.
Does Childhood Trauma Cause Bipolar Disorder?
While there is a link betweenchildhood trauma or maltreatmentand bipolar disorder, the exact nature of how or why this happens is still unclear and is the focus of ongoing research.
Understanding Relationship Trauma
Stressful Life Events Affect the Course of Bipolar Disorder
Stressful life events such as job loss, parental loss, divorce, disability, andlosing a relative to suicideplay their part in the onset and course of bipolar disorder. Research has shown a relationship between recent stressful life events (i.e., within the last six months) and the onset of bipolar disorder manic or depressive episodes in at-risk persons.
There are many reasons why stressful life events occur and whether or not they lead to mental illness. Experiencing negative life events does not mean someone will develop bipolar disorder.
Mania Definition, Causes, and Treatment
Substance Misuse May Trigger Episodes
Bipolar disorder and substance use disorders are often found together in clinical settings. Research has shown there is a two-way relationship between cannabis, cocaine, opioid, sedative, and alcohol misuse and bipolar disorder. In other words, using substances can trigger manic or depressive episodes or relapse in people with susceptibility to bipolar disorder, and bipolar disorder can increase therisk of developing substance use disorders. Substance use can also lead to misdiagnosis of bipolar disorder rather than be a causative factor, though.
9 Common Depression Triggers (and How to Manage Them)
Risk Factors for Bipolar Disorder
We know more about risk factors for bipolar disorder than direct causes. Risk factors like genetics, childhood maltreatment, stressful life events, and substance misuse, for example, do not directly cause bipolar disorder. Rather, they contribute to someone’s overall likelihood of developing bipolar disorder.
Risk factors also offer insight into bipolar disorder predictability, soearly interventions can be made to reduce the risk of bipolar disorder where possible. Having several risk factors for bipolar disorder does not mean someone will inevitably develop bipolar disorder.
Co-Morbid ConditionsA small number of studies have identified the following medical conditions associated with bipolar disorder. These conditions may be linked to bipolar disorder because they share similar inflammatory and stress-related causes:Irritable bowel syndrome(IBS)AsthmaObesityMigraine headachesTraumatic brain injuryAnxiety disorders
Co-Morbid Conditions
A small number of studies have identified the following medical conditions associated with bipolar disorder. These conditions may be linked to bipolar disorder because they share similar inflammatory and stress-related causes:Irritable bowel syndrome(IBS)AsthmaObesityMigraine headachesTraumatic brain injuryAnxiety disorders
A small number of studies have identified the following medical conditions associated with bipolar disorder. These conditions may be linked to bipolar disorder because they share similar inflammatory and stress-related causes:
List of Mental Illnesses
Bipolar Disorder Brain Differences
Brain structure and function may differ in people with bipolar disorder compared to people without bipolar disorder and to people with other mental illnesses, according to the National Institute of Mental Health.
Specific brain differences are seen in the following areas:
Difference Between Bipolar I and Bipolar IIBipolar disorder has subtypes, Bipolar I and Bipolar II. Thedifference between Bipolar I and Bipolar II is the severity of symptoms, including the severity of mania. People living with Bipolar II are said to experience less severe and shorter episodes of mania, known as hypomania.
Difference Between Bipolar I and Bipolar II
Bipolar disorder has subtypes, Bipolar I and Bipolar II. Thedifference between Bipolar I and Bipolar II is the severity of symptoms, including the severity of mania. People living with Bipolar II are said to experience less severe and shorter episodes of mania, known as hypomania.
The Anatomy of the Brain
What Causes Worsening Bipolar Disorder Symptoms?
The Role of Medication for Bipolar DisorderBeing unmedicated or stopping pharmaceutical treatment is another cause of symptom relapse and worsening bipolar symptoms. Preventing futuremood episodescomes down to taking mood stabilizers like lithium on an ongoing basis and adhering to medication plans.Bipolar disorder will not go away on its own, but with the right treatment, symptoms can be effectively managed.
The Role of Medication for Bipolar Disorder
Being unmedicated or stopping pharmaceutical treatment is another cause of symptom relapse and worsening bipolar symptoms. Preventing futuremood episodescomes down to taking mood stabilizers like lithium on an ongoing basis and adhering to medication plans.Bipolar disorder will not go away on its own, but with the right treatment, symptoms can be effectively managed.
Other Causes of Bipolar Disorder Complications
Psychological and social factors can cause bipolar disorder complications. These include a lack of social support and family dysfunction.In other words, not having adequate support and understanding from loved ones and caregivers can cause bipolar disorder complications.
Getting HelpIf you or a loved one needs help with bipolar disorder or the associated signs and symptoms, contact theSAMHSA National Hotlinefor treatment and support group referrals at1-800-662-HELP (4357). If you are having suicidal thoughts, dial988to contact the988 Suicide & Crisis Lifelineand connect with a trained counselor. If you or a loved one are in immediate danger, call911.
