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If you have a parent or sibling with bipolar disorder, you may have wondered: Am I at risk too? The truth is, bipolar disorder is one of the most heritable mental health conditions—with research showing a 44 percent to 90 percent increased risk if a close family member is affected. But genes are only part of the picture.
While the answer to, “Is bipolar disorder genetic?” is yes, it’s only part of the picture. Thanks to advances in genetic research and brain imaging, we now know that environmental triggers, trauma, and even brain activity patterns also play a major role in who develops bipolar disorder—and how it shows up.
In this blog, you’ll discover what science says about the genetic connection, plus how understanding your brain can lead to a more accurate diagnosis and more effective treatment.
Non-genetic or environmental factors significantly contribute to the risk of developing bipolar disorder, often interacting with genetic predispositions
Bipolar disorder (BD) is a serious mental health condition characterized by dramatic shifts in mood states and energy levels. These shifts are typically more pronounced than the normal ups and downs most people experience. They are intense emotional states or mood episodes that occur over a distinct period of time—lasting from days to weeks to months.
Formerly called manic-depressive illness, bipolar disorder’s mood states include periods of mania/hypomania (extreme happiness) and depression (sad or low mood). These episodes follow a cyclical pattern. That said, it’s not uncommon for people with bipolar disorder to have periods of neutral mood states as well.
Related: Signs of Bipolar Disorder in Adolescents and Teens
Bipolar disorder’s manic states are characterized as intensely happy or highly agitated with a decreased need for sleep and having grandiose ideas or racing thoughts. The disorder’s depressive states are characterized as having low mood, loss of interest in activities once found pleasurable, and sometimes, suicidal thoughts. (A more comprehensive list of signs of manic/depressive episodes is listed below.)
More than 40 million adults worldwide are affected by bipolar disorder, as well as millions of children and adolescents. The disorder typically begins in young adulthood (late teens to mid-20s), but it can start earlier in childhood or in mid-life as well.
The National Institute of Mental Health (NIMH) reports that about 2.8 percent of U.S. adults had the mental disorder in the past year, impacting males (2.9 percent) and females (2.8 percent). About 4.4 percent of U.S. adults will have BD at some point during their lives.
Bipolar disorder is a serious mental health condition, ranking sixth on the list of the world’s leading causes of disability, according to the World Health Organization.
When left untreated, it can greatly impact a person’s quality of life and can cause major problems such as:
On a hopeful note, research has found that early and accurate diagnosis combined with patient acceptance of the disorder are key to treatment success in many cases of BD.
Press Play to Learn More About What Bipolar Disorder Is
In this video, Dr. Faber, a clinical psychiatrist at Amen Clinics Encino, dives deep into understanding Bipolar Disorder. He clarifies what it is and explores common symptoms.
Click below to tune in.
Bipolar disorder runs in families. People with a parent or sibling with bipolar disorder are more likely to have bipolar disorder, but not everyone with higher bipolar disorder genetic risk will develop it. Also, many genes are involved in the development of the mental health disorder—no one gene can cause the condition.
While research on the rates of bipolar disorder heritability varies, one recent large study published in JAMA Psychiatry found a 44 percent heritability rate for BD. Not surprisingly, research with twins has shown higher estimated rates of heritability ranging from 60 percent and 90 percent.
Additionally, research on families with bipolar disorder suggest that different types of bipolar disorder—for example, bipolar 1 vs bipolar 2—are partly genetically distinct. The risk factor for bipolar 2 disorder is higher in relatives of people with bipolar 2 than relatives of those with bipolar 1. (The different types of bipolar disorder are explained in detail below.)
It’s important to note that many individuals with increased genetic risk for bipolar disorder do not develop the condition. That said, they may be more likely to develop it after experiencing trauma or other stressful life events.
Related: 5 Ways Your Family History Affects Your Mental Health
While genetics play a key role in bipolar disorder, they don’t tell the whole story. Other causes of bipolar disorder include environmental factors, such as trauma, chronic stress, substance use, sleep disruption, and the use of some medications. These factors can interact with genetic vulnerabilities and significantly increase the risk of developing the condition.
Understanding and addressing these non-genetic influences not only helps reduce the risk but can also improve outcomes for those already living with bipolar disorder.
Non-Genetic Risk Factors of BD
This is not an exhaustive list. There are other influencing factors too, such as birth-related factors, infections, and persona and social background.
Bipolar disorder is polygenic, meaning that many genes play a role in its development. In recent years, genetic research has yielded a number of discoveries that are progressing science to potentially develop new treatments to successfully manage the mental health issue.
