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 What is the cause of bipolar disorder? 

bipolar disorder and childrenThe search for the cause of bipolar disorder made very little progress over the first half of the 20th century.  While there continued to be various hypotheses as to the cause of bipolar disorder, research did not seem to confirm their validity.  For example, psychodynamic theorists suggested that mania (similar to depression) emerges from the loss of a loved object.  They stated that while some people introject the lost object and become depressed, others deny the loss and become manic.  In this explanation, in order to avoid the terrifying conflicts generated by the loss, they escape into it a dizzying round of activity.  Controlled studies have not found any systematic relationship between loss and the onset of a manic episode, although some case reports have occasionally seemed to fit somewhat with this explanation.  More recently, biological research has produced some much more promising clues of possible causes of bipolar disorder including research into neurotransmitter activity, sodium ion activity and genetic factors. 

 

Neurotransmitters as a possible cause of bipolar disorder? 

There has been some suggestion that overactivity of the neurotransmitter norepinephrine could be related to mania.  This explanation was suggested by several clinicians back in the 1960s when researchers found a relationship between low norepinephrine activity and unipolar depression.  One research study found norepinephrine activity of persons with mania to be higher than individuals with depression or control subjects.  The blood pressure medicine, Reserpine, was given to patients in one study to reduce norepinephrine activity in the brain and manic symptoms were said to have subsided. 

Because there is often a parallel between norepinephrine and serotonin activity in unipolar depression, some theorists believed that mania may also be related to high serotonin activity, but no relationship was able to be found.  However, research has found that mania like depression may be linked to low serotonin activity.  Researchers found for example, that the drug lithium may actually increase brain serotonin activity.  Lithium was found to be and continues to be an effective treatment for bipolar disorders.  It is now believed that depression and mania both may be related to low levels of serotonin. 

In an effort to somehow reconcile these somewhat contradictory findings, researchers have proposed a permissive theory of mood disorders.  They now argue that low serotonin activity opens the door to mood disorder and permits the activity of norepinephrine (or even possibly other neurotransmitters) to define the actual form the disorder will take.  Low serotonin activity accompanied by a low norepinephrine activity may lead to depression.  Low serotonin activity accompanied by high norepinephrine activity may lead to mania.  These explanations seem to be more in line with current beliefs about the cause of bipolar disorder.  

Subsequent pages will also look at Ion activity and genetic factors as potential causes of bipolar disorder. 

Information from Abnormal Psychology Fourth Edition by Ronald Comer

Additional information and webpage by Paul Susic MA Licensed Psychologist Ph.D Candidate (Health Psychology

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