Will Mental Illness Run In My Family
If someone in your family has a mental illness, you might be worried about developing the same condition.
If you have a mental illness you might be worried that your children or siblings will develop the same or a different mental illness.
Most people with a mental illness do not have relatives with the same illness. But research does suggest that mental illness can run in families.
The table below shows the chances of schizophrenia or bipolar disorder being passed down through family members. These numbers are based on recent studies. But different studies can show different numbers.
|Lifetime chance. This is the chance of someone in the general population developing the condition during their lifetime.||1 in 100|
|If one of your biological parents has the condition||6 in 100|
|If both of your biological parents have the condition||45 in 100|
|If your brother or sister has the condition||9 in 100|
|If your identical twin has the condition||40-50 in 100|
|If your non-identical twin has the condition||17 in 100|
|If a second degree relative has the condition. For example, your aunt, uncle or grandparent.||3 in 100||5 in 100|
It might be helpful to look at the figures in the table in a different way. For example, the chance of someone developing bipolar disorder is 1 out of 100. This means that 99 people are not going to develop bipolar disorder.
What If Im Not Happy With My Treatment
If you arent happy with your treatment you can:
- talk to your doctor about your treatment options,
- ask for a second opinion,
- get an advocate to help you speak to your doctor,
- contact Patient Advice and Liaison Service , or
- make a complaint.
There is more information about these options below.
How can I speak to my doctor about my treatment options?
You can speak to your doctor about your treatment. Explain why you arent happy with it. You could ask what other treatments you could try.
Tell your doctor if there is a type of treatment that you would like to try. Doctors should listen to your preference. If you arent given this treatment, ask your doctor to explain why it isnt suitable for you.
Whats a second opinion?
A second opinion means that you would like a different doctor to give their opinion about what treatment you should have. You can also ask for a second opinion if you disagree with your diagnosis.
You dont have a right to a second opinion. But your doctor should listen to your reason for wanting a second opinion.
What is advocacy?
An advocate is independent from the mental health service. They are free to use. They can be useful if you find it difficult to get your views heard.
There are different types of advocates available. Community advocates can support you to get a health professional to listen to your concerns. And help you to get the treatment that you would like. NHS complaints advocates can help you if you want to complain about the NHS.
What Medications Are Used To Treat Bipolar Disorder
Certain medications can help manage symptoms of bipolar disorder. You may need to try several different medications, with guidance from your healthcare provider, before finding what works best.
Medications healthcare providers generally prescribe to treat bipolar disorder include:
- Mood stabilizers.
- Second-generation neuroleptics .
If youre taking medication for bipolar disorder, you should:
- Talk with your healthcare provider to understand the risks, side effects and benefits of the medication.
- Tell your healthcare provider about any prescription drugs, over-the-counter medications or supplements youre already taking.
- Tell your healthcare provider right away if youre experiencing concerning side effects. They may need to change your dose or try a different medication.
- Remember that medication for bipolar disorder must be taken consistently, as prescribed.
Mood stabilizers for bipolar disorder
People with bipolar disorder typically need mood-stabilizing medication to manage manic or hypomanic episodes.
Types of mood stabilizers and their brand names include:
Thyroid gland and kidney problems can sometimes develop when taking lithium, so your healthcare provider will monitor the function of your thyroid and kidneys, as well as monitor the levels of lithium in your blood, as levels can easily become too high.
The following are signs of lithium toxicity . Call your healthcare provider immediately or go to the nearest emergency room if you experience:
Who Does Bipolar Disorder Affect
Bipolar disorder can affect anyone. The average age of onset is 25 years, but, more rarely, it can start as early as early childhood or as late as in your 40s or 50s.
Although bipolar disorder affects people assigned female at birth and people assigned male at birth in equal numbers, the condition tends to affect them differently.
People AFAB with bipolar disorder may switch moods more quickly. When people with bipolar disorder experience four or more manic or depressive episodes in a year, this is called rapid cycling. Varying levels of sex hormones and thyroid hormones, together with the tendency for people AFAB to be prescribed antidepressants, may contribute to the more rapid cycling in this population.
People AFAB with bipolar disorder may also experience more periods of depression than people AMAB.
Symptoms Of Bipolar Disorder
If you think you or someone in your family may have bipolar disorder, its helpful to know what symptoms to look for. The type of bipolar disorder a person has determines the symptoms they will experience. In general, the main symptoms of the different types of bipolar disorder are mania and depression.
The symptoms of bipolar mania include:
- restless and impulsive behavior
- an unrealistic perception of abilities
- happiness, even to the point of euphoria
- participating in risky behavior, such as gambling, drunk driving, or impulsive sex
- talking quickly
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What Causes Bipolar Disorder
There is no one thing that is considered to be solely responsible for causing bipolar disorder, be it your genes or your lifestyle. This is because the underlying cause has more to do with your immediate brain chemistry than anything else. Neurotransmitters are the chemicals and hormones that regulate our brain and bodys functioning. When theres an imbalance in these vital neurological messengers , the resulting abnormalities are whats identified as mental illness.
