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