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May 28

Stress and Trauma as Risk Factors for Bipolar

bipolarI have long been interested in the relationship between traumatic experiences and bipolar disorder.

A couple of years ago I gave a presentation at the University of California, San Francisco, Bipolar Disorder Clinic on the topic.

I got interested in the issue because I noticed how many of the women in my clinic with bipolar disorder also had childhood PTSD. What I discovered was that many of them (too many of them for this to be a coincidence) had been victimized by a bipolar family member.

Presumably, the reason they had developed bipolar disorder themselves involved an interaction between the genes they shared with that family member and their traumatic experiences.

However, when I tried to find research on the topic I came up empty.

Was it possible that this association only existed in my clinic? I found it hard to believe. And there were hints in other studies that seemed to confirm the finding of an association between trauma and bipolar disorder.

So, I was intrigued by a recent article in Psychiatry News that summarized a study in Molecular Psychiatry that found that the risk of bipolar was more than doubled if someone had a history of traumatic experiences.

Not only was the risk increased, but once a person did develop symptoms, they were more likely to have chronic symptoms.

To quote that article –

…subjects who had incurred physical abuse, sexual abuse, or economic deprivation during childhood were two to three times more likely to develop bipolar disorder than subjects who had not experienced such adversities. And among the some 1,200 subjects who had entered the study with bipolar disorder, such negative childhood experiences were also strong predictors of bipolar episodes recurring. Moreover, past-year traumatic events were associated with a significantly higher risk for both the onset of bipolar disorder and recurrent bipolar episodes.

A strength of this study was that it was prospective (meaning the study looked at the pattern of traumatic experiences at one point in time and then examined how many people later developed bipolar). This is much better data than our own which just showed a surprising correlation. It suggests that trauma can trigger bipolar. And, as the study’s authors point out, suggests that intervention to treat traumatic experiences in childhood could lead to a reduction in severe bipolar mood cycling.

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