Getting Help
If you or a loved one needs help with bipolar disorder or the associated signs and symptoms, contact theSAMHSA National Hotlinefor treatment and support group referrals at1-800-662-HELP (4357). If you are having suicidal thoughts, dial988to contact the988 Suicide & Crisis Lifelineand connect with a trained counselor. If you or a loved one are in immediate danger, call911.
Living With Bipolar Disorder
Summary
There isn’t a single known cause for bipolar disorder. Rather, research suggests a combination of factors contribute to someone’s likelihood of developing this mental illness. Contributing risk factors include genetics, childhood maltreatment or trauma, and substance misuse, along with stressful life events, other medical conditions, brain differences, and social variables, all play some role. Risk factors are not fate.
What It’s Like Living With a Spouse Who Is Bipolar
16 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Psychiatric Association.What are bipolar disorders?Kupka R, Duffy A, Scott J, et al.Consensus on nomenclature for clinical staging models in bipolar disorder: A narrative review from the International Society for Bipolar Disorders (ISBD) Staging Task Force.Bipolar Disord.2021;23(7):659-678. doi:10.1111/bdi.13105National Institute of Mental Health.Bipolar disorder.Rowland TA, Marwaha S.Epidemiology and risk factors for bipolar disorder.Ther Adv Psychopharmacol. 2018;8(9):251-269. doi:10.1177/2045125318769235Quidé Y, Tozzi L, Corcoran M, Cannon DM, Dauvermann MR.The impact of childhood trauma on developing bipolar disorder: current understanding and ensuring continued progress.Neuropsychiatr Dis Treat. 2020;16:3095-3115. doi:10.2147/NDT.S285540Rowland TA, Marwaha S.Epidemiology and risk factors for bipolar disorder.Ther Adv Psychopharmacol. 2018;8(9):251-269. doi:10.1177/2045125318769235Bortolato B, Köhler CA, Evangelou E, et al.Systematic assessment of environmental risk factors for bipolar disorder: an umbrella review of systematic reviews and meta-analyses.Bipolar Disord.2017;19(2):84-96. doi:10.1111/bdi.12490Wu MK, Wang HY, Chen YW, Lin PY, Wu CK, Tseng PT.Significantly higher prevalence rate of asthma and bipolar disorder co-morbidity: a meta-analysis and review under PRISMA guidelines.Medicine (Baltimore). 2016;95(13):e3217. doi:10.1097/MD.0000000000003217Zhao Z, Okusaga OO, Quevedo J, Soares JC, Teixeira AL.The potential association between obesity and bipolar disorder: a meta-analysis.J Affect Disord. 2016;202:120-123. doi:10.1016/j.jad.2016.05.059Fornaro M, Stubbs B.A meta-analysis investigating the prevalence and moderators of migraines among people with bipolar disorder.J Affect Disord. 2015;178:88-97. doi:10.1016/j.jad.2015.02.032Perry DC, Sturm VE, Peterson MJ, et al.Association of traumatic brain injury with subsequent neurological and psychiatric disease: a meta-analysis.J Neurosurg. 2016;124(2):511-526. doi:10.3171/2015.2.JNS14503Nabavi B, Mitchell AJ, Nutt D.A lifetime prevalence of comorbidity between bipolar affective disorder and anxiety disorders: a meta-analysis of 52 interview-based studies of psychiatric population.EBioMedicine. 2015;2(10):1405-1419. doi:10.1016/j.ebiom.2015.09.006National Institute of Mental Health.Bipolar disorder.Strakowski SM, DelBello MP, Adler CM.The functional neuroanatomy of bipolar disorder: a review of neuroimaging findings.Mol Psychiatry. 2005;10(1):105-116. doi:10.1038/sj.mp.4001585Beyer JL, Kuchibhatla M, Payne ME, MacFall J, Cassidy F, Krishnan KRR.Gray and white matter brain volumes in older adults with bipolar disorder.Int J Geriatr Psychiatry. 2009;24(12):1445-1452. doi:10.1002/gps.2285Miklowitz DJ, Johnson SL.Social and familial factors in the course of bipolar disorder: basic processes and relevant interventions.Clin Psychol (New York). 2009;16(2):281-296. doi:10.1111/j.1468-2850.2009.01166
