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Is Bipolar Disorder Hereditary?

Is Bipolar Disorder Hereditary?

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When we can see our family in ourselves, it’s easy to wonder what else we might have inherited from them, particularly when it comes to our mental health.

We may see them managing their condition and wonder if we’ll need to do the same. Especially when dealing with a complex and often misunderstood diagnosis like bipolar disorder, the looming question of whether it’s been passed onto you or not can be unsettling.

When armed with knowledge and proactive strategies, it doesn’t have to be.

In this detailed article, we’ll uncover the potential role genes play, the other risk factors, and the implications of both.

Genetics’ role in bipolar disorder

Like many mental health conditions, bipolar disorder results from a mix of genetic and environmental influences. The fact that the biological children or siblings of those with bipolar disorder are much more likely to develop it themselves suggests there’s a genetically linked component to the condition.

However, this doesn't mean bipolar disorder is directly ‘inherited’ in the way eye color or hair texture might be. Instead, what is passed down are genetic variants that can make you more predisposed to developing the disorder.

The likelihood of inheriting bipolar disorder

The average risk for bipolar disorder has typically been reported to be around 1%, though recent estimates are as high as 4%. However, having a ​​first-degree relative, such as a biological parent or sibling, with the condition can increase your risk.

According to the National Institute of Mental Health, having one parent with bipolar disorder increases one’s risk by a range of 15% to 30%. When both parents are affected by the disorder, the risk increases to a range of 50% to 75%.

This means that it is fairly heritable, but bipolar disorder can also be influenced by other risk factors, which is why people can be diagnosed without having a family history.

​​If you have a genetic predisposition, it doesn't automatically mean you will develop the condition; however, having that family history does make it essential for you to watch for the symptoms of bipolar disorder so you can manage it if it does develop.

Can bipolar disorder skip a generation?

It could look like the disorder skipped a generation because not everyone who carries the genes will show symptoms. The genetic expression or combination of genes that contribute to the disorder could remain dormant or not expressed.

What this means: Theoretically, a person can have a genetic predisposition to bipolar disorder without it seeming like they have any affected relatives in their immediate family.

Additionally, bipolar disorder can be misdiagnosed, as its symptoms overlap with other mental health conditions, complicating its diagnosis early in its course, which is also why it could initially appear to skip a generation.

Is there a bipolar gene?

The short answer is no. Even though researchers have found some specific genes that might be involved, there's no single ‘bipolar gene’ responsible for the disorder.

The bottom line: Its development stems from a complex interplay between numerous genes and environmental influences.

A combination of minor variations in multiple genes is believed to contribute to an individual's overall risk.

Close-up of redhead bearded man in white shirt looking stressed while sitting at a table.

Other risk factors

There are a broad set of risk factors that go beyond genetics. The genetic aspects of bipolar disorder don't act in isolation — they’re constantly interacting with many environmental elements and other neurological factors. 

Brain injury or structural factors

A history of severe head injury has been associated with an increased risk of developing bipolar disorder, suggesting that brain structure or brain function abnormalities might play a role in the disorder's onset.

Also, brain-related conditions, such as epilepsy, often occur alongside bipolar disorder and can be passed down in families.

Environmental factors

Our genes can interact with the impacts of our environment in ways that can affect our mental health. People might inherit genes that make them more likely to be affected by stress or more prone to substance misuse.

This can make it hard to predict who will develop bipolar disorder, but it also provides avenues for preventing expression or minimizing the impact of the disorder by considering environmental factors.

Traumatic events
Experiencing severe trauma can affect one’s mental health.
Traumatic life events, particularly in early life, can have a gene-environment interaction, influencing changes in the structure and function of the brain over time.

Research suggests a connection between childhood trauma and experiences of bipolar disorder that are early onset and more severe later in life.

What you can do: Engaging in therapy, especially cognitive behavioral therapy (CBT) or dialectical behavior therapy (DBT), provides strategies for coping with emotional distress and trauma, helping lessen the impact of this type of environmental factor.

Substance use
Substance misuse and bipolar disorder often occur together, influenced by both genetics and environment. The relationship between them is two-way: substance use can increase the risk of developing bipolar disorder and can also result from it.

Genetic factors linked to the disorder might also make a person more prone to substance use disorders, and similarly, genes associated with addiction can increase the risk of bipolar disorder.


What you can do: If you have a family history of bipolar disorder or have been diagnosed, you should exercise caution regarding the use of substances. Support groups or therapy can help with coping with the urge to use substances.

Poor sleep
If your sleep patterns are off, it could be an early indication of emerging or destabilizing bipolar disorder.

