Bipolar disorder can affect the brain

Origin and course

At the same time, environmental, psychological and social factors also have an influence on whether the disease breaks out and what course it takes. The environmental factors include, for example, negative life events, stress, but also major changes in life. Psychological factors that can negatively influence the illness are negative attitudes, poor processing of events or the abuse of alcohol. As social factors, for example, frequent criticism or rejection can have an unfavorable effect on the course of the disease.

A disordered lifestyle, for example an irregular sleep-wake rhythm or phases with intensive and less intensive work, can trigger renewed phases of illness. Not only can particularly positive events such as a sense of achievement and changes in living conditions, for example a long vacation trip, trigger, but also negative events, such as the death of a relative, a manic or hypomanic episode.

On the other hand, there are also protective factors that can reduce the likelihood of further disease phases. These include psychological factors such as the ability to cope with stress or the self-responsible use of medication, but also social factors, for example a stable partnership or the support of relatives.

The model by Meyer (2008) assumes that at the beginning of a manic or hypomanic phase there are first changes in the level of activity and in the duration of sleep. These then lead to a rise in mood towards euphoria or irritability. According to Meyer, this sets in motion a vicious circle: Self-esteem continues to rise and those affected often stop taking their medication on their own initiative, which further intensifies the manic symptoms. Criticism from relatives can in turn lead to increased irritability.


The first symptoms usually appear in early adulthood, around the age of 20. Around half of those affected initially experience a depressive episode. The bipolar disorder is not yet recognized at this point in time and therefore cannot yet be treated accordingly. The diagnosis “bipolar” is usually only made at the age of 30. At this age there is often a first stay in hospital.

At first glance, bipolar II disorder appears to be a less severe disorder because of the more pronounced symptoms. However, the phases with a stable mood are often shorter than with bipolar I disorder, which is also very stressful for those affected.

Without medication, half of those affected will relapse in the first year after the first phase of the disease. In some cases the phases of elevated and depressed mood follow one another directly, for example when a mania turns into depression, but sometimes months or years can also lie between the phases of the illness.

Often times, other mental health problems arise in connection with bipolar disorder. Abuse or addiction to alcohol or drugs is the most common. Anxiety disorders, drug abuse and personality disorders are also not uncommon in the context of bipolar disorder.