In terms of psychiatric medication, lithium is currently the main treatment for bipolar disorder. However, it doesn’t help all patients and can have significant side effects
In 2025, findings were published from one of the largest genome-wide studies to date on bipolar disorder. An international team of psychiatric genetics researchers identified 298 regions of the genome (essentially a human’s “blueprint”) containing DNA variations that increase risk and 36 genes suspected to be relevant to it. More research will be conducted on these genes.
A 2022 genetic study involving thousands of people with bipolar disorder helped to reveal new insight into the disorder’s molecular underpinnings. The effort pinpointed a gene called AKAP11 as a particularly strong risk factor for both BD and schizophrenia—the first time a single gene had been identified as having a major impact on bipolar disorder risk.
What’s more, the protein product of AKAP11 was found to interact with another protein called GSK3B, which is a molecular target of lithium and a possible mechanism of efficacy. Isolating the AKAP11 gene may uncover more information about how lithium works and its effects in the body. This, in turn, could potentially lead scientists to identify other therapeutic targets.
Research also suggests that altered calcium functioning may play a role in bipolar disorder. Experts believe that dysregulation of calcium signaling (the process by which cells use calcium ions to communicate) pathways in the brain may contribute to the mood swings and cognitive impairments seen in bipolar disorder.
Other studies suggest the genes CACNA1C and ANK3 are risk factors for BD, as variants of these genes impact neuronal functioning by modulating calcium and sodium channels. However, more research is needed to more fully understand their role and impact in BD.
Signs of bipolar disorder include the following symptoms associated with manic and depressive episodes.
Signs of Manic Episodes
Signs of Depressive Episodes
These symptoms appear at different levels of severity depending on which bipolar type an individual has.
Like so many mental health conditions, bipolar disorder is not a simple or single condition—it manifests in different ways. Mental health experts have identified at least four types of the condition. Knowing an individual’s type is essential for developing the right medication and therapeutic approach.
The types are distinguished by the severity of the symptoms (yet all four types are equally serious):
The great news is that bipolar disorder responds well to proper treatment. However, getting an accurate diagnosis to determine your bipolar type can be challenging. Unfortunately, research shows that 69 percent of patients with bipolar disorder are misdiagnosed initially. And they can remain misdiagnosed for over seven years.
When functional brain imaging, such as the SPECT scans used at Amen Clinics, is part of a comprehensive evaluation, it can aid in the accurate diagnosis of bipolar disorder. Brain SPECT imaging evaluates blood flow and activity in the brain. It shows three things: healthy activity, too little activity, or too much activity.
SPECT scans of people with cyclic mood disorders often show focal areas of increased activity in the limbic system as well as too much activity across the surface of the brain.
Another benefit of a SPECT scan for bipolar disorder is that it can help differentiate between bipolar disorder vs traumatic brain injury. The brain-imaging work at Amen Clinics shows that many people misdiagnosed with bipolar disorder actually have a TBI that has never been properly diagnosed or treated. For these people, healing the underlying TBI can be instrumental in alleviating symptoms linked to BD.
A SPECT scan for bipolar disorder can also help with compliance, which is a common problem for many people with bipolar disorder. When they start to feel better, they don’t believe they have a problem at all and often stop taking their medication.
For many patients, seeing their brain scan helps them accept their diagnosis, stay compliant with treatment, and feel empowered to heal.
Individuals diagnosed with bipolar disorder or genetically predisposed to bipolar disorder have reason to be more hopeful than ever before. With accurate diagnosis and early treatment, good outcomes follow.
World Health Organization survey research shows that the majority of individuals with bipolar symptoms find that treatment helps. And the National Alliance on Mental Illness (NAMI) reports that when serious mental illnesses are addressed with the best treatments, between 70 and 90 percent of individuals have a significant reduction of symptoms and improved quality of life.
Bipolar disorder is influenced by both genetics and life experiences. You may have a genetic predisposition, but trauma, brain injury, substance use, and stress can also play a major role.
Yes. At Amen Clinics, we use SPECT brain imaging as part of a comprehensive evaluation. Brain scans can help identify bipolar patterns and rule out other conditions that mimic its symptoms such as depression, anxiety, or even trauma-related issues.
We believe in a comprehensive approach tailored to your brain. That means combining medication (when necessary) with lifestyle changes, nutritional support, therapy, and ongoing monitoring to improve stability, focus, and quality of life.
Mood disorders, such as depression or bipolar disorder, and other mental health conditions can’t wait. At Amen Clinics, we provide personalized, science-backed treatment plans designed to target the root causes of your symptoms. Our 360-approach includes brain SPECT imaging, clinical evaluations, innovative therapeutic techniques, medications (when necessary), and holistic lifestyle recommendations to promote the health of your brain, body, and mind. Speak to a specialist today at 888-288-9834 or visit our contact page here.
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