Are People Born with Bipolar Disorder?
I’m not sure that I was born with bipolar disorder. I might have been. I might have been born with such genetic predisposition that no matter what happened I would have bipolar disorder. Or I might not. I really don’t know and science isn’t in a position to tell me.
But like with most things mental illness, there is a debate about it. Are people born with bipolar disorder?
Heritability of Bipolar Disorder
Of course, I had the genetics for bipolar disorder passed down to me from my father. Having a parent with bipolar disorder increases your chances of getting bipolar dramatically.
- The chances of bipolar disorder when one parent has bipolar – 30-305%
- The chances of bipolar disorder where both parents are bipolar – 70-75%
- When one twin has bipolar, the chances of a fraternal twin having bipolar disorder – 14%
- When on twin has bipolar, the chances of an identical twin having bipolar disorder – 65% (range: 33-90%)
The average person’s chance of having bipolar disorder is 1%.
(So people who say bipolar disorder isn’t genetic are loopy.)
Are People Born with Bipolar Disorder?
But of all those above people, only about 0.2-0.4% of children have bipolar disorder so most of those people won’t develop bipolar disorder until they are adults (although many show signs in adolescence).
So, as a doctor once explained to me, it’s like marbles in a jar.
When you’re born, you’re born with a jar and your risk of mental illness is the marbles inside the jar. Some people are born with very few marbles as they have little genetic risk passed down to them. Then, as life progresses, stressors, which we know are risk factors for mental illness, put more marbles in the jar. You might have had a stressful birth (yes, really a risk factor), you might have been abused or maybe you were severely bullied. In go the marbles to the jar.
For most people, the jar continues to hold the marbles just fine. And better yet, you can even take marbles out of the jar with things like therapy and other coping strategies.
But for some people, the risk factors just keep coming until, well, they lose their marbles.
And losing your marbles is more common in people with high genetic risk as those people start with a whole mess of marbles in their jar to begin with so it doesn’t take much for them to run out of space.
So is it possible for you to have so much risk that you’re born with bipolar disorder? Theoretically yes, in the minority of cases, some people might be just born that way with no help from the environment at all.
Are You Destined for Bipolar Disorder?
But even if you’re not born with bipolar disorder, I suspect some people are so heavily burdened with genetics it’s mostly a forgone conclusion anyway but maybe these people won’t develop symptoms in childhood. After all, none of us makes it into adulthood without suffering some traumas. Life is unpredictable for all.
Does the Cause of Bipolar Disorder Matter?
Well, certainly to researchers it does, and it should, but for any individual I would say no, not so much. Because whether you jar was full of genetics or other risk factors for mental illness, the fact is you’re stuck with bipolar disorder now anyway. The thing to know is that being born with a disorder doesn’t make it any more or less real than one you developed along the way. And saying “no one is born with bipolar disorder” is just another way of trying to suggest that bipolar disorder is a “less-than” illness or trying to blame someone for causing your mental illness.[pull]After all, no one knows why someone who smokes all their life escapes cancer while the person with an über-healthy lifestyle dies of cancer at 34.[/pull]
Well, no one did. You didn’t cause your bipolar disorder and neither did any other one thing. Mental illness is complicated and no one knows where their marbles all come from. The causes don’t have to be genetic, and the causes certainly don’t have to be known, for a disease to be real.
After all, no one knows why someone who smokes all their life escapes cancer while the person with an über-healthy lifestyle dies of cancer at 34.
And bipolar is the same. No one really knows why some of us end up sick and others don’t. But that doesn’t make it less real, less devastating or anyone’s fault.