In the case of bipolar disorder, there are many neurotransmitters at play. Dopamine, serotonin, GABA, epinephrine, norepinephrine, glutamate, and acetylcholine have all been linked to BDs underlying symptoms. However, scientists have yet to find whether there is a singular root cause for bipolar disorder or whether its the result of several neurochemical imbalances acting independently but simultaneously.
Symptoms In Children And Teens
Symptoms of bipolar disorder usually emerge in early adulthood, though they can occur at any age. Sometimes, they can appear in children.
Signs that a child may have bipolar disorder
- lose interests in things they used to enjoy
- think about death or suicide
There are many reasons why children and teens can experience mood changes or moods that seem extreme. The hormonal changes in puberty can lead to fluctuations in mood, and the symptoms of ADHD and other conditions can resemble those of bipolar disorder.
If youre concerned about yourself or a young person, seek medical help early. Whatever the reason for mood changes in a young person, getting a correct diagnosis can help manage the symptoms and prevent long-term complications.
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What Causes Postpartum Bipolar Disorder
Postpartum mental health conditions may be caused by dramatic hormonal shifts after birth and certain women seem to be more susceptible. As for bipolar disorder, individual brain chemistry, as well as physical brain changes and genetic makeup may play a role.
If you have a history of postpartum depression or postpartum psychosis, or a personal or family history of bipolar illness, you may be more at risk for developing symptoms of bipolar disorder in the postpartum period.
What Is The Treatment For Mania Hypomania And Depression
You can check what treatment and care is recommended for bipolar disorders on the National Institute for Health and Care Excellence website.
NICE produce guidelines for how health professionals should treat certain conditions. You can download these from their website at:
The NHS doesnt have to follow these recommendations. But they should have a good reason for not following them.
What medications are recommended?
Mood stabilisers are usually used to manage mania, hypomania and depressive symptoms.
The mood stabilisers we talk about in this factsheet are:
- Certain benzodiazepine medication
Mania and hypomaniaYou should be offered a mood stabiliser to help manage your mania or hypomania. Your doctor may refer to your medication as antimanic medication.
If you are taking antidepressants your doctor may advise you to withdraw from taking them.
You will usually be offered an antipsychotic first. The common antipsychotics used for the treatment of bipolar disorder are:
If the first antipsychotic you are given doesnt work, then you should be offered a different antipsychotic medication from the list above.
If a different antipsychotic doesnt work, then you may be offered lithium to take alongside it. If the lithium doesnt work you may be offered sodium valproate to take with an antipsychotic. Sodium valproate is an anticonvulsive medication.
Sodium Valproate shouldnt be given to girls or young women who might want to get pregnant.
- Fluoxetine with Olanzapine
Types Of Bipolar Disorder
People are diagnosed with three basic types of bipolar disorder that involve clear changes in mood, energy, and activity levels. These moods range from manic episodes to depressive episodes.
- Bipolar I disorder is defined by manic episodes that last at least 7 days or when manic symptoms are so severe that hospital care is needed. Usually, separate depressive episodes occur as well, typically lasting at least 2 weeks. Episodes of mood disturbance with mixed features are also possible. The experience of four or more episodes of mania or depression within a year is termed rapid cycling.
- Bipolar II disorder is defined by a pattern of depressive and hypomanic episodes, but the episodes are less severe than the manic episodes in bipolar I disorder.
- Cyclothymic disorder is defined by recurrent hypomanic and depressive symptoms that are not intense enough or do not last long enough to qualify as hypomanic or depressive episodes.
Other specified and unspecified bipolar and related disorders is a diagnosis that refers to bipolar disorder symptoms that do not match the three major types of bipolar disorder outlined above.
Fetal And Neonatal Outcomes
Congenital abnormalities were examined in three studies. Jablensky et al. found no difference in congenital abnormalities in women with BD compared with those with no mental health difficulties , but is not included in the meta-analysis.
The combined results of the other two studies showed that 21,632 women without BD had a baby with congenital abnormality, out of 766,750 , while 175 women with BD, out of 4034, had one . This difference is statistically significant . There was no heterogeneity shown between the two studies: Chi2=0.02, df=1 I2=0 %.
Mei-Dan et al. found that BD presented increased risk for congenital anomalies compared with the referent group , when adjusted for maternal age and parity . Bodén et al. also found the prevalence of congenital malformations was 2 % for infants born to women without BD . For women with BD who were not treated with mood stabilisers the rate was 1.90 %, and those women with BD who were treated with mood stabilisers had rates ranging from 0 to 3.50 %, depending on the drug used. The authors did not compare these results statistically however, if the results for women without BD and the women with no treatment for BD are combined and compared with the 12 abnormalities out of 320 women with BD who were treated , the difference is statistically significant , indicating that medications for the treatment of BD in pregnancy are associated with fetal abnormalities.
Small for gestational age
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What Types Of Therapy Are Used To Treat Bipolar Disorder
Psychotherapy, also called talk therapy, can be an effective part of the treatment plan for people with bipolar disorder.
