What are the Major Causes and Symptoms of Bipolar Disorder?

Symptoms of Bipolar Disorder

Mariah Carey. Bebe Rexha. Russell Brand. Catherine Zeta-Jones. What do these celebrities all have in common? They have all gone public with their diagnoses of bipolar disorder. They are among the nearly 6 million American adults who are affected by the condition, which is characterized by extreme mood swings and significant changes in energy and activity levels. Symptoms of bipolar disorder often emerge in a person’s late teens or early 20s but can also occur later in life. What is it that makes some people more vulnerable to this potentially debilitating disorder that is associated with relationship problems, job performance issues, increased risk of suicide attempts, and a decrease of over 9 years in life expectancy?

Researchers have been working for decades to uncover the underlying causes of bipolar disorder and have discovered a variety of physical, emotional, psychiatric, and lifestyle factors that may increase risk.

Researchers have been working for decades to uncover the underlying causes of bipolar disorder and have discovered a variety of physical, emotional, psychiatric, and lifestyle factors that may increase risk. Click To Tweet

Before exploring these potential risk factors, it’s important to understand the basics of bipolar disorder and its symptoms.


Bipolar disorder is also referred to as bipolar spectrum disorder and was previously known as manic-depressive illness. It is a brain disorder that involves both manic episodes and depressive episodes that shift in a cyclical pattern.

Symptoms of manic episodes include:

  • Abnormally elevated mood
  • Inflated self-esteem
  • Decreased need for sleep
  • Increase in goal-oriented activity
  • Grandiose notions, ideas, or plans
  • Increased talking or pressured speech
  • Racing thoughts
  • Inability to “turn off the mind”
  • Poor judgment that leads to risk-taking behavior
  • Hypersexuality or hyperreligiosity
  • Excessive appetite
  • Inappropriate social behavior
  • Irritability or aggression
  • Delusions or hallucinations

Symptoms of depressive episodes include:

  • Persistent sad or negative mood
  • Loss of interest in usually pleasurable activities
  • Feelings of guilt, worthlessness, helplessness, and hopelessness
  • Sleeping too much or too little, or waking up too early
  • Decreased energy, fatigue, or feeling “slowed down”
  • Difficulty concentrating
  • Thoughts of death or suicide, or suicide attempts


Some of the factors that may increase the risk of bipolar disorder include the following:

1. Genetics

Having a family member with bipolar disorder increases the odds that you may experience it. As early as 2007, researchers had identified 2 genes—ANK3 and CACNA1—associated with bipolar disorder. More recent findings in the American Journal of Medical Genetics shows that numerous genetic variations are likely linked to the condition.

2. Emotional trauma

A 2016 review of scientific studies point to traumatic childhood experiences as a risk factor for bipolar disorder and for more severe outcomes related to the condition. Enduring adverse childhood experiences—such as the death of a parent, sexual abuse, or neglect—have been linked to an earlier age of onset of bipolar symptoms and a higher risk of suicide.

3. Substance abuse

There is a high prevalence of addiction in people with bipolar disorder, which is known as comorbidity or dual diagnosis. It appears that the association is a two-way street. Having bipolar disorder increases the likelihood of self-medicating with substances. Likewise, using drugs or alcohol may contribute to the severity of bipolar symptoms. For example, addictive substances may prolong manic or depressive episodes. Specifically, cannabis use was identified in a 2015 review in the Journal of Affective Disorders as a risk factor for bipolar disorder that may cause or exacerbate manic episodes. Alcohol and drugs are also associated with changes in the brain that may play a role in bipolar disorder.

4. High stress

Periods of extreme stress, such as the death of a loved one, divorce, disability, or other life events may trigger the onset of symptoms. A number of studies have found that when stressful life events occur, the following 6 months are associated with an increased risk of the onset of bipolar symptoms.

5. Infections

Some research has found an association between infections, such as T. gondii, and bipolar disorder, although the scientific evidence is mixed.

6. Medical issues

Obesity, migraine headaches, irritable bowel syndrome, and asthma are also associated with bipolar disorder, but it is unclear if there is a causal relationship. It has been suggested that bipolar disorder and these physical ailments may share inflammation as an underlying factor.

7. Mental health issues

A systematic review of existing research indicates that a number of psychiatric issues—including anxiety disorders, panic disorder, ADD/ADHD, conduct disorders, and aggression—raise the risk of developing bipolar disorder.

