Bipolar disorder, previously known as manic depression, is a condition that affects your mood, causing it to swing from one extreme (depression, or periods of feeling very low) to another (mania, or periods of feeling very high). The exact cause of bipolar is unknown, but the condition is thought to be caused by a combination of physical, environmental and social factors.
We asked three RSCPP therapists to explain in more detail some of the possible causes or contributing factors for developing bipolar disorder.
Many of the current approaches to gaining a better understanding of bipolar involve looking to childhood experiences or genetic predispositions as possible causes of the condition.
Registered Psychotherapist Susan Heath says, "bipolar disorder, despite being so well known, is still little understood and creates great distress for the sufferer and the family. While we can think of it as arising from a disturbance in brain chemistry, this doesn't answer the question of what causes such disturbance in the first place."
Susan explains that she often looks for developmental causes as, "looked at this way, I can begin to think of it as 'a disease of consciousness and of the ego, rather than a disease of mood'."
In her view, this may be due to the way we learn about ourselves and our identities during very early infancy. "Think for a moment about how an infant learns to regulate mood. Anybody who has cared for a tiny baby has witnessed the sudden swing from dreamy contentment to a roar of rage, often in seconds," she explains. The role of the caregiver in this situation plays an important part in helping the baby to learn to regulate mood.
However, she adds, when this has not happened, you may find that you "lack a secure sense of identity, and you are less resilient to changes or difficulties you encounter in the environment. For someone suffering from bipolar disorder this can be difficult, so it is important to stabilise the outside world as much as possible. Sudden change or any stressful tendencies can destabilise the brain chemistry very easily, triggering a bipolar episode."
Registered Psychologist Anita Rajan also agrees that people affected by bipolar disorder "appear to lack some behavioural and emotional self-regulation. These extreme 'spikes' [in mood] that go below or above the socially accepted norms seem to have some roots in childhood."
She adds: "Childhood is the time when you learn self-control and regulation - a process which may have manifested in soothing or loving. In people with bipolar, this could not be internalised and utilised later in life. This is especially true in the depression phases of the condition, while the 'high' - a phase of extreme creativity and energy - could be linked to parental discipline or guidance, which impacts on how you regulate mood swings."
These kinds of early experience, Susan points out, "are by no means a sure and certain 'cause', or even a consistent, underlying factor in bipolar disorder. But it does give a clue as to how your therapist may be able to help to relieve the symptoms of this desperately painful condition. Stressful situations are common triggers for a bipolar episode, and the more you can stop and think about these, the more likely it is that you will be able to find a way of stabilising and regulating mood swings."
Besides these environmental causes, some therapists believe that the development of bipolar disorder is strongly linked to your genetic predisposition for the condition.
Registered Counsellor Imelda Turnock says, "research indicates a strong possibility that genetic factors play an important part in the illness, with a higher chance of onset if a family member has bipolar."
Imelda adds: "The condition almost certainly suggests an imbalance of neurotransmitters, particularly the chemicals responsible for sending messages between brain neurons which affect mood. An imbalance of hormones is thought to be an additional factor which may play a part in the onset of the condition."
If there is such a predisposition for bipolar, she adds, "it may remain dormant until activated either on its own or by major life stressors such as childbirth, a relationship breakdown or money problems amongst many other factors, although the trigger differs for each person and stress is thought to be a catalyst rather than a cause."