According to a new study discussed on Health.com "about 2.4% of people around the world have had a diagnosis of bipolar disorder at some point in their lifetime, according to the first comprehensive international figures on the topic.The United States has the highest lifetime rate of bipolar disorder at 4.4%, and India the lowest, with 0.1%". 

Bipolar disorder has a strong genetic component. Depending on which studies you look at, the  gentics acount for anywhere from 40-60% of the vulnerability. While that seems like a high number it also means 40-60% of the risk of developing the disorder  despite having the same genes comes from the environment. Only 40-60% of  every set of identical twins will develop the disorder. So what is it that could be triggering this high rate of bipolar disorder in the US?

Let's look at this problem from the 'macro' to the micro' levels. On a socio-economic macro level, the US, as the largest and most industrialized Western society, has a somewhat exagerated culture. First, we have the largest gap between rich and poor, so the economic stresses on a large part of thepopulation are greater than in other western societies. This translates into psychological stress, more substance abuse, poorer quality nutrition, and fragmentation of the family. Early child hood rearing is more likely to be by a day care center -which is inherently unstable (people change centers or caregivers change in a center) and impersonal. There is a higher likelihood of bullying and reduced supervision.

The result of all this is impaired social bonding in those who are particularly vulnerable. The poor nutrition results in imparied metabolic functioning (now we are into the micro level), trouble making or breaking down neurotransmitters, more likely infection and inflammation (which change brain chemistry). This is a simple overview, and many books could easily be written about this subject (in fact I have written three books myself on these factors). Suffice it to say that the most vulnerable amoung us pay the price for our imbalanced society. Included in that group are the young, the ill, the genetically vulnerable, and the elderly.

Let me start by acknowledging what is well known: Manic Depression or Bipolar disorder can be a devastating illness. Affecting at least 1% of the population, it can, untreated, result in suicide, ruined careers and devastated families. Bipolar disorder is often accompanied by alcohol and drug abuse and addiction, criminal and even violent behavior. I acknowledge this, because I do not want to make light of the burden this illness places on people’s lives, their families and communities.

On the other hand, the history of the world has been influenced very significantly by people with manic depression (see my website www.wholepsychiatry.com for details)-from actors and actresses (Patty Duke, Jim Carey and Robin Williams) to Politicians (Winston Churchill, Theodore Roosevelt) to astronauts (Buzz Aldren), media mogels (Ted Turner) and perhaps even well known religious figures.

It seems clear that for at least some people with Bipolar disorder, there is an increased sense of spirituality, creativity, and accomplishment. It may be that having bipolar disorder holds great potential, if one is able to master or effectively channel the energies, which are periodically available, to some higher task. This would of course presume the ability to abstain from harmful drugs and alcohol, to have good character, and at least some supportive relationships and community networks.

It might be helpful to consider a reconceptualization. Perhaps instead of it being a disorder, we can think of people with bipolarity as having access to unusual potency. This potency will find a way to be outstanding-either in a destructive way, or in a constructive way. If such a choice is presented to the person, perhaps it can open some doors.

I will be discussing this and other aspects of bipolar disorder on Wednesday, August 4th @ 12PM Eastern time in my free virtual teleconference.