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Does stress have any
effect on Bipolar Disorder?
 While
the onset of depression has been well-established in research
literature for many years, most of the focus of literature on bipolar
disorder has focused on the relationship between stressful life events
and the precipitation of episodes among individuals with an
established diagnosis of bipolar disorder, rather than precipitating
the initial onset of the disease.
One
prospective study of persons with bipolar I disorder found no
difference in life events among individuals who became depressed,
others who became manic and those who remained well. The only
difference seemed to be that individuals with manic disorder seemed to
experience more work-related difficulties. Other studies have found
mixed reports as to whether there were increased rates of adverse life
events in the months preceding admission to a hospital for either
manic or depressive episodes.
However, there are several studies that demonstrate a relationship
between stressful life events and affective episodes in an established
bipolar illness. There have been mixed results however, and
methodological problems have made interpretations of studies difficult
and comparison across studies absolutely impossible. Some of the
examples of methodological problems include recall bias in
retrospective designs and sample heterogeneity, definition of onset of
mood disorder, and choice of signal event (i.e. hospitalization versus
onset of episode). Another problem with the studies includes
differences in attribution recall, which can be significantly
different depending upon whether persons interviewed for life events
prior to or after the related episode has commenced.
In
summary, it seems likely that adverse life events are probably
associated with bipolar and other mood disorders, particularly when
those episodes are sufficiently severe to result in hospitalization.
Obviously, in this respect, such life events need to be attended to
and from a theoretical view it is not clear that such events actually
play a positive role in the development of the disease.
From DSM-IV-TR Mental
Disorders: Diagnosis, Etiology and Treatment by Michael B. First and
Allan Tasman
Additional information and
webpage by
Paul Susic MA Licensed Psychologist Ph.D Candidate
(Health Psychology)
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