People affected by bipolar disorder often ask ‘Why me?’ Some of them, particularly if they do not receive support from their families in managing their condition, wonder if it is in some way their fault. Even worse they may have been told by misguided family members that they could be perfectly ‘normal’ if only they would ‘just snap out of it’. Confronted with such attitudes the person with bipolar disorder can feel guilty and ashamed of themselves.

However, medical research has shown that bipolar disorder is one of a number of mental health conditions which have a genetic cause. If there is either bipolar disorder or schizophrenia within a family, members of their family have a predisposition to develop either of the two diseases. An aunt with bipolar disorder, for instance, might have a schizophrenic nephew. An identical twin is three times more likely than a fraternal twin to have the same mood disorder as its brother or sister.

The genetic factor is linked to a particular chemical in the brain that causes mood swings.

Bipolar disorder may not actually caused by the way families behave, but there appears to be some evidence that parents can pass on particular ways of behaving which exacerbate the condition.

Equally, stress alone does not cause bipolar disorder; many people undergo stressful situations without developing bipolar disorder. However, stress does play a part in the onset of symptoms; frequently, the symptoms are first seen shortly after a major stress incident such as bereavement, the birth of a child, or the loss of a job.

The removal of the stress, though, does not result in the eradication of the disorder. Once the symptoms have become evident and the disorder has been developed, it remains, and often worsens, even though the stress has been removed or ameliorated.

Scientific research continues to develop new information and theories about bipolar disorder. A study in the American Journal of Psychiatry in 2000 suggested that the brain of people with bipolar disorder were different from other brains, since in particular areas they contained many more cells that send signals to other brain cells. This makes the brain overstimulated, and accounts for many of the symptoms that characterize bipolar disorder.

Other studies focus on the place of neurotransmitters as a cause of bipolar disorder. Low levels of specific neurotransmitters such as serotonin are implicated. Norepinephrine and dopamine deficiencies might also influence the development of bipolar disorder. It is also possible that the cause is not so much low levels of any one neurotransmitter, as an imbalance between the different neurotransmitters. The exact role of neurotransmitters in bipolar disorder, then, is still in doubt, but it is clear that they do play a part in predisposing the individual to the condition.

The truth is probably that bipolar disorder is the result of a complex interaction between a number of different factors, both genetic and behavioral. It is likely that individuals who are born with a predisposition to bipolar disorder do not develop it until some incident in their lives, whether that is abuse in the household or a single incident of major stress, sets it off. Both the genetic, inherited predisposition, and the stress, are required; one without the other will not cause the condition – a bit like having a firework, but needing to light the match.

What is very clear is that bipolar disorder is not the individual’s fault; it has real physical and genetic causes. And coping with bipolar disorder is not about ’snapping out of it’ – it is a serious condition, and one that needs to be correctly diagnosed and treated by a medical professional.

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