Greg Mercer - May 1, 2013 ←
Thanks Natasha for your great work. You make a strong case, but need to consider it’s weak side. If we rely on genetics for legitimacy, you may leave out most people with Bipolar. A majority of folks with Bipolar – likely a group of related illnesses we haven’t teased apart yet – will have no parental history of it. Here’s why: take 100 thousand people. 1% have bipolar : thus 1000; 99 thousand do not. Of Bipolar parents, assuming same number of kids per parent across the board (one for simplicity), 300 to 750 have Bipolar (using your stats , 30 to 75%). Of not bipolar parents, 990 develop Bipolar: 1% of 99k. So despite the high genetic predisposition, a solid majority of Bipolar folks will lack parents with bipolar, yet their illnesses are just as real and worthy of consideration & treatment, right? We could assume the genes are there from past generation so, but we need not have solidly proven cause(s) to take an illness seriously, as we have just as little knowledge of causes for most medical illnesses, like diabetes or HTN or most cancers. I argue that as long as we feel compelled to offer more solid ‘proof’ of legitimacy than folks with other illnesses do, we will never fully defeat stigma, as we’re setting ourselves up from failure, scientifically, for some time to come.
Helen Quinn - April 22, 2013 ←
I believe that it is very important to be knowledgable about familial dispositions if possible. I am 63. Had I known about my mother’s family’s Long predisposition to mental illness of all sorts, I and other descendants could have advocated for our illnesses decades ago. Now I see how very ill my mother was throughout her life and how that influenced my life. In 1960 at age 10, I was diagnosed with clinical depression at the University of Minnesota. However, kids weren’t. Treated then. I was told to get back to school the next day. My mother was “treated” for my illness. In a sense, I learned from that to overcome enormous obstacles and succeed in my personal and professional life until I quite literally hit the wall in my early 40′s. I had episodes before that and took medication but always made my way back without missing a step. At one point after my fall, a psychiatrist asked to do a case study of her family beginning in the 1850′ when they began immigrating to this country. I refused. Then my fairly young children saw their mother destroyed. Once I reached a remission of sorts, I began researching everything I could find about that family… For the sake of my children. My son, 33, has had bouts of depression, BUT he knows that he should seek help and can feel better. In summary, if one plans to have children, learning about mental health history just like learning about predispositions to cancer and the like is vital. Please show your love by watching and teaching in a gentle but serious manner.
Annette Monckton - April 2, 2013 ←
Thank you all for taking the time to share your knowledge and life experiences. I have been completing a far bit of research into Bipolar due to an experience I encountered in the middle of the year 2012. After a friend was diagnosed with a rare form of aggressive breast cancer, I felt compelled to help her in any way I could. Inadvertently as a result of sleep deprivation I ended up having a manic episode. However the doctors didn’t take the time to understand me or the full picture. I was actually testing some psychological theories for myself at the time ,or a book I was developing.
The medical profession were quick to label me with bipolar and throw drugs at me. Other than the manic episode I didn’t have any other symptoms and I knew how I travelled into a different mental state. Basically my body produced natural adrenaline to cope with the lack of sleep and I became addicted to that to a degree and lost control of my behavior. I was detained and trapped in a psyche ward for 3 weeks. The doctors said I had improved and was making great progress however they didn’t know that I had not been consuming the medication. Unfortunately because they didn’t take the time to assess me properly or listen I had to fend for myself. I kept most of the tablets, had recorded consults with the psychiatrist and observed what was happening around the ward during my hospital stay. I didn’t have a problem with being labelled bipolar and having a mental illness. I had a problem with taking medication I did not need.
I’m no doctor but I was able to prove for myself that sleep is vital for maintaining a healthy mental balance. I also believe that if emotionally challenged it can create an imbalance. I was able to prove that for me the imbalance was created by adrenaline due to sleep deprivation. It wasn’t a physical biochemistry imbalance lurking in my mind or a disease. There are no conclusive tests to confirm bipolar and it’s all based on behavior. If the medical profession do not assess all components of a persons life it can lead to an incorrect diagnosis. In 1973, homosexuality was delisted as a mental illness, seems absurd that it was one in the first place. Obviously people didn’t fit society’s mould and were deemed mentally ill.