Psychotherapy is a term for a variety of treatment techniques that aim to help you identify and change troubling emotions, thoughts and behaviors. Working with a mental health professional, such as a psychologist or psychiatrist, can provide support, education and guidance to you and your family.
Different types of therapy for bipolar disorder include:
Talking To A Health Care Provider About Your Mental Health
If you or someone you know is in immediate distress or is thinking about hurting themselves, call or text the 988 Suicide & Crisis Lifeline at 988 or chat at 988lifeline.org. You can also contact the Crisis Text Line . For medical emergencies, call 911.
Communicating well with a health care provider can improve your care and help you both make good choices about your health. Find tips to help prepare for and get the most out of your visit. For additional resources, including questions to ask a provider, visit the Agency for Healthcare Research and Quality website.
Rarer Types Of Bipolar Disorder
There are two other types of the disorder that are less common than bipolar I and II. Cyclothymic disorder involves changes in mood and shifts similar to bipolar I and II, but the shifts are often less dramatic in nature. A person with cyclothymic disorder can often function normally without medication, though it may be hard. Over time, a persons changes in mood may develop into a diagnosis of bipolar I or II.
Bipolar disorder not otherwise specified is a general category for a person who only has some symptoms of bipolar disorder. These symptoms are not enough to make a diagnosis of one of the other three types.
While bipolar disorder can be difficult to diagnose, once its identified, it can be treated.
Can Lack Of Sleep Worsen The Symptoms Of Bipolar Disorder
The problem for those with bipolar disorder, however, is that sleep loss may lead to a mood episode such as mania in some patients. Worrying about losing sleep can increase anxiety, thus worsening the bipolar mood disorder altogether. Once a sleep-deprived person with bipolar disorder goes into the manic state, the need for sleep decreases even more.
In one study, researchers interviewed 39 bipolar patients with primarily manic or depressed episodes to determine the presence of social rhythm disruptions during the two months prior to the onset of the mood.
When comparing the results with volunteers in the control group, researchers concluded that most people with bipolar disorder experience at least one social rhythm disruption prior to a major mood episode. In addition, the researchers found that social rhythm disruption affected more bipolar patients with mania than the patients with depression. Their findings concluded that 65% of the patients with bipolar disorder had at least one disruption in their daily rhythm in the eight weeks before the onset of a manic episode.
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Chemical Imbalance In The Brain
Bipolar disorder is widely believed to be the result of chemical imbalances in the brain.
The chemicals responsible for controlling the brain’s functions are called neurotransmitters, and include noradrenaline, serotonin and dopamine.
There’s some evidence that if there’s an imbalance in the levels of 1 or more neurotransmitters, a person may develop some symptoms of bipolar disorder.
For example, there’s evidence that episodes of mania may occur when levels of noradrenaline are too high, and episodes of depression may be the result of noradrenaline levels becoming too low.
Why Theres More To Borderline Personality Disorder Risk Than Just Genes
Even though there are strong genetic ties in the development of BPD, thats not the entire story. John Oldham, MD, a professor of psychiatry at Baylor College of Medicine in Houston and the author of the classic personality-type guidebook The New Personality Self-Portrait, talks to families about the interplay between genes and the environment. Think of two men who both have family histories of type 2 diabetes and have exactly the same genetic risk, he says. One is highly active and watches his diet and never develops diabetes. The other never exercises, becomes overweight, and thus develops diabetes. The predisposing risk is not enough alone, but the right environment will turn on those genes and lead to the disease, he says. This is also true of BPD.
There are some eventual results of a genetic predisposition to develop the condition. Once its been turned on by repetitive or continued stress because of bad luck or an unsupportive environment, its hard to get back on track, continues Dr. Oldham. While this can be chronic invalidation at home, its often a traumatic event physical abuse, sexual abuse, neglect that pulls the trigger. One systematic review of 10 studies in 2018 found that maltreatment during childhood was a risk factor for developing BPD symptoms. Another new study in 2018 linked childhood sexual abuse to BPD.
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What Are The Signs And Symptoms Of Bipolar Disorder
The defining sign of bipolar I disorder is a manic episode that lasts at least one week, while people with bipolar II disorder or cyclothymia experience hypomanic episodes.
But many people with bipolar disorder experience both hypomanic/manic and depressive episodes. These changing mood states dont always follow a set pattern, and depression doesnt always follow manic phases. A person may also experience the same mood state several times with periods of euthymia in between before experiencing the opposite mood.
Mood changes in bipolar disorder can happen over a period of weeks, months and sometimes even years.
An important aspect of the mood changes is that theyre a departure from your regular self and that the mood change is sustained for a long time. It may be many days or weeks in the case of mania and many weeks or months in the case of depression.
The severity of the depressive and manic phases can differ from person to person and in the same person at different times.
Signs and symptoms of manic episodes
Some people with bipolar disorder will have episodes of mania or hypomania many times throughout their life others may experience them only rarely.
Signs and symptoms of a manic episode include:
Most of the time, people experiencing a manic episode are unaware of the negative consequences of their actions. With bipolar disorder, suicide is an ever-present danger some people become suicidal in manic episodes, not just depressive episodes.