The management of bipolar disorder, also known as manic depression, has focused primarily on medications as treatment. Although the cause is not known, bipolar disorder is thought to be hereditary, since it commonly runs in families. As of 2010, there is no single cause, but many factors combine to result in bipolar disorder. Understanding the environmental triggers of bipolar disorder gives the patient the opportunity to have more influence on its progression.
Post-Traumatic Stress Disorder
Individuals with post-traumatic stress disorder (PTSD), a type of anxiety disorder that develops after a harrowing event, are often later diagnosed with bipolar disorder. Conversely, bipolar disorder is often a precursor to PTSD. While it is not known if one causes the other, it is clear that trauma-related anxiety creates a breeding ground for the development of bipolar disorder or the worsening of symptoms. Turbulent relationships, chaotic circumstances, the loss of a loved one or past childhood abuse all have heightened impact on the bipolar patient. The ongoing stress impacts adrenaline levels and may eventually induce the brain's hippocampus, the area of the brain associated with memory, to shrink.
Seasonal Changes
Changes in seasons, light and temperature appear to have a significant influence on bipolar patients--especially those with bipolar II--according to an Oct. 25, 2007 article on Medical News Today. Dr. Karen Shin at Toronto University in a 2005 study separated seasonally affected individuals into five groups: those with no diagnosis, those with depression, those with seasonal depression, those with seasonal bipolar disorder and those with bipolar disorder.The greatest mood changes were reported by both groups of bipolar participants.
The seasons appear to affect mood episodes for bipolar patients. Mania reportedly occurs more in late summer and early fall, with depressive episodes occurring in late fall and early spring. The rate of suicide among bipolar patients increases during the summer months of May and June.
Smoking
Cigarette smoking is popular among bipolar patients, providing a calming effect during mania and a jolt of energy during depression. Smoking causes a reduction in the gene MAOB that is responsible for regulating stress, and subsequently increases adrenaline. Increased smoking is causally related to increased psychosis in bipolar patients, according to an article in the 2001 "British Journal of Psychiatry."
Substance Abuse
According to the National Institute on Alcohol Abuse and Alcoholism, more than 60 percent of bipolar patients have a substance abuse disorder, based on findings from the National Institute of Mental Health's Epidemiologic Catchment Area (ECA) study. It is not known if there is a causal relationship between substance abuse and bipolar disorder, but it is clear that the common characteristics of both--recklessness, compromised judgment and pleasure-seeking behaviors--are greatly increased when both disorders co-occur.
References
- Medical News Today: Discovering a Seasonal Pattern in Bipolar Disorder Symptoms May Have Implications for Better Management
- National Institute of Mental Health: Bipolar Disorder
- "The Daily Gazette": Kay Redfield Jamison Explores the Link between Madness and Creativity
- National Institute on Alcohol Abuse and Alcoholism: Bipolar Disorder and Alcoholism
- "British Journal of Psychiatry": Cigarette Smoking and Psychotic Symptoms in Bipolar Affective Disorder