I have no doubt that people suffer mentally but I do think it can be a little misleading for the medical profession to label people with an illness that can not be conclusively proven. I do believe some people require medication to assist them to achieve a healthy mental state however dealing with the emotions and developing strategies to cope would provide a better collective result than the current treatment on offer today. What I witnessed was a merry go round of drugs and some of these actually caused the very symptoms that the doctors were trying to treat. One vicious cycle and a ward of depressed lost souls. It was heart breaking for me to watch and since writing my book, I have been actively offering a different insight in the event that it helps others. If you’re interested in the book, it called Crazy Normal, Normal Crazy! By Annette Monckton and can be purchased from http://www.lulu.com.
Wishing you all a life of love, laughter and happiness.
silver price - September 3, 2012 ←
Yet the evidence to date suggests that a high number of artists and writers, far more than could be expected by chance, meet the diagnostic criteria for bipolar disorder.
Catherine Simmons - August 31, 2012 ←
Like you say Natasha, there is no reason to blame anyone..feeling guilty definitely doesn’t help the here and now. But, Bipolar Disorder is a set of symptoms and it’s very useful to try and find out what the “marbles” might be for any one individual; this way you can have a patient centered approach to treatment and spend less time on the trial and error approach which is very upsetting for everyone involved!
I found this link useful, especially with respect to the hormonal influences which are felt by folks who are diagnosed later in life (this could also help explain in some cases why people become resistant to drug therapy over time, and have to try something new) :
http://www.mcmanweb.com/epigenetics.html
Twiddle - August 31, 2012 ←
Got my diagnosis in my early 40′s but knowing what I know now about bipolar, I’d say it manifested initially when I was a pre-teen. For potential future treatments it’s a good question and I suppose some people want to know but for me it’s about the here and now. :)
Natasha Tracy - September 2, 2012 ←
Hi Twiddle,
Yup, I’m more about the here and now myself, but I think this question, and the associated answer, sometimes brings comfort to people.
- Natasha Tracy
randall ross - August 30, 2012 ←
i was 3 yrs of age and telling my mother i wished i could die and end the feelings i had all mixed up in my head no sleep for days then depression . i had no freinds to speeck uf never really have . all they want is what would do.
Natasha Tracy - September 2, 2012 ←
Hi Randall,
I’m sorry to hear you have gone through that. I can’t imagine how hard that is. All I can tell you is that other people have lived through that type of childhood and come out the other side. You’re not alone.
- Natasha Tracy
Richard - September 6, 2012 ←
I posted here before, and I made the mistake of attacking people. We all have to love each other and be strong. A few days ago somebody where I live slipped me an herbal drink that smelled a little bit like chocolate but had a dangerou undertone to its smell and I was not aware of what it was. He told me what it was when I started feeling funny and I condemn him for doing this to me but I love him still. I strongly condemn hallucinogens and I do not recommend anybody taking them for the likely possibility of having a psychotic break or developing a terror disorder. I escaped unscathed but only because I had a partner to talk to and tell her what was on my mind. If she were not there I strongly believe I would be a vegetable and in a mental hospital today so I hope you understand wat I’m saying. It was not weed or mushrooms or acid and I will not tell you what it was. Under that influence I felt the love of my dad and mom as a child and choked up. I felt like it was when my mom commited suicide and I cried but it was not overwhelming. There were some problems and fight and I wish there was nothing but love in every instance but sometimes you can’t help questioning things and it’s not good to question things especially undr the influence. I had a problem that was not recognized as a mental illness and medication could not help but therapy could. This was why I was placed in a mental hospital but I was not insane. I had an annoying problem but I could function. You see youalways have to defend your mental integrity under any circumstances. But all the deception of the hospital made me crumble under the influence and I felt sheer terror beyond any magnitude and more than I ever experienced. I felt I was in danger of going insane. Faily problems kept breaking me from good feeling and I realized that for some time in the past I allowed myself to question too much and be panicked. If you realize any problem in the past get therapy or talk to people and do not take this substance. You cannot allow your mind to entetain conspiracy theories under the influence. You see under the influence I started to panick and I told myself I didn’t want to go back to the hospital and I had to support my partner. Luckily she was there. I did not tell her that i needed help only that it was a strong substance. I talked to her about what I was feeling and that we all need to love each other and that helped. You see after I panicked and before I talked to her I was walking down the hall and I was disturbed to notice tat the walls were vibrating in and out very rapidly. But I stabilized went to sleep and woke up still feeling a little funny but I recovered after a day. Taking this substance opened me up and made m feel love forget about my problems and made me feel like I used to feel when everything was great. Another thing was that it opened me up sexually and I experienced sex greater than I ever felt and had the strongest orgasm of my life. I hope it’s ok for me to say that. But I cannot sign off on this substance which although it’s natural I discovered it’s a schdule III drug. If you do support it be aware that is possibly illegal. I will say one thing that although this country often says it’s founded on freedom it needs to be founded on love and we need to wipe out any deception through love. I will say one other thing that it is my belief that mental illness and psychosis and depression mania panick or anything can be cured by people reaching out to you and for you to reach out to others. I don’t believe any mental illness is so far gone that love and understanding cannot cure. That is my belief. [moderated]
Natasha Tracy - September 6, 2012 ←
Hi Richard,
Everything you’ve said is just fine and your experience but I had to moderate out your email address as I don’t want people leaving that kind of personal information here.
