Bipolar disorder: Family history, triggering situations combine to worsen symptoms

In the extreme, bipolar disorder — formerly known as manic-depression — encompasses moods that can range from extremely energized behavior to sad and hopeless periods.

“People are much more aware of mental health these days, but they don’t always understand it,” said Michael Dicharry, M.D., assistant professor of clinical psychiatry for LSU.

“The word bipolar is thrown around a lot, particularly with kids in college, who may be going through finals. But, lack of sleep and trouble concentrating may lead to yo-yo moods … this is to be expected considering the stress.”

True bipolar disorder, which involves a chemical imbalance in the brain, is typically diagnosed during adolescence or early adulthood.

During mania, people may experience delusions of grandeur, may jump from topic to topic while speaking, and often can’t stop talking in an uninterrupted stream of consciousness, which, says Dicharry, makes others very uncomfortable. Severe manic symptoms may require hospitalization.

Depressive episodes can include feeling restless, sleeping too much, trouble concentrating and a lack of interest in almost all activities. Extreme episodes can involve feelings of worthlessness and even thoughts of suicide. Extreme moods on either end of the manic-depressive spectrum can result in psychosis.

Healthcare providers base diagnoses on symptoms and family history, not brain imaging, although newer research has indicated that the brains of those with bipolar disorder may exhibit differences from those without the disorder.

There’s a genetic component as well, but genes don’t tell the whole story.

“In identical twins, the incidence is only 50%, which means it’s not entirely genetic, and may also come from other genes, as well,” Dicharry said.

“It can be environmental, as well. A study which looked at Syrian refugees who had fled to Scandinavia after relentless bombings in Aleppo indicated increased rates of psychosis because of exposure to constant trauma. So, stress can induce a variety of mental disorders, even psychosis.”