Understanding the Causes of Bipolar Disorder

Learn About the Possible Causes of Bipolar Disorder

Struggling with mental health
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Can bipolar disorder be caused by a shortage of lithium in the brain or dog bites in childhood? Not surprisingly, there is a great deal of misinformation to be had when it comes to talking about the possible causes of bipolar disorder. To add to the confusion, scientific research continues to publish new information and theories. 

Theories of the Cause(s) of Bipolar Disorder

Has anyone found the true cause of bipolar disorder?

Unfortunately, there is no simple answer. Most scientists believe that mental illnesses are caused by a combination of several factors working together. In bipolar disorder, these factors are usually divided into biological and psychological causes. In other words, the main reasons mental illness develops are physical (biological) and environmental.

Possible Genetic Factors of Bipolar Disorder

When talking about biological causes, the first question is whether bipolar disorder can be inherited. This issue has been researched through multiple families, adoption, and twin studies. In families of persons with bipolar disorder, first-degree relatives (parents, children, siblings) are more likely to have a mood disorder than the relatives of those who do not have bipolar disorder. Studies of twins indicate that if one twin has a mood disorder, an identical twin is about three times more likely than a fraternal twin to have a mood disorder as well.

In bipolar disorder specifically, some studies have put the concordance rate (when both twins have the disorder) at 80 percent for identical twins as compared to only 16 percent for fraternal twins. This is important for genetic theories because identical twins occur when one fertilized egg splits in two, meaning that they share the same genetic material.

Fraternal twins, on the other hand, come from separate fertilized eggs, so their inherited genes can be different. There is overwhelming evidence that bipolar disorder can be inherited and that there is a genetic vulnerability to developing the illness.

The Relationship Between Neurotransmitters and Mood Disorders

However, exactly what is inherited? The neurotransmitter system has received a great deal of attention as a possible cause of bipolar disorder. Researchers have known for decades that a link exists between neurotransmitters and mood disorders because drugs that alter these transmitters also relieve mood disorders:

  • Some studies suggest that a low or high level of a specific neurotransmitter such as serotonin, norepinephrine, or dopamine is the cause.
  • Other studies indicate that an imbalance of these substances is the problem, i.e., that a specific level of a neurotransmitter is not as important as its amount in relation to the other neurotransmitters.
  • Still, other studies have found evidence that a change in the sensitivity of the receptors on nerve cells may be the issue.

In short, researchers are quite certain that the neurotransmitter system is at least part of the cause of bipolar disorder, but further research is still needed to define its exact role.

Stress Triggers and Bipolar Disorder

For mental, emotional, and environmental issues, stressful life events are thought to be the main element in the development of bipolar disorder. These can range from a death in the family to the loss of a job, and from the birth of a child to a move. It can be pretty much anything, but it cannot be precisely defined, since one person's stress may be another person's piece of cake.

With that in mind, research has found that stressful life events can lead to the onset of symptoms in bipolar disorder. However, once the disorder is triggered and progresses, "it seems to develop a life of its own." Once the cycle begins, psychological and/or biological processes take over and keep the illness active.

The Bottom Line

When we look for the cause of bipolar disorder, the best explanation according to the research available at this time is what is termed the "Diathesis-Stress Model." The word diathesis, in simplified terms, refers to a physical condition that makes a person more susceptible than usual to certain diseases. Thus the Diathesis-Stress Model says that each person inherits certain physical vulnerabilities to problems that may or may not appear depending on what stresses occur in his or her life. 

So the bottom line, according to today's thinking, is that if you have bipolar disorder, you were likely born with the possibility of developing this disorder and something in your life triggered it. However, scientists could refine that theory tomorrow. The one sure thing is that they won't give up looking for answers.


  • Akiskal HS. Mood disorders: Clinical features. In BJ Sadock et al., eds., Kaplan and Sadock's Comprehensive Textbook of Psychiatry, 9th ed., vol. 1, pp. 1693-1733. Philadelphia: Lippincott Williams and Wilkins  (2009).