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So far, we don’t know much about the cause of manic depression, but it’s clear that it is an interplay of genetic vulnerability, individual development, and contributing psychosocial factors prior to an episode.

Studies of family members, twins and adoptions have shown that genetic factors play an important part in the development of bipolar mood disorders. However, the exact details are not yet clear. The inheritance is polygenic (involving multiple genes) and very complex, so many questions are still left unanswered.

Heredity and the desire to have a child

People who are diagnosed with bipolar disorder, often ask about the heredity of the condition when they want to have a child. Let’s look at the numbers. The chance of a child who also has depression or bipolar mood disorder later in life is about twenty percent if one of the parents has (had) this. This is higher than average. When both parents have a mood disorder, the probability goes up even more.

The advice on whether or not to have children depends on several factors, such as the risk of relapse and its expected severity. Besides this, it is important to consider if pregnancy and parenthood are not too demanding for the parents. And who in their social circle could support them?

Triggering factors

Episodes can follow after a stressful event, but also come without a clear trigger. Changes in the day-and-night routine (for instance because of working late shifts, being awake overnight or jet lag) can stimulate the development of mania or depression. Severe mood swings, just like with psychosis, can also be triggered by a physical illness or the use of drugs, alcohol, or certain medication.

Logo Ralph Kupka PsychoseNet

Prof. dr. Ralph Kupka is professor of Bipolar Disorders at Amsterdam University Medical Center, and clinical psychiatrist at two large mental health centers: GGZinGeest in Amsterdam, and Altrecht in Utrecht. He is chair of the Dutch Foundation for Bipolar Disorders (KenBiS) and Vice-President of Education of the International Society for Bipolar Disorders (ISBD).

Ralph has been active in national and international research consortia of bipolar disorders since 1995, and chief editor of the first Dutch handbook about this illness. He has chaired guideline committees and is board member of AKWA, the quality institute for mental health in the Netherlands.

Read more about Bipolar disorder:

Source: Kenniscentrum Bipolaire Stoornissen (Dutch website)