16 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Psychiatric Association.What are bipolar disorders?Kupka R, Duffy A, Scott J, et al.Consensus on nomenclature for clinical staging models in bipolar disorder: A narrative review from the International Society for Bipolar Disorders (ISBD) Staging Task Force.Bipolar Disord.2021;23(7):659-678. doi:10.1111/bdi.13105National Institute of Mental Health.Bipolar disorder.Rowland TA, Marwaha S.Epidemiology and risk factors for bipolar disorder.Ther Adv Psychopharmacol. 2018;8(9):251-269. doi:10.1177/2045125318769235Quidé Y, Tozzi L, Corcoran M, Cannon DM, Dauvermann MR.The impact of childhood trauma on developing bipolar disorder: current understanding and ensuring continued progress.Neuropsychiatr Dis Treat. 2020;16:3095-3115. doi:10.2147/NDT.S285540Rowland TA, Marwaha S.Epidemiology and risk factors for bipolar disorder.Ther Adv Psychopharmacol. 2018;8(9):251-269. doi:10.1177/2045125318769235Bortolato B, Köhler CA, Evangelou E, et al.Systematic assessment of environmental risk factors for bipolar disorder: an umbrella review of systematic reviews and meta-analyses.Bipolar Disord.2017;19(2):84-96. doi:10.1111/bdi.12490Wu MK, Wang HY, Chen YW, Lin PY, Wu CK, Tseng PT.Significantly higher prevalence rate of asthma and bipolar disorder co-morbidity: a meta-analysis and review under PRISMA guidelines.Medicine (Baltimore). 2016;95(13):e3217. doi:10.1097/MD.0000000000003217Zhao Z, Okusaga OO, Quevedo J, Soares JC, Teixeira AL.The potential association between obesity and bipolar disorder: a meta-analysis.J Affect Disord. 2016;202:120-123. doi:10.1016/j.jad.2016.05.059Fornaro M, Stubbs B.A meta-analysis investigating the prevalence and moderators of migraines among people with bipolar disorder.J Affect Disord. 2015;178:88-97. doi:10.1016/j.jad.2015.02.032Perry DC, Sturm VE, Peterson MJ, et al.Association of traumatic brain injury with subsequent neurological and psychiatric disease: a meta-analysis.J Neurosurg. 2016;124(2):511-526. doi:10.3171/2015.2.JNS14503Nabavi B, Mitchell AJ, Nutt D.A lifetime prevalence of comorbidity between bipolar affective disorder and anxiety disorders: a meta-analysis of 52 interview-based studies of psychiatric population.EBioMedicine. 2015;2(10):1405-1419. doi:10.1016/j.ebiom.2015.09.006National Institute of Mental Health.Bipolar disorder.Strakowski SM, DelBello MP, Adler CM.The functional neuroanatomy of bipolar disorder: a review of neuroimaging findings.Mol Psychiatry. 2005;10(1):105-116. doi:10.1038/sj.mp.4001585Beyer JL, Kuchibhatla M, Payne ME, MacFall J, Cassidy F, Krishnan KRR.Gray and white matter brain volumes in older adults with bipolar disorder.Int J Geriatr Psychiatry. 2009;24(12):1445-1452. doi:10.1002/gps.2285Miklowitz DJ, Johnson SL.Social and familial factors in the course of bipolar disorder: basic processes and relevant interventions.Clin Psychol (New York). 2009;16(2):281-296. doi:10.1111/j.1468-2850.2009.01166
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Psychiatric Association.What are bipolar disorders?Kupka R, Duffy A, Scott J, et al.Consensus on nomenclature for clinical staging models in bipolar disorder: A narrative review from the International Society for Bipolar Disorders (ISBD) Staging Task Force.Bipolar Disord.2021;23(7):659-678. doi:10.1111/bdi.13105National Institute of Mental Health.Bipolar disorder.Rowland TA, Marwaha S.Epidemiology and risk factors for bipolar disorder.Ther Adv Psychopharmacol. 2018;8(9):251-269. doi:10.1177/2045125318769235Quidé Y, Tozzi L, Corcoran M, Cannon DM, Dauvermann MR.The impact of childhood trauma on developing bipolar disorder: current understanding and ensuring continued progress.Neuropsychiatr Dis Treat. 2020;16:3095-3115. doi:10.2147/NDT.S285540Rowland TA, Marwaha S.Epidemiology and risk factors for bipolar disorder.Ther Adv Psychopharmacol. 2018;8(9):251-269. doi:10.1177/2045125318769235Bortolato B, Köhler CA, Evangelou E, et al.Systematic assessment of environmental risk factors for bipolar disorder: an umbrella review of systematic reviews and meta-analyses.Bipolar Disord.2017;19(2):84-96. doi:10.1111/bdi.12490Wu MK, Wang HY, Chen YW, Lin PY, Wu CK, Tseng PT.Significantly higher prevalence rate of asthma and bipolar disorder co-morbidity: a meta-analysis and review under PRISMA guidelines.Medicine (Baltimore). 2016;95(13):e3217. doi:10.1097/MD.0000000000003217Zhao Z, Okusaga OO, Quevedo J, Soares JC, Teixeira AL.The potential association between obesity and bipolar disorder: a meta-analysis.J Affect Disord. 