Thanks.
- Natasha Tracy
Flabbergasted Mom - August 30, 2012 ←
Thank you Natasha.
:)
Janet Singer - August 30, 2012 ←
This is one of those posts where the word Bipolar could be replaced by OCD and it would still all ring true…..the same thoughts and issues arise. Is it genetic? Is it our fault? Are we born with it? I love your analogy with the marbles. That is an easy-to-understand explanation for anyone who’s interested. Thanks for another great post.
Natasha Tracy - September 2, 2012 ←
Hi Janet,
You’re welcome :)
I totally agree. This is true for any mental illness and probably many illnesses in general. I do love the marble analogy, which is why I shared it. I think it’s something we can all visualize and understand.
- Natasha Tracy
Elaine - August 30, 2012 ←
Funny enough my Psychologist and I were just discussing this yesterday. I definitely have a genetic predisposition as I’ve seen bipolar attributes in my mom, and it has been diagnosed in my dad’s family too. My 6 year old daughter is showing some very soft symptoms, but I’d hate to label her this young
But with all that there was a ton of marbles that were added growing up, and I think those more than anything else contributed to where I am today. The good news is those marbles are much easier to beat than the genetics. It also gives me hope that I can get so much better that the biological effects of bipolar will be managed fully with medication.
I think a lot of time people don’t do well on medication alone because we dismiss those other factors.
Thanx for your great blog
Elaine
Natasha Tracy - September 2, 2012 ←
Hi Elaine,
It is helpful knowing that we can take some of our “life” marbles out and the good news is that you can hopefully avoid adding those types of marbles to your daughter’s jar.
Regarding your daughter, I would recommend you get a book on parenting a child with bipolar disorder. Your child absolutely might not be bipolar but maybe knowing about it now, can help you parent in a way that can avoid it or lessen it, if it comes, in the future. This isn’t my area, personally, but there are books on this subject: http://www.amazon.com/s/ref=nb_sb_noss?url=search-alias%3Daps&field-keywords=bipolar+children
- Natasha Tracy
Debra - August 30, 2012 ←
For me it doesnt matter so much whether I was born with it or just had genetic flags for it. What does matter is today and how to make it as well as it can be.
Though if they do find genetic markers it could mean something wonderful in the future. It could be that they treat the marker preventing many would be bipolar later on life.
Natasha Tracy - September 2, 2012 ←
Hi Debra,
I tend to agree; I’m not about the here and now, personally. But the answers to these fundamental questions help put some people’s minds at ease. And, of course, as you said, the answers are important to researchers and possibly future patients.
- Natasha Tracy
randall ross - August 29, 2012 ←
i was born with it now i suffer bipolar 1 i have no idea what normall is its no big deal i guese
Sarah - August 28, 2012 ←
I have fun with this one. When among friends, if the topic of someone I dislike from the past comes up, I say that the offending person has given me bipolar disorder. I wasn’t born with this off sense of humour. It’s something I acquired along the way.