While sleep disturbances are features of bipolar disorder, they may also contribute to its onset, especially when considering genetic predispositions.

What you can do: Keeping a regular sleep schedule is an important part of managing the condition.

Tense relationships
Social relationships can have a profound impact on mental health, acting as either sources of support or stress. Examples of the latter include:

  • Being in a rocky relationship, which could make the ups and downs of bipolar disorder even worse.
  • Workplace conflicts, which could trigger stress.
  •  Arguments or a lack of understanding within a family, which could serve as both a stressor and trigger. 

While these stressful social interactions don’t directly cause bipolar disorder, the stress could make someone with the disorder more vulnerable to experiencing emotional highs and lows and influence its manifestation and severity.

What you can do: Those at risk or in the process of managing the condition should prioritize supportive, relaxed social environments.

Black young man with hand on chin looking confident and thoughtful.

Understanding and managing bipolar risk

Digging into how genetic and environmental factors play a role in bipolar disorder gives you a chance to take control. Knowing if you have a hereditary risk of bipolar disorder can be crucial in identifying and managing it early. Early detection allows for both preventive steps and lifestyle changes that may make symptoms less intense and episodes easier to handle, or could potentially delay the onset of the disorder.

Explore more: 10 Things to Know About Bipolar Disorder

Being aware of the genetic risk factors of bipolar disorder also sets you up to take a proactive approach to mental health, including going to therapy, participating in routine screenings, and adopting healthy habits like managing stress and exercising regularly. Being hands-on early helps manage the potential impact of bipolar disorder symptoms and empowers you to take control of your mental wellness, enhancing your overall well-being.

Whether you’ve been diagnosed or think there’s a likelihood you could develop bipolar disorder due to family history, personalized care is of the utmost importance.

Recognizing that your mental health experiences are unique, we're here to support you with flexibility, compassion, and the specialized care you deserve. We offer online access to licensed therapists and prescribers, all from the comfort of your own home. Our highly rated mental health professionals can help you with concerns about hereditary risks, understanding the signs and symptoms of bipolar, coping strategies for environmental stressors, or bipolar symptom management.

If you or a loved one have concerns about bipolar disorder, including its potential hereditary factors, consider reaching out to one of Cerebral’s mental health specialists to begin the conversation on your terms.


Images via shurkin_son, drobotdean, and andreas on Freepik.

