Bipolar disorder is probably caused by several factors that are partly related. However, much remains unclear.
Biochemical
According to several studies of biochemical factors related to bipolar disorder, norepinephrine, dopamine and serotonin have an important role in this mood disorder. Of these, there is a deficiency in a depressive episode and probably an abundance in mania.
Another cause may be a shortage of fatty acids such as omega 3 in childhood or in later stages of life. These fatty acids are known as DHA and EPA. There are conclusions and findings from studies in which omega 3 fatty acids (EPA and DHA) are applied to depressed patients and / or patients with mental illnesses such as ADHD (attention deficit hyperactivity disorder), bipolarity, schizophrenia and autism.
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Biogenetic
Many studies show that individual vulnerability or heredity could be an important factor for bipolar disorder. For example, the chance of this mood disorder is greater when close relatives also suffer from the disorder. The chance that children of a parent with bipolar disorder themselves also suffer from bipolar disorder is 20%. If both parents have bipolar disorder, the chances of children developing the disorder are 50%.
Cognitive
Disturbed thought processes can develop a negative self-image, which contributes to depression. Due to the cognitive dysfunction, the person involved can develop a pessimistic thinking pattern and feel worthless, for example. This can cause depression or promote relapse and duration.
Learning theoretical
Through genuine and perceived failure, people can become convinced that everything in life is failing and that they no longer have a grip on life. This can be a factor in the development of depression. There is then talk of a “learned helplessness.”
Object loss theoretical
This is a psychoanalytic theory that deals with an interrupted bonding process during the first 6 months of life. After leaving or separating an important person in this phase of life, the child will withdraw from others.
Disrupted development
A psychoanalytic theory states that during the upbringing of a child, a love-hate relationship could develop between the child and the mother / caregiver on the way to independence. The carer will order the child to obey, even when it is at the expense of his needs and desires. The child wants to meet the expectations of the parent (s), but at the same time he / she is angry about their demands. The bipolar disorder would then arise from the disturbed ego development in which anger turns inwards (depression). By the denial of this inner depression, a mirror image would manifest itself. The superego thus formed would then lead to manic behavior.
Drugs and alcohol
In most cases, certain mood-altering substances, such as drugs and alcohol, can ‘trigger’ bipolar disorder and further stimulate people who are prone to it.

Other possible causes
A.L. Querido (Dutch psychiatrist) writes about the differences between psychological factors and psychosocial factors. These are internal, personal factors and external, environmental factors, which influence the inner world.
Both positive and negative events, such as promotion or divorce, can bring stress. Too much stress (for someone prone to it) can contribute to depression or mania. The social environment is also an important factor. It has been scientifically demonstrated that a person functions better if he is part of a group (or network) within which he is accepted and / or supported.
Psychological factors include past life events that have not been properly processed (trauma). In addition to the fact that the risk of (non-chronic) depression is increased after a traumatic event, problems in processing it play a role in the development of (chronic) mania or depression. Blocking painful memories and / or feelings can lead to a disturbance in the emotional life, and thus to bipolarity.