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Bipolar Disorder


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Bipolar Disorder




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Does stress have any effect on Bipolar Disorder? 

While the onset of depression has been well-established in research literature for many years, most of the focus of literature on bipolar disorder has focused on the relationship between stressful life events and the precipitation of episodes among individuals with an established diagnosis of bipolar disorder, rather than precipitating the initial onset of the disease. 

One prospective study of persons with bipolar I disorder found no difference in life events among individuals who became depressed, others who became manic and those who remained well.  The only difference seemed to be that individuals with manic disorder seemed to experience more work-related difficulties. Other studies have found mixed reports as to whether there were increased rates of adverse life events in the months preceding admission to a hospital for either manic or depressive episodes. 


However, there are several studies that demonstrate a relationship between stressful life events and affective episodes in an established bipolar illness.  There have been mixed results however, and methodological problems have made interpretations of studies difficult and comparison across studies absolutely impossible.  Some of the examples of methodological problems include recall bias in retrospective designs and sample heterogeneity, definition of onset of mood disorder, and choice of signal event (i.e. hospitalization versus onset of episode).  Another problem with the studies includes differences in attribution recall, which can be significantly different depending upon whether persons interviewed for life events prior to or after the related episode has commenced. 

In summary, it seems likely that adverse life events are probably associated with bipolar and other mood disorders, particularly when those episodes are sufficiently severe to result in hospitalization.  Obviously, in this respect, such life events need to be attended to and from a theoretical view it is not clear that such events actually play a positive role in the development of the disease.

From DSM-IV-TR Mental Disorders: Diagnosis, Etiology and Treatment by Michael B. First and Allan Tasman

Additional information and webpage by Paul Susic MA Licensed Psychologist Ph.D Candidate (Health Psychology)

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