Editing Bipolar disorder (section)

=== Environmental ===
[[Psychosocial]] factors play a significant role in the development and course of bipolar disorder, and individual psychosocial variables may interact with genetic dispositions.<ref name="Serretti">{{cite journal |vauthors=Serretti A, Mandelli L | title = The genetics of bipolar disorder: Genome 'hot regions,' genes, new potential candidates and future directions | journal = Molecular Psychiatry | volume = 13 | issue = 8 | pages = 742–71 | year = 2008 | pmid = 18332878 | doi = 10.1038/mp.2008.29 | doi-access = free }}</ref><ref>{{Cite journal |last1=Robinson |first1=Natassia |last2=Bergen |first2=Sarah E. |date=2021-06-28 |title=Environmental Risk Factors for Schizophrenia and Bipolar Disorder and Their Relationship to Genetic Risk: Current Knowledge and Future Directions |journal=Frontiers in Genetics |volume=