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Here are some common reasons an episode is triggered: Stress Stressful life events, whether positive or negative, can trigger mood episodes. This includes work-related stress, relationship problems, or significant life changes such as moving or changing jobs. Lack of sleep Sleep disturbances can trigger both manic and depressive episodes. It's crucial to establish a regular sleep routine and ensure you get enough restful sleep each night. Medications Certain medications, especially antidepressants, can trigger manic episodes in people with bipolar disorder. Always consult your doctor before starting or stopping any medication. Negative life events Traumatic events or significant losses, such as the death of a loved one or a divorce, can trigger depressive episodes. It's important to seek support during these times. Drug or alcohol use Substance abuse can exacerbate bipolar symptoms and trigger episodes. Avoiding drugs and limiting or stopping alcohol use can help you manage bipolar disorder more effectively. Explore more: Can I Drink Alcohol With Bipolar Disorder? Seasonal changes Changes in seasons, especially the transition to winter, can trigger depressive episodes. Light therapy or other interventions can help manage symptoms of seasonal affective disorder (SAD). Hormonal changes Hormonal fluctuations, such as those experienced during pregnancy or menopause, can affect mood stability. It's important to monitor these changes and seek medical advice if needed. Co-occurring medical conditions Other health conditions, such as thyroid disorders or chronic illnesses, can influence bipolar symptoms. Regular medical check-ups can help you manage these conditions. How to manage triggers Managing triggers to reduce or avoid bipolar mood episodes is a critical part of achieving a balanced life with bipolar disorder. 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Images by freepik, Drazen Zigic, and ansiia on Freepik. *The information in this blog is provided as a general educational resource only, and is not to be used or relied on for any diagnostic or treatment purpose. This information should not be used as a substitute for professional diagnosis and treatment and does not create any patient-physician relationship between you and Cerebral. Please consult your health care provider before making any health care decisions or to get guidance about a specific medical condition.
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Bipolar Disorder
Does Bipolar Disorder Get Worse With Age?
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Studies indicate that about 5-10% of new bipolar disorder diagnoses are in adults over 50, sometimes referred to as ‘late-onset bipolar disorder.’ Why does this happen? It’s likely due to a variety of factors, including symptom overlap with other conditions and evolving views of the importance of mental health. Reasons for misdiagnosis Late-onset bipolar disorder can be challenging to diagnose due to its likelihood to exhibit symptoms differently, the complexity of symptoms, and the presence of other age-related health issues. Bipolar disorder in older adults can present predominantly with depressive episodes. Since these episodes can look very similar to clinical depression, it's not uncommon for the condition to be misdiagnosed as unipolar depression. Additionally, manic phases in those with bipolar disorder who are post-50 might not be as pronounced as in younger individuals. Sometimes, these manic episodes are less about traditional mania and more about irritability or less obvious changes in energy, which can be easily overlooked or misattributed. In some cases, there could be a misdiagnosis of dementia in patients who are actually experiencing bipolar disorder, or vice versa. The overlap in symptoms for both dementia and the depressive or manic phases of bipolar disorder can include: Memory loss Disorientation Impaired executive function  Both dementia and bipolar disorder can include behavioral disturbances, too. In the case of bipolar disorder, these might be part of a manic episode, whereas, in dementia, they could be due to cognitive decline, making the correct diagnosis challenging. Historical stigma and late diagnosis It’s no secret that mental health was heavily stigmatized and a taboo conversation topic in previous decades. Back then, this stigma often prevented individuals from seeking help or even acknowledging mental health issues. As societal understanding and acceptance of mental health issues have improved, more older adults could be seeking treatment for symptoms that may have been present but unaddressed for decades. This shift could explain an increase in diagnoses of late-onset bipolar disorder as well as re-evaluations of misdiagnoses. In short: Reasons for late diagnoses could be that people now in their 50s and beyond grew up during times when psychiatric treatment options weren’t as advanced or as socially accepted as they are today.  Late-onset bipolar disorder Typically diagnosed after the age of 50, late-onset bipolar disorder can present unique challenges and considerations. Unlike early-onset bipolar disorder, which generally appears in adolescence or early adulthood, late-onset bipolar disorder can be influenced by a range of factors.  Why bipolar disorder can develop in later years The development of bipolar disorder in adults age 50 and older can often be explained by the significant changes the brain and body undergo as part of the aging process. Some of the reasons why bipolar disorder might emerge late in life include: Increased biological vulnerability: Age-related physiological changes can make the brain more susceptible to bipolar disorder. Reduced resilience in brain function can lead to an inability to regulate mood effectively. Cumulative health issues: Older adults often have a higher burden of chronic illnesses, which can stress the body and brain, potentially triggering or unmasking psychiatric conditions, including bipolar disorder. Medication-induced: Sometimes, the treatments for other age-related health issues can have side effects that manifest as bipolar symptoms. Certain medications used to treat physical ailments could influence mood regulation or even directly trigger manic or depressive episodes. These triggers could complicate treatment plans, and, in some cases, a multidisciplinary approach to treatment will be needed. Other reasons for showing bipolar symptoms Neurological changes, other medical conditions, and hormonal imbalances can present symptoms that mimic those of bipolar disorder. Other explanations for those signs could include: Brain atrophy: As people age, there can be a general reduction in brain volume and mass. This atrophy can affect neurotransmitter systems, potentially triggering psychiatric symptoms, including those associated with bipolar disorder. Vascular changes: Microvascular disease can cause changes to the brain's small blood vessels, damaging brain tissue that contains nerve fibers and connects to other parts of the brain. This can produce bipolar-like symptoms. Neurodegenerative diseases: Conditions such as Alzheimer's disease or Parkinson's disease can exhibit symptoms that mimic bipolar disorder, such as mood swings and erratic behavior. Stroke and brain injuries: Strokes or traumatic brain injuries can lead to changes in personality and mood regulation, potentially initiating bipolar-like