Limiting Hereditary Vulnerability

You're watching Bipolar and Focus, I'm Jane Pauley.

For decades, it has been known that Bipolar runs in families, which means it's genetic.

But that's not the only factor and it doesn't guarantee that someone will get it. Dr. Igor Galynker is the director of Beth Israel's Family Center for Bipolar Disorder. And welcome!

Is bipolar hereditary or not?

To some extent, you may inherit vulnerability or you may inherit particularly difficult combination of the genes that can actually make you bipolar.

So in addition to the genetics, what are the other factors?

There is a psychosocial factor and there are biological factors.

The psychosocial factors are your lifestyle -- your external stressors to your lifestyle like moving, the number of projects that you try to handle at the same time.

The psycho factors meaning psychological factors are the way you interact with other people mostly including the family and your loved ones.

And biological factors which are very, very important involved other biological illnesses you may have, medications that you take, illicit drugs, your health and sleep, hygiene and exercise.

All of these are biological factors which are exceedingly important in whether somebody will or will not develop bipolar illness.

Why does sleep have so much to do with wether someone will develop bipolar disorder or have a recurrence?

People with bipolar disorder have abnormal sleep. Okay, it's actually, they have abnormal sleep architecture and lack of sleep is one of the things that typically precede the onset of bipolar illness.

You talked about psychosocial factors.

Most of those are related to stress and let's talk about children and adolescence, and the stress in their lives.

Divorce is very traumatic for children particularly divorce where children are used as instruments and the parents fighting with each other.

Changing schools and moving around a lot is very difficult for a child because you have to break with the group of friends and form new friends.

In adolescence, it's particularly important to be part of a group so that creates additional stress.

So the bottom line here is that there are factors that pertain to whether you get a bipolar disorder or not,

some of which one might have no control over and some of which one might have some degree of control. How can a family dynamic affect the vulnerability?

If you have the combination of hostility over involvement and criticism.

The likelihood of some developing bipolar disorder is much higher and reducing malignant and harmful family interactions can protect the child.

And in fact, prevent somebody who with a fairly high vulnerability to develop that illness from developing it.

Someone who is worried about the genetic implications for a family -- they might want -- to have someday.

What can they do to create a family dynamic that would moderate the likelihood that their children would get bipolar?

They should create a healthy lifestyle which involves both reduced stress and a particular style of family interactions. So they would try not to divorce in the future.

They would want to create a particular structure in the family that emphasizes constancy, a routine over excitement and unpredictability.

Living in one place, taking the same vacations all the time.

They should know that -- for instance, if they have a child that is highly active and does not sleep enough and very smart,

that's a great thing, but on the other hand, that might indicate vulnerability for developing bipolar illness.

So pushing the child into -- activities which precludes sleep -- actually, would be counterproductive and may precipitate the illness.

So to go backwards, if a child has a high load, if you will, of stress and a predisposition to a bipolar disorder,

the stress is going to make it more likely that they will get it than if they had not had so much stress?

Absolutely!

Thank you, Dr. Galynker and --

My pleasure.

 

Thank you for watching Bipolar in Focus.