8. Traumatic brain injury

If you’ve had a head injury, you have higher odds of developing bipolar disorder, according to a 2016 review of 57 studies on TBI and subsequent psychiatric issues. One of the studies included found that people with a prior TBI were 28% more likely to develop bipolar disorder. Brain SPECT imaging can be beneficial in detecting damage from a TBI.

9. Poor sleep

A lack of quality rest appears to impact the severity of manic and depressive episodes, particularly in women with the condition. This finding comes from a University of Michigan 12-year study on 1,100 individuals with bipolar disorder.

10. Gut health issues

This same research from the University of Michigan also found that people with bipolar disorder who are taking antipsychotic medications have lower levels of certain gut bacteria and less diversity of bacteria.

Understanding and treating the various factors that can contribute to bipolar disorder or that increase the severity of bipolar symptoms is one of the keys to managing the condition.

Bipolar disorder and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.


  1. Bipolar is over diagnosed and it’s a big money maker for doctors. You should grow out of it and not have to take medicines for life. The medicines will put you in a grave thirty years early. Often used to cover up sexual assault.

    Comment by J — October 11, 2021 @ 3:35 AM

  2. I know someone who was incorrectly diagnosed as bi-polar & suffered for years under the hands of ignorant psychistrists taking lithium, a variety of anti-depressants (which never helped him) & when he experienced mania- a variety of anti-psychotics which often made him wilder. Then through his parents, who found out about re-diagnosis, he went to see a neruologist (SUNY) for a B.E.A.M.; a neuro-psychologist for a Halsteid-Reitan; then tests under a psychiatrist. All there concurred that this U.S. Military Veteran who was diagnosed by first U.S. Army then VA psychiatrists with bi-polar;; was NOT bi-polar but had TEMPORAL LOBE EPILEPSY. The psychiatrist took him OFF lithium & the current anti-depressant and placed him on CARBAMAZEPINE. The psychiatrist said: “Any one who says you are a bi-polar is ignorant & does not know what they are doing!” Even if we did not give him the battery of tests; the fact that lithium, anti-depressants & anti-psychotics DO NOT WORK but that anti-convulsants do are proof he is NOT bi-polar. That U.S. Army Retired Captain was doing poorly & heading to a group home; instead, due to the CORRECT DIAGNOSIS (not bipolar) he started functioning well= went back to graduate school=and he is a Licensed Mental Health Counselor in the State of Hawaii. I know him well because Dr. AMEN I am that person. Had I lingered in the VA system as a bipolar taking the lithium, anti-depressants & anti-psychotics I would be living in some group home depressed & without hope! I am convinced that that psychiatrist is correct: IF the traditional lithium, anti-depressants & anti-psychotics DO NOT WORK & the anti-convulsants do (like Depakote, Carbamazepine & others) then that is PROOF they are NOT BIPOLAR but have TEMPORAL LOBE EPILEPSY..However, the multi trillion dollar drug industry (for anti-depressants & anti-psychotics) would fight you tooth & nail because they are stronger than R. J. Reynolds (cigarettes). IF 10-20-30-40% or more people with a BIPOLAR DIAGNOSIS were rediagnosed as having TEMPORAL LOBE EPILESY & all they needed for meds was anti-convulscents then the trillion dollar drug industry for anti-depressants & anti-psychotics would be devastated. I know the aforementioned medications help some people but most who take them are more likely, like me, to be “bound” by them !

    Comment by MICHAEL Henry QUAY — October 11, 2021 @ 4:59 AM

  3. Thanks for another great article.

    Comment by Timothy Lee — October 11, 2021 @ 5:23 AM

  4. Excellent article. Never knew factors other than hereditary.

    Comment by Holly Weiss — October 11, 2021 @ 5:52 AM

  5. Having a head injury as a young child, coupled with the death of my father at age 11 yrs. were two factors in my disorder, however, I have lived with it for over 60 years and have never used any illegal drugs, and keep my weight the same as in high school (100 – 110). It is possible to live with this disorder, graduate from college, and lead a pretty exciting, eventful life.

    Comment by Mrs. Ferris S.Whitfield — October 11, 2021 @ 7:23 AM

  6. how sad!

    Comment by Doug Morris — October 11, 2021 @ 8:29 AM

  7. And probably something to do with low progesterone.

    Comment by a f — October 11, 2021 @ 9:22 AM

  8. A 19-year-old friend had COVID in winter 2020, then developed long COVID with severe headaches, brain fog, etc. for months. His first bipolar (manic) episode began in August 2021 – the episode hasn’t ended. He was involuntarily hospitalized twice in September.