Flabbergasted Mom - August 28, 2012 ←
I was only diagnosed with bipolar this summer, in my 40th year and I’ve been battling with question since the diagnosis because this is the one question I wanted an answer to. Was whether or not I am “to blame” for having this new-to-me diagnosis or if this diagnosis is something that has been somehow missed since I was first diagnosed with severe depression at the age of 18 and then with all my subsequent and additional diagnoses since that point.
But if even a traumatic birth can be a factor, then perhaps i really did have no chance to avoid this at all and I can stop blaming myself.
I just find the lack of concrete answers disconcerting. If there were where physical ways to diagnosis and monitor I feel like I could be more open about the whole process and then it wouldn’t have to be an invisible disability anymore and maybe we’d get more respect from the people we deal with, especially the professionals.
Sorry for the vent – your post just opened me up.
KG - August 29, 2012 ←
Flabbergasted, I’m 42 and learned I’m Bipolar ten months ago. I, too, was misdiagnosed with Depression at 18. My support group is full of people whose condition was also missed until later in life, so you’re in good company.
I feel I was born with a strong predisposition (I had anxiety issues from the get go) and had a sibling who was full on manic as a child. In talking to one of my cousins, I learned there’s a lot of Bipolar on that side of the family tree. The other side has some stuff going on as well.
My 19 yo manifests some Borderline and Bipolar symptoms, and started with anxiety as I did. As a parent, I naturally weeded out some of the biggest contributing factors to my mental health issues, and the kid went off the deep end eventually anyway. Modern life stresses an anxious introvert out, period. One way or another, I was going to snap. He was going to snap. I’m relieved he snapped before he could lay waste to his adult life, while the stakes are still fairly low.
Though not often, I’ve been told I obviously brought on my mental health problems myself. It’s untrue, unfair, and uninspiring. It also ignores the years I spent in and out of therapy trying to get to get help. I will not allow anyone in my life who thinks and speaks to me like this, it’s like telling me I caused my nearsightedness and can only blame myself for requiring corrective lenses. The right people respect honesty and sincere self-management effort. And the person who needs to be the most honest, sincere, compassionate, accepting, and understanding person in my treatment plan is me.
Flabbergasted Mom - August 30, 2012 ←
KG,
Is it strange to say it’s kind of nice to know that I’m glad to know that I’m not the only person this happened to? Because I was kind of feeling like it was a big cosmic “HA HA” finger-pointing at me on top of all the other “marbles” I’ve had in my life and it made me feel better to know that you’ve had the same thing happen even though I wouldn’t actually wish it on anyone.
Know what I mean??
FM
JulieC - September 17, 2012 ←
I was diagnosed first with depression, too. I like to think of it not so much as a misdiagnosis, but as an incomplete diagnosis. Now they’re starting to think of recurring depression as one more disorder on the bipolar spectrum–part of the same biological family of issues, where you’re talking about the same kinds of things or related kinds of things going wrong in the brain and body.
When I was diagnosed with depression, the doctor had never seen me hypomanic, nobody really thought much about hypomania, and I’d never really had a manic episode. I had my first manic episode when it was triggered by antidepressants and the returning sunlight in spring one year.
It’s kind of iffy whether they should have me in bipolar II or bipolar I, because before my pdoc added One More Drug, i had problems with a mixed kind of state. Technically that moves me over. But really? Absent the drugs, I never go manic. I oscillate between rather depressed and sheer agony close to taking half a Superman leap (or something else), with brief forays into hypomania.
Anyway. Yeah. Bipolar type 2. The Real Downer kind of bipolar.
It’s almost impossible not to diagnose that as major depression (“unipolar depression”) when you first see it.
It only comes out that it’s bipolar later, over time. And with the developing understanding that “Unipolar Depression” isn’t, that “depression” is just another variant of bipolar with euthymia being its other pole, moving from “depression” to “bipolar” isn’t a radical change in diagnosis–it’s just a refinement within the main diagnosis (bipolar) of which subtype you’ve got.