2016;202:120-123. doi:10.1016/j.jad.2016.05.059Fornaro M, Stubbs B.A meta-analysis investigating the prevalence and moderators of migraines among people with bipolar disorder.J Affect Disord. 2015;178:88-97. doi:10.1016/j.jad.2015.02.032Perry DC, Sturm VE, Peterson MJ, et al.Association of traumatic brain injury with subsequent neurological and psychiatric disease: a meta-analysis.J Neurosurg. 2016;124(2):511-526. doi:10.3171/2015.2.JNS14503Nabavi B, Mitchell AJ, Nutt D.A lifetime prevalence of comorbidity between bipolar affective disorder and anxiety disorders: a meta-analysis of 52 interview-based studies of psychiatric population.EBioMedicine. 2015;2(10):1405-1419. doi:10.1016/j.ebiom.2015.09.006National Institute of Mental Health.Bipolar disorder.Strakowski SM, DelBello MP, Adler CM.The functional neuroanatomy of bipolar disorder: a review of neuroimaging findings.Mol Psychiatry. 2005;10(1):105-116. doi:10.1038/sj.mp.4001585Beyer JL, Kuchibhatla M, Payne ME, MacFall J, Cassidy F, Krishnan KRR.Gray and white matter brain volumes in older adults with bipolar disorder.Int J Geriatr Psychiatry. 2009;24(12):1445-1452. doi:10.1002/gps.2285Miklowitz DJ, Johnson SL.Social and familial factors in the course of bipolar disorder: basic processes and relevant interventions.Clin Psychol (New York). 2009;16(2):281-296. doi:10.1111/j.1468-2850.2009.01166
American Psychiatric Association.What are bipolar disorders?
Kupka R, Duffy A, Scott J, et al.Consensus on nomenclature for clinical staging models in bipolar disorder: A narrative review from the International Society for Bipolar Disorders (ISBD) Staging Task Force.Bipolar Disord.2021;23(7):659-678. doi:10.1111/bdi.13105
National Institute of Mental Health.Bipolar disorder.
Rowland TA, Marwaha S.Epidemiology and risk factors for bipolar disorder.Ther Adv Psychopharmacol. 2018;8(9):251-269. doi:10.1177/2045125318769235
Quidé Y, Tozzi L, Corcoran M, Cannon DM, Dauvermann MR.The impact of childhood trauma on developing bipolar disorder: current understanding and ensuring continued progress.Neuropsychiatr Dis Treat. 2020;16:3095-3115. doi:10.2147/NDT.S285540
Bortolato B, Köhler CA, Evangelou E, et al.Systematic assessment of environmental risk factors for bipolar disorder: an umbrella review of systematic reviews and meta-analyses.Bipolar Disord.2017;19(2):84-96. doi:10.1111/bdi.12490
Wu MK, Wang HY, Chen YW, Lin PY, Wu CK, Tseng PT.Significantly higher prevalence rate of asthma and bipolar disorder co-morbidity: a meta-analysis and review under PRISMA guidelines.Medicine (Baltimore). 2016;95(13):e3217. doi:10.1097/MD.0000000000003217
Zhao Z, Okusaga OO, Quevedo J, Soares JC, Teixeira AL.The potential association between obesity and bipolar disorder: a meta-analysis.J Affect Disord. 2016;202:120-123. doi:10.1016/j.jad.2016.05.059
Fornaro M, Stubbs B.A meta-analysis investigating the prevalence and moderators of migraines among people with bipolar disorder.J Affect Disord. 2015;178:88-97. doi:10.1016/j.jad.2015.02.032
Perry DC, Sturm VE, Peterson MJ, et al.Association of traumatic brain injury with subsequent neurological and psychiatric disease: a meta-analysis.J Neurosurg. 2016;124(2):511-526. doi:10.3171/2015.2.JNS14503
Nabavi B, Mitchell AJ, Nutt D.A lifetime prevalence of comorbidity between bipolar affective disorder and anxiety disorders: a meta-analysis of 52 interview-based studies of psychiatric population.EBioMedicine. 2015;2(10):1405-1419. doi:10.1016/j.ebiom.2015.09.006
Strakowski SM, DelBello MP, Adler CM.The functional neuroanatomy of bipolar disorder: a review of neuroimaging findings.Mol Psychiatry. 2005;10(1):105-116. doi:10.1038/sj.mp.4001585
Beyer JL, Kuchibhatla M, Payne ME, MacFall J, Cassidy F, Krishnan KRR.Gray and white matter brain volumes in older adults with bipolar disorder.Int J Geriatr Psychiatry. 2009;24(12):1445-1452. doi:10.1002/gps.2285
Miklowitz DJ, Johnson SL.Social and familial factors in the course of bipolar disorder: basic processes and relevant interventions.Clin Psychol (New York). 2009;16(2):281-296. doi:10.1111/j.1468-2850.2009.01166
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