We use our own and third party cookies to offer you our services, customize and analyze your browsing and show you advertising related to your preferences. By continuing to browse, we consider that you accept its use. You can change the settings and get more information in the
The cause is in its origin, essentially, biological and genetic. The limbic system is responsible for regulating the emotions and that the mood is stable and in keeping with the circumstances. That is to say, it has a bearing in that each day we get up with a similar and coherent mood with what happens in life. Obviously, this mood will be more or less stable depending on different aspects, like physical health, rest, daily events, etc.
In the case of individuals that have a bipolar disorder, the limbic system functions erroneously, causing their mood to suffer sudden changes without there necessarily being a personal, work, family, or social reason, that justifies it.
Neurotransmitters like dopamine, serotonin, and acetylcholine, play a crucial role in each phase. In the manic phases, there is an increase in dopamine levels, and in the depressive ones, a decrease in serotonin. Hormones, such as thyroxin, are also important.
El primer factor de riesgo –y la causa de la mayoría de recaídas- es dejar de tomar la medicación.
The main risk factor—and the cause of the majority of relapses—is to stop taking the medication. Almost half of those that suffer from a bipolar disorder do not take the medication prescribed by their psychiatrist correctly, which may lead to the appearance of new episodes and a gradual worsening of the course of the illness.
Another very common trigger is the consumption of alcohol and other toxic habits—cannabis, cocaine, designer drugs, and coffee abuse.
To sleep less than seven or eight hours, as this could be an indicator of the onset of euphoria phase, and may trigger an episode.
Certain drugs that are used for other illnesses can also act as triggers for new episodes. Among them are the corticosteroids. In this sense, it is recommended to consult the psychiatrist if certain drugs can be taken.
Childbirthin some women can act as a trigger due to the hormonal changes. One usually hears of post-partum depression: this has nothing to do with psychological factors of the type “fear of the responsibility of being a mother” or “to feel empty”. It is simply a sudden drop in the level of oestrogens, which can lead to a post-partum depression episode—more common in women with a bipolar disorder—as well as post-partum mania.
Episode triggering factors
Psychological factors also have an important role as triggering factors, that is to say, they act as the trigger that sets off an episode. Psychological-type factors, such as stress or negative life events, can trigger a manic or depressive episode in an individual vulnerable to the disorder.
Both negative and positive life events can trigger an episode. That is to say, an episode may start after being sacked from work, or after being promoted, after being divorced, or after starting a relationship. It is interesting that the positive or negative sign of the triggering event does not determine whether the episode is depressive or manic.
It is expected, for example, that someone with a bipolar disorder begins a depressive episode after the death of a loved one, but the reality is that many patients with a bipolar disorder start a manic episode after a distressing event. This leads to thinking to what extent the biological factors, more than the psychological ones, are decisive in this illness.
Apart from the psychosocial triggering factors, there are various situations that can lead to the appearance of a new episode.
We are sorry, we are working to improve PortalCLÍNIC. Help us become better, tell us why
Thanks for your help!
An error has occurred and we were unable to send your opinion, please try again later.
Substantiated information by:
Ana Isabel Martínez AránPsychologyPsychiatry and Psychology Department
Diego Alberto Hidalgo MazzeiPsychiatristPsychiatry and Psychology Department
Eduard Vieta PascualPsychiatristPsychiatry and Psychology Head of Department
Mercè Comes ForasteroNurse Specialist in Mental HealthPsychiatry and Psychology Department
Published: 20 March 2018
Updated: 20 March 2018
The donations that can be done through this webpage are exclusively for the benefit of Hospital Clínic of Barcelona through Fundació Clínic per a la Recerca Biomèdica and not for BBVA Foundation, entity that collaborates with the project of PortalClínic.
Receive the latest updates related to this content.
Thank you for subscribing!
If this is the first time you subscribe you will receive a confirmation email, check your inbox
An error occurred and we were unable to send your data, please try again later.
Subscribe to the Newsletter of Clínic
Receive the latest news from our institution directly to your email.
Thanks for your subscription!
We have received your information. Check your inbox, in a few moments you will receive a confirmation email.
An error has occurred and we have not been able to send your data, please try again later.
More about assistance and health
Join our job pool
Hospital Clínic de Barcelona looks for talented professionals to cover job openings on a regular basis.