"Jane" asks: "Is bipolar genetic or can it be brought on by traumatic experiences?"
She goes on to say: "I have had several traumatic things happen to me and just wondered if this has caused me to be the way I am. I have two siblings without bipolar, so it just makes me think that one or all my experiences set this off."
Great question, Jane. How great? A few weeks ago I would have answered your query quite a bit differently than I'm answering now. Not that I would have been wrong a few weeks ago, but attending two psychiatric conferences very recently has added a new layer of insights.
Let's start off with the proposition that we're talking about the interaction between genes and environment. It's not either-or. It's both-and. A simple way of putting it is our genes are all about how we react to whatever life throws our way. But it's not quite that simple, as we shall see.
Bipolar is highly heritable, as established by numerous family studies. But finding bipolar genes has been a rather daunting and frustrating task. The experts are in agreement that we are looking for many genes, each with a small effect. Your particular collection of "bipolar" genes is likely to vary somewhat (or even quite a bit) from my collection of bipolar genes.
It gets more complicated, because our brains are not organized according to the DSM (the diagnostic bible), so in all likelihood we need to be looking for more than "bipolar" genes. These would include more common gene variations that effect the general population as well, such as messed up sleep, or overreaction to stressful events.
Genes that affect how we react to the environment
Let me give you an example, involving a landmark study published in Science in 2003:
Scientists had been tracking a certain New Zealand population from birth. One year, they surveyed this population about recent stressful events in their lives, such as death in the family, losing a job, or breakup with a partner.
Lo and behold, among those meeting the criteria for four recent stressful events, 43 percent of those with a certain gene variation (what they call the short allele to the serotonin transporter gene) experienced depression vs just 17 percent with the long allele.
It's important to note that this gene variation is not a "depression" gene. Rather, think of the variation as making one susceptible to stress and its downstream effects (which may include depression). Call it a "stress" gene. One variation renders us vulnerable to stress, the other sets us up to be more resilient.
This particular gene is one of many that affects the function of the brain's amygdala. The amygdala mediates fear and arousal, and kicks off our limbic "fight or flight" response. You are probably alive today because your fight or flight system responded just as it should when you encountered a dangerous situation. But suppose, say, you get a panic attack in a supermarket for no good reason? Then, your amygdala is far too sensitive for your own good.
This study is a classic example of genes and environment interacting. A host of other related findings corroborate the principle, and a number of studies have implicated that same stress gene (as well as others) in numerous other mental illnesses and conditions.
Environment impacting our genes
So, what is environment? According to the experts it's anything that impacts our health. This includes your living situation, what's going on around you, and also involves your memories, including traumatic ones.
Environment is not separate from our brains. Environment, in fact, plays a major role in creating our brains. For instance, women growing up in stressful homes may lay down more neural connections than usual between the amygdala and other parts of the brain. This would cause them to view the world as more threatening, which would make their lives a lot more stressful.
As you can see, it starts to get complicated. But allow me to add something I just learned from a conference I attended in San Francisco a couple of weeks ago. We heard about how our genes affect how we react to our environment. But we can also change our environment to affect our genes.
For instance, many of our genes only come into play in certain circumstances. Research into alcoholism is shedding quite a bit of light on this. In the right surroundings, away from negative influences, certain vulnerability genes may never be switched on. The environment, in effect, neutralizes the genes.
At the same conference, Dean Ornish MD of UCSF described a 2008 study published in PLoS that found that the relaxation response in trained meditators switched off cancer-promoting genes.
What this means
We are not helpless bystanders. Neither our genes nor our upbringing nor our present circumstances automatically doom us to lives of misery and despair. Yes, we may have been dealt bad cards, but that does not mean we have to fold our hand.
In San Francisco, I heard Robert Cloninger MD of Washington University (St Louis) talk about self-awareness, our unique ability to respond intelligently to our environment rather than blindly reacting. Yes, we may have our work cut out for us, but change can happen fast, he told his audience.
Be hopeful. YOU are in charge ...
Published On: June 06, 2009
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