So the big question in a diagnosis would be whether you were looking at a patient who was chronically mentally ill with bipolar disorder, which you’d preliminarily assign a subtype OR whether you were looking at a patient who was having a first time ever episode of depression and might not ever have another one.
What I suspect we would see if we plotted severity of mania and hypomania symptoms on a curve, in a large study, where we found some way to get a reliable record of a mood diary, is not a stairstep function of unipolar depressives who had euthymic periods, bipolar 2′s hypomanic moods, and bipolar 1′s manic moods.
If we plotted actual mood data from actual patients, I think we’d find that across a large patient population of all subtypes of bipolar disorder, the curve of what constitutes a positive swing is smooth, not stairstep, and incidence of who has which “subtype” is a matter of where you arbitrarily draw the mood line.
My guess would be it would look like half a bell curve with a lot of depressives whose “up” looked like euthymia, and a few type 1′s whose up looked like blazingly psychotic mania, a bunch of type 1s whose up looked like garden variety mania, with the 2′s on an arch in that bell that leaves it not very well defined where the depressives end and they start, or where the 2′s end and the 1′s start.
That’s just my guess, based on the people I’ve known and how fuzzy the definitions have seemed to me. I wouldn’t know until and unless someone actually does the research.
If there are hard and fast genetic or biological differences between the subtypes, I could be wrong, and it could well be a clean, stair-step type graph. Too bad there’s probably not enough research money to find out. It would tell us a lot about the underlying biochemistry.
JulieC - September 17, 2012 ←
What I mean by “the curve of what constitutes a positive swing” is–when we look at someone’s hypomanic or manic episode, just how pumped are they? Mood, hours of sleep, hours in darkness for sleep, and similar questions–you can get at it.
Dang I wish I’d had the money for grad school. Wah. This would have been fun. Oh well.
Rating life consequences is not very useful in this instance, because life consequences have a lot to do with impulse control, and impulse control has a lot to do with factors that may be mania-independent, like damage to relevant areas of the frontal lobe that may have happened during previous episodes (or some other way–exec. function damage, anyway, that a bipolar I is more likely to have).
I’m not saying that damage isn’t relevant diagnostically. I’m just saying that it can and should be measured separately and in some other study. It’s doable.
Natasha Tracy - September 18, 2012 ←
Hi JulieC,
You make some good points and it’s true that all symptoms fall on a continuum. Bipolar falls on a continuum too where at one end there is depression and at the other there is bipolar I.
The thing is though, an “incomplete” diagnosis is as bad as the wrong one as it leads to the wrong treatment, so that’s a “wrong” as it gets in my book. And a wrong diagnosis of unipolar depression is mostly made by people who don’t know what to look for as there are many symptoms of bipolar disorder that are known but are not part of the DSM. You might call these “soft” symptoms of bipolar disorder or suggestive symptoms – not in and of themselves conclusively indicative, but suggestive of bipolar: http://www.healthline.com/health-blogs/bipolar-bites/soft-signs-bipolar-disorder
So yes, an “incompletely” diagnosis, to me, isn’t particularly excusable from someone who knows what they’re doing.
- Natasha Tracy
Natasha Tracy - August 29, 2012 ←
Hi Flabbergasted,
If there’s one thing I can tell you it’s that the bipolar is _not_ your fault – you did nothing wrong. Bad things happen to good people and bipolar is one of those bad things.
http://natashatracy.com/mental-illness-issues/meaning/bad-diseases-happen-good-people/
I know the lack of concrete answers is frustrating. It’s as frustrating for me as it is for you. No one likes it and science is getting closer all the time, but the fact is, we don’t know how most diseases work, and it could be a very long time before we do. I would recommend you try to accept that.
Yes, if it wasn’t an invisible illness we might get more respect but keep in mind we are in excellent company with other “invisible” illnesses like autoimmune diseases and pain disorders.
http://www.thirdage.com/fibromyalgia/have-a-chronic-disease-you-re-a-spoonie
I don’t think you’re ranting, I think you’re having a very natural reaction to a very difficult situation. Drop by and express yourself any time.
- Natasha Tracy