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Bipolar disorder

What causes bipolar disorder

As with many other diseases, bipolar disorder does not have one specific cause, but is brought on by several contributing factors.

Studies have shown that bipolar disease is significantly more likely to affect people who have a close relative who suffers from it. That does not mean that a person will undoubtedly have the disorder if one of their parents is affected by it, nor does it mean that the disorder is definitely passed on to the children.

There is no definitive and unequivocal explanation about the role of the brain and neurotransmitters.
The disease has been associated with low or high levels or incorrect ratios of neurotransmitters like dopamine, norepinephrine, and serotonin in various parts of the brain. The disorder has also been linked to excessive levels of the stress hormone cortisol, or the increased sensitivity of neuron receptors in certain regions of the brain.

Studies have also shown a link to thyroid disorders.
Brain scans have shown functional changes associated with bipolar disorder in the frontal and temporal lobes and the basal ganglia.
Differences in the circulation and the structure of the regions of the brain which regulate mood and impulse control have also been demonstrated.

One of the key symptoms of the mania and depression phases is disordered sleep rhythms. Insomnia may be a triggering factor for mania, and it can certainly perpetuate or exacerbate that state.

As with many other diseases, stress-inducing life changes, such as changes in close relationships, work, or changing schools, may be a risk factor for bipolar disorder.

Treatment of bipolar disorder

The treatment strategy may vary between phases, but one should take into account that the treatment will last for a long time, meaning years as a rule, and require constant monitoring of one’s condition and mood changes.

Medications

Medications help to stabilise the mood and control the symptoms. Mood stabilisers, antipsychotics, and less frequently antidepressants combined with other medications are used for treatment

Psychotherapy

The choice of psychotherapy depends on the condition, the phase of the disease, and personal preference. Working with a doctor or psychologist, the patient can choose between educative therapy, cognitive behavioural therapy, family psychotherapy, or, in the stable phase, psychodynamic therapy.

How can I help myself?

The key is to observe your moods – how they change and what you and others notice in situations where your mood starts to become elevated or depressed. The important thing about bipolar disorder is to keep your mood in balance – the aim is to stay on level 0 (see figure), where your mood is at its most regular and stable.

Analyse yourself

… and write down how you are feeling, what you are thinking and doing in the different mood phases – when your mood starts to become elevated or depressed. Ask your close friends and family members to help you – they may have noticed some things that you may not be aware of.

Put together a plan of action

– Put together a plan of action – a list of things you can do to keep your mood balanced. Ask your close friends and family members to help you to find solutions. When you are in a depressed mood, read the section on depression

Here are some suggestions for the mania period:

Oh lovely, sweet mania!

You would like to go, do, talk, organise, nothing can stop you…

STOP! Mania is followed by depression. During the mania period, you do things that you would normally never do. Medications and therapy will help you to keep your mood stable. You can help yourself by learning to behave in less self-damaging ways during the mania period.

Put together a plan!

  • Keep your wallet ‘empty’ – do not keep cash in the house and set your bank card limits to minimal. Ask your friends or loved ones for help with financial planning if necessary.
  • Get some exercise, move around – that helps to exert energy, and will also help to prevent depression and relieve stress.
  • Learn something new – using your energy to obtain new skills/knowledge is better than doing something risky.
  • Be honest with yourself. During mania, you feel very powerful, superhuman. Remind yourself of who you really are. Although you may enjoy being a superhero, you are still human. There are things in your life that you like, people who care about you and whom you love.

And finally: no matter how good you may feel during the mania phase, that feeling will not last. It will pass and you will feel normal again; you may possibly fall into depression. Do not stop taking your medication during mania. Mania is temporary, but its consequences may not be.

Daily mood monitoring

Fill this table out daily, or more often if someone notices changes in your mood. If you observe your mood changing too often, come up with a plan of action.