    Could COVID / long COVID (perhaps due to brain swelling) be a trigger for bipolar illness? Would this affect his prognosis?

    Comment by Pam W — October 11, 2021 @ 10:27 AM

  9. Our son was diagnosed with bipolar disorder by a local university hospital psychiatrist, less than a year ago. This diagnosis came months after he graduated with an engineering degree, during our states lock down for Covid last year. He was called in for interviews, but no job fit his specialty. At that time, his girlfriend’s minister told them not to date each other, and yes, this was an overstep by the minister. He then worked overtime for Amazon during the busy Christmas season enabling him to make student loan payments. In addition, our son’s newly acquired interest in a specific online investment app, became the center of an historic crisis, when frozen briefly, due to ‘market volitility’. This event was covered by every media outlet. However profitable for him, our son, risking all savings, was stunned by the intensity of that situation (as we all were). He had, what I refer to as a major anxiety attack. We took him to Amen Clinic. Our Dr., found little support for the bipolar diagnosis. But continued to give him almost the same meds prescribed by the university. He became unmotivated and was not himself. After several months, he stopped taking the meds, has become more engaged, goes to the gym more often, but is not actively seeking employment, lives off the profit from the investment. He plays video games with his roommate most days when he is not doing things with church. He and his girlfriend still talk. He does have a few of the risk factors listed here including emotional trauma from childhood. He says he’s grown tired of therapists, because he’s looking for specific results and gets discouraged when he does not see improvement in himself. His SPECT scan did not show bipolar patterns, and we do not see a pattern of bipolar behavior in his life, except when triggered by events that would seem to be universal triggers. I don’t know exactly how to respond to this article, but, I do agree with one who responded, M.H. Quay, in that bipolar is over diagnosed. And it seems to be trending as a diagnosis these days, as well as the meds could create quite a profit for those who want to throw medication at the problem without treating root causes.

    Comment by Marie — October 11, 2021 @ 1:04 PM

  10. My son was diagnosed bi-polar in fall 2017. Many meds later, alcohol addiction, and completing alcohol rehabilitation – he passed away unexpectedly January 2021. He was 40 years old, working as a certified arborist, and left a 6 year old son whom he loved very much.
    I so wish I had known about the Amen Clinic in Chicago area. I found out around the same time as his death.

    Comment by Patricia Hoffman — October 11, 2021 @ 1:20 PM

  11. As a licensed professional counselor, it is the one thing I struggle with the most. It is over DX and is given to doctors that see women with borderline personality. When emotionally dysregulated, the DX can be thrown at you and then the majic pill is prescribed. No pills treat personality symptoms such as emotional dysregulation. It is also given to many of my clients that have suffered trauma, all kinds. I was told by one psychiatrist that I worked will with , ‘you have to have been hospitalized’ and another psychiatrist says, ” You can have only one manic episoders”. ( I think this refers to inability to sleep for four of more days).
    I would be very interested in what a SPECT shows in the brain vs a brain with major depresson or trauma. I think people are very wise to not accept the opinion of one psychiatrist but to find others for evaluation. The medications have varying negative side effects.
    Thanks for the article and the comments!

    Comment by susan — October 11, 2021 @ 3:34 PM

  12. Our son was diagnosed with bi polar recently after a series of depressive episodes and manias.
    He has fought taking medications and the last episode of depression lasted over a year and a half. He realizes now he is one of those people that will get worse with no medications and he has had a lot of support and therapy etc- and any one who says they can get through this diagnosis without trying medications needs to really think and speak carefully to a community where every person is different and needs for some are greater than others . I thank god every day our son is still alive and is thriving … we don’t know what tomorrow will hold but we know and more importantly he knows that he needs medications for a healthy life.

    Comment by JANINE — October 11, 2021 @ 6:23 PM

  13. Hi
    MICHAEL Henry QUAY is there a way to contact you because one of my family members has similar issue and is diagnosed as bipolar but the medication is not working
    Thank you

    Comment by Susan — October 12, 2021 @ 1:59 PM

  14. I’m diagnosed with bipolar type 1 & it’s not possible to describe how hard it is to live with. Some of these comments, in particular the first one stating a person should just grow out of it, are why I deal with it completely alone. I do my absolute best to live well but would give anything to have someone understand. It’s taught me to live with a great deal of empathy for others because we have know idea of the silent battle some people fight within.

    Comment by Melinda — October 21, 2021 @ 5:26 AM

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