By definition bipolar disorder is a mental illness that is characterized by extreme mood swings that fluctuate between the high of mania and the low point known as depression. Conventional psychological wisdom (that is not an oxymoron) says that to be diagnosed with bipolar disorder a person must have experienced a minimum of at least one manic episode. If such an episode needs to be a thing of the past before diagnosis can be confirmed, at risk factor may prove to be elusive as well before the fact.
The exact cause of bipolar disorder is still unknown although bipolar disorder appears to run in families. A tantalizing association that runs along family lines seems to point to a genetic factor without specifically identifying genetic elements that are responsible for bipolar disorder even in part.
Changes in the levels of brain chemicals called neurotransmitters are also cited as likely causes and possible effects of bipolar disorder. Levels of noradrenaline and serotonin are associated with depression and bipolar disorder. It has also been shown that levels of a third neurotransmitter called serotonin have an affect on mood and mood disorders in general.
The full weight of research seems to suggest that disparate factors combine to produce a chemical imbalance in the brain that at least resembles the way that psychotropic chemicals act on the brain, but doesn’t really come close to mimicking their effects in any meaningful way.
Environmental factors have also been considered as precipitators of the disorder. These include stress, alcohol or drug abuse, and lack of sleep. A particularly difficult environmental factor revolves around family studies that indicate that parental behavior that exhibits symptoms of bipolar disorder can provoke occurrences of bipolar disorder in offspring. Nurture cannot be ruled out as a cause, but in most such cases nature is present as a genetic factor which clouds any definitive conclusions regarding behavioral modelling and bipolar disorders. Dramatic life events revolving around romance, bereavement and employment may also trigger bipolar episodes.
Researchers have also demonstrated a link between hormone levels and bipolar disorder. Hypothyroidism has been shown to produce depression and mood instability, with females particularly prone to experience mood swings at puberty.
Ultimately the 6 million individuals diagnosed as being bipolar in the United States are divided evenly between the sexes with the disorder tending to manifest itself differently along sexual lines. Mixed state episodes and rapid cycling of episodes between manic and depressive is seen more in women whose first episode tends to be a depressive one. By contrast the initial bipolar disorder episode in men tends to be manic.
In perhaps another chicken or egg enigma about 50 per cent of individuals who are diagnosed with bipolar disorder have a drug or alcohol abuse problem. Since these individuals are inclined to self-medicate with these substances after episodes of mania or depression it is difficult to determine whether their bipolar disorder led to their abusing drugs and alcohol or whether drugs and alcohol contributed to their bipolar disorder.