There is strong evidence that demonstrates that the weeks preceding the onset of a manic episode are normally marked by an increase in frequency of stressful life events. Studies have come to the conclusion that stressful life events often trigger relapse among individuals who have successfully recovered from past episodes.
Extroverted Personality in Bipolar Depression
According to research, people who have an extroverted personality are less likely to relapse because these individuals usually have a greater ability to maintain a supportive social network, which is crucial in coping with bipolar disorder symptoms. Research also pinpointed that individuals who are surrounded by an environment high in criticism and hostility are more likely to relapse shortly after they are discharge from the hospital or from a treatment program.
Depressive and Manic Episodes
Most of the psychoanalytic theory concerning the etiology of bipolar mood disorders is of the view that both depressive and manic episodes arise from a low self-concept; depressive episodes demonstrate this. Manic episodes represent a defense against the low self-concept as they act in the opposite direction, a kind of reaction formation. Evidence for this theory has come into light from cognitive research that has shown that bipolar disorder symptoms in a manic episode have higher ratings of self-esteem compared to bipolar patients in a depressive episode. Despite all this, bipolar patients demonstrate lower self-esteem ratings in both manic and depressive episodes compared to unaffected individuals.
Biological Factors
A number of studies have been conducted on the relation between genes and bipolar disorder. Most of the studies are of the opinion that genes play a crucial role in developing bipolar disorder, accounting for around 80% of the variance in vulnerability. The concordance rate for identical twins hovers around 69%, this figure dips to 19% for fraternal twins. There is a much higher risk involved for individuals with a family member who shows evidence of the disorder, yet it is still not clear what exactly is being inherited in terms of particular genes. Among the relatives of bi polar probands, the risk for both bipolar and unipolar mood disorder is much greater compared to individuals in the general population.
NIMH
According to the National Institute of Mental Health (NIMH), there is no one cause for bipolar disorder; instead there are many factors that come together to produce the illness in some people. Since it is believed that bipolar disorder runs in families, scientists everywhere have been conducting research to find the genes thought to have a role in switching on the effects of bipolar disorder. According to research, bipolar disorder does not occur due to a single gene but a number of gene combinations.
Psychological Factors
Psychological factors also play a prominent part in both the psychopathology of the disorder and the psychotherapeutic factors focused at alleviating core symptoms. All factors must be taken into account for treating the illness including the episode triggers, minimizing negative expressed emotion in relationships, finding prodromal symptoms before full-blown recurrence and analyzing the parameters that lead to maintenance of remission.
When standard medication treatment is used in collaboration with evidence-based psychotherapies for bipolar disorder, it increases the time the individual stays well longer than medications alone.
These psychotherapies include interpersonal and social rhythm therapy for bipolar disorder, family oriented therapy for bipolar disorder, psychoeducation and family detection. Some studies are of the view that abnormalities in brain function give rise to feelings of anxiety. Remember that when the situation is tough and there is some chance of stress an individual may have his first major depression.
