Is Bipolar Disorder Caused By a Chemical Imbalance?

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A chemical imbalance can cause bipolar disorder. Genetics is also a key contributor to bipolar disorder. Though this mental illness can be challenging and complicated for loved ones to understand, effective treatment can lead to a full and healthy life.

How a Chemical Imbalance Can Lead to Bipolar Disorder

Aside from genetics, a common cause of bipolar disorder is indeed a chemical imbalance, specifically malfunctioning in neurotransmission. It is important to note that the chemical imbalance caused by malfunctioning neurotransmitters can be hereditary.

In turn, genetics and chemical imbalances are intrinsically linked to one another. We can think of neurotransmitters as the body’s messengers. They send information from one cell to the next, dictating essential functions like breathing and cognition.

In bipolar disorder, some genes regulate neurotransmission, meaning that these genes can be linked to chemical imbalances that then lead to the expression of bipolar disorder symptoms. 

Which Hormones Contribute to a Chemical Imbalance?

A chemical imbalance often doesn't exist in isolation, and sex hormones like estrogen can contribute to an imbalance.

Estrogen

Evidence indicates that hormones like estrogen can play a role in the onset of bipolar disorder among birthing people. For example, reproductive events like pregnancy and childbirth may result in something called postpartum psychosis.

Psychosis is a condition that can occur as a symptom of bipolar disorder and is characterized by delusions, hallucinations, and the loss of contact with reality. Postpartum psychosis is when psychosis onsets following a person giving birth and can be linked to bipolar disorder.

Researchers believe that low estrogen levels are the culprit for the chemical imbalance that triggers bipolar disorder symptoms like psychosis. In a 2014 study, researchers found a correlation between symptoms of bipolar disorder, including postpartum psychosis, and low estrogen levels. This same article found that symptoms subsided after receiving estrogen treatments.

If you or someone you love is experiencing a reproductive event and suffers from bipolar disorder, it is worth discussing with your doctor if estrogen treatments could provide relief.

Neurotransmitters

Neurotransmitters (e.g., dopamine, serotonin, norepinephrine, etc.) are chemicals that help neurons communicate.

For those with bipolar disorders, the ability of these neurotransmitters to function correctly is impaired. When these neurotransmitters are affected, sleep, sexual function, and mood can be impacted.

Below are some neurotransmitters that are affected in people with bipolar disorder.

  • Noradrenaline
  • Serotonin
  • Dopamine
  • Gamma-aminobutyric acid (GABA)

How Can Genetics Influence a Chemical Imbalance?

Some may wonder how genetics might influence a chemical imbalance. Researchers suspect that biochemical abnormalities may be genetic, though they acknowledge that research is lacking on this subject.

As the literature on the genetics of chemical imbalances develops, there may be further evidence proving that genetics and chemical imbalances are inextricably linked in bipolar disorder.

Bipolar Disorder Treatment 

There is no cure for bipolar disorder, but treatment options can manage symptoms, decrease the frequency and severity of episodes, and even lead to euthymic states (aka periods of time when no manic or depressive symptoms are present).

There are multiple options for treating bipolar disorder:

Coping With Bipolar Disorder

Coping with bipolar disorder can be challenging, but there are ways to make it easier.

  • Learn more about bipolar disorder: Learning more about the causes of the condition is very important, and it may be worth sharing with your loved ones, too. Doing so may increase understanding and acceptance of this disorder.
  • Plan for any life events that may be triggering: For example, now that we know hormones can influence a chemical imbalance and we know that can be extra tricky for bipolar disorder, we can now plan accordingly. This could look like having a postpartum mental health emergency plan in place that all of your providers and support system are aware of. Be sure to consult a psychiatrist if you're considering going on contraceptives since they can impact your hormones. Additionally, team up with your providers to make a plan if you know you'll be experiencing a period of increased stress, like spending time with family or transitioning to a new job.
  • Make some lifestyle changes and shifts: Keep in mind that having bipolar disorder doesn't have to take away things you love and enjoy. When traveling, adjust your sleep schedule to accommodate any time changes in the weeks leading up to your trip. Keep an extra stash of your medication in your car, purse, or wallet—this way you won't miss a dose in case you forget to bring them along with you.

Reminder

Most importantly, remember that bipolar disorder is a term that describes how your brain functions, but it isn't the sum of who you are. You are much more than any one condition you may live with.

7 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Maletic V, Raison C. Integrated neurobiology of bipolar disorder. Front Psychiatry. 2014;0. doi: 10.3389/fpsyt.2014.00098

  2. Meinhard N, Kessing LV, Vinberg M. The role of estrogen in bipolar disorder, a review. Nord J Psychiatry. 2014;68(2):81-87. doi: 10.3109/08039488.2013.775341

  3. National Institute of Mental Health. Understanding Psychosis.

  4. Sheffler ZM, Reddy V, Pillarisetty LS. Physiology, Neurotransmitters. [Updated 2022 May 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-.

  5. Lee JG, Woo YS, Park SW, Seog DH, Seo MK, Bahk WM. Neuromolecular Etiology of Bipolar Disorder: Possible Therapeutic Targets of Mood StabilizersClin Psychopharmacol Neurosci. 2022;20(2):228-239. doi:10.9758/cpn.2022.20.2.228

  6. Manji HK, Quiroz JA, Payne JL, et al. The underlying neurobiology of bipolar disorder. World Psychiatry. 2003;2(3):136-146. PMID: 16946919

  7. National Institute of Mental Health (NIMH). Bipolar disorder.

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By Julia Childs Heyl, MSW
Julia Childs Heyl, MSW, is a clinical social worker and writer. As a writer, she focuses on mental health disparities and uses critical race theory as her preferred theoretical framework. In her clinical work, she specializes in treating people of color experiencing anxiety, depression, and trauma through depth therapy and EMDR (eye movement desensitization and reprocessing) trauma therapy.