Bipolar Disorder (cont.)
What illnesses often co-exist with bipolar disorder?
Substance abuse is very common among people with bipolar disorder, but the
reasons for this link are unclear. Some people with bipolar disorder may try to
treat their symptoms with alcohol or drugs. However, substance abuse may trigger
or prolong bipolar symptoms, and the behavioral control problems associated with
mania can result in a person drinking too much.
Anxiety disorders, such as post-traumatic stress disorder (PTSD) and social
phobia, also co-occur often among people with bipolar disorder. Bipolar
disorder also co-occurs with attention deficit hyperactivity disorder (ADHD),
which has some symptoms that overlap with bipolar disorder, such as restlessness
and being easily distracted.
People with bipolar disorder are also at higher risk for thyroid disease,
migraine headaches, heart disease, diabetes, obesity, and other physical
illnesses. These illnesses may cause symptoms of mania or depression. They
may also result from treatment for bipolar disorder.
Other illnesses can make it hard to diagnose and treat bipolar disorder.
People with bipolar disorder should monitor their physical and mental health. If
a symptom does not get better with treatment, they should tell their doctor.
What are the risk factors for bipolar disorder?
Scientists are learning about the possible causes of bipolar disorder. Most
scientists agree that there is no single cause. Rather, many factors likely act
together to produce the illness or increase risk.
Genetics
Bipolar disorder tends to run in families, so researchers are
looking for genes that may increase a person's chance of developing the illness.
Genes are the "building blocks" of heredity. They help control how the body and
brain work and grow. Genes are contained inside a person's cells that are passed
down from parents to children.
Children with a parent or sibling who has bipolar disorder are four to six
times more likely to develop the illness, compared with children who do not have
a family history of bipolar disorder. However, most children with a family
history of bipolar disorder will not develop the illness.
Genetic research on bipolar disorder is being helped by advances in
technology. This type of research is now much quicker and more far-reaching than
in the past. One example is the launch of the Bipolar Disorder Phenome Database,
funded in part by NIMH. Using the database, scientists will be able to link
visible signs of the disorder with the genes that may influence them. So far,
researchers using this database found that most people with bipolar disorder
had:
- Missed work because of their illness
- Other illnesses at the same time,
especially alcohol and/or substance abuse and panic disorders
- Been treated or
hospitalized for bipolar disorder.
The researchers also identified certain
traits that appeared to run in families, including:
- History of psychiatric hospitalization
- Co-occurring obsessive-compulsive
disorder (OCD)
- Age at first manic episode
- Number and frequency of manic
episodes.
Scientists continue to study these traits, which may help them find
the genes that cause bipolar disorder some day.
But genes are not the only risk factor for bipolar disorder. Studies of
identical twins have shown that the twin of a person with bipolar illness does
not always develop the disorder. This is important because identical twins share
all of the same genes. The study results suggest factors besides genes are also
at work. Rather, it is likely that many different genes and a person's
environment are involved. However, scientists do not yet fully understand how
these factors interact to cause bipolar disorder.
Brain structure and functioning
Brain-imaging studies are helping scientists
learn what happens in the brain of a person with bipolar disorder. Newer
brain-imaging tools, such as functional magnetic resonance imaging (fMRI) and
positron emission tomography (PET), allow researchers to take pictures of the
living brain at work. These tools help scientists study the brain's structure
and activity.
Some imaging studies show how the brains of people with bipolar disorder may
differ from the brains of healthy people or people with other mental disorders.
For example, one study using MRI found that the pattern of brain development in
children with bipolar disorder was similar to that in children with
"multi-dimensional impairment," a disorder that causes symptoms that overlap
somewhat with bipolar disorder and schizophrenia. This suggests that the
common pattern of brain development may be linked to general risk for unstable
moods.
Learning more about these differences, along with information gained from
genetic studies, helps scientists better understand bipolar disorder. Someday
scientists may be able to predict which types of treatment will work most
effectively. They may even find ways to prevent bipolar disorder.
Next: How is bipolar disorder diagnosed? »
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