symptoms. Thyroid disorders: Thyroid dysfunctions, which are more common in older adults, can lead to significant mood swings and psychiatric manifestations that resemble bipolar disorder. Other endocrine changes: Changes in hormonal levels due to aging, such as decreases in estrogen or testosterone, can also impact mood and behavior. The complexity of diagnosing the issue could require careful psychological and medical evaluation. How does bipolar change as you age? As individuals step into their later years, the intensity and presentation of bipolar symptoms undergo significant transformations. Let’s explore how aging impacts bipolar disorder. How elderly bipolar symptoms differ Bipolar symptoms can shift with age. For instance, older adults might experience more depressive episodes and fewer manic episodes, or they may find that their episodes are more prolonged than when they were younger. Additionally, research suggests that while the frequency of manic episodes may decrease with age, depressive episodes can become more severe and last longer. This effect of aging on bipolar disorder can significantly impact an individual’s quality of life and requires tailored treatment. Symptoms also could blur into a mixed emotional state, making it challenging to differentiate between mania and depression.  Changes in the brain The impact of age on the brain further complicates the clinical picture. Aging affects brain structure and function, which can make symptoms harder to manage and predict. Studies have pointed to the possibility of accelerated brain aging in those with bipolar disorder, potentially influencing symptom severity and treatment responsiveness. Bipolar disorder and life expectancy Managing bipolar disorder is crucial to maintaining quality of life. People with bipolar disorder may have a shortened lifespan and may experience biological aging at a faster rate. The disorder’s associated behaviors and comorbid conditions such as cardiovascular disease can also impact life expectancy. Additionally, because one could experience more severe depressive episodes in their later years, thoughts of suicide could become more prevalent, increasing the risk of self-harm or suicide attempts. Remember: Seek immediate help if you're ever thinking about acting on suicidal thoughts, in a crisis, or experiencing extreme emotional distress.  Call or text 988 for the National Suicide Prevention Hotline. Call 911 if you’re having a mental health emergency. Text HOME to 741-741 if you're emotionally distressed and need immediate support. Regular monitoring and support for mental health alongside strategies to reduce these risks and maintain safety should be aspects of one’s treatment plan in their later years. It’s also vital for adults in their 50s and above to have routine health screenings and maintain a comprehensive care treatment plan that addresses both mental and physical health. Should treatments for bipolar change as you get older? The short answer: Most likely. As you age, both your body and your brain can undergo significant changes that can alter your symptoms and the way you respond to bipolar treatment options. Because of that, it can become important to make bipolar treatment adjustments in older age to account for these physiological and psychological developments. Let’s explore some of the common modifications people in their 50s and beyond may need to make. Medication for late-onset bipolar With age, the way drugs are processed can be affected in the following ways: Risk of adverse drug reactions: Older adults are more susceptible to side effects from medications due to changes in metabolism and increased sensitivity to drugs. Higher comorbidity rates: The presence of other health conditions often means that the interaction of various medications must be carefully managed to avoid issues. Considering some may experience cognitive decline in their later years, more straightforward medication routines may be needed to make it easier to stick to taking medications while aging with bipolar disorder. Therapy options for older adults with bipolar Therapy can be a cornerstone of treatment at any age. However, the focus might shift towards addressing specific life stage concerns, including retirement, loss of loved ones, and changes in independence. Cognitive behavioral therapy (CBT) and other forms of psychotherapy can be tailored to help cope with the transitions that aging naturally brings. Explore more: A Guide to Finding A Therapist For Bipolar Disorder The importance of complementary care Lifestyle adjustments and non-medical interventions can be a critical addition to finding balance while living with bipolar disorder, including: Seeing social connections and participating in support groups to combat isolation, which can exacerbate symptoms. Keeping a routine to maintain balance. Engaging in regular physical exercise to boost mood and preserve health. Using mindfulness and relaxation techniques, which can help manage stress and promote emotional stability. All of these strategies can enhance quality of life and support overall well-being.  Getting personalized mental health care While aging with bipolar disorder can present new challenges, understanding these changes can lead to better management strategies and a higher quality of life. It's important to consult licensed professionals who can tailor treatment plans with age-associated adjustments. After all, the aging process affects all of us differently. Some may feel and function just like they did in their younger years, while others may have developed health conditions that impact their mobility, ability to drive, or ability to perform daily tasks. Because retirement and aging can bring about many life transitions, you may want to consider online therapy and virtual medication management. Some of the benefits of choosing an online mental health service like Cerebral over traditional in-person visits include: Convenient access to care from the comfort of your home: This is especially helpful if you live in an area with few mental health resources, live in more than one home throughout the year, or have limited mobility.  Frequent monitoring and easier communication with licensed providers: This can be crucial in managing medication adjustments and addressing any emerging issues promptly. An integrated approach that includes both psychiatric medication management and psychotherapy: This holistic approach addresses both the biochemical and psychological aspects of the disorder in a coordinated manner under one simple, affordable monthly payment. Plus, Cerebral offers more flexible scheduling options than traditional in-person visits. This flexibility is particularly beneficial for individuals with bipolar disorder, whose symptoms can fluctuate unpredictably, requiring more frequent support or prompt interventions. Explore more: How Does Cerebral Work? Images by freepik, freepik, and freepik on Freepik. *The information in this blog is provided as a general educational resource only, and is not to be used or relied on for any diagnostic or treatment purpose. This information should not be used as a substitute for professional diagnosis and treatment and does not create any patient-physician relationship between you and Cerebral. Please consult your health care provider before making any health care decisions or to get guidance about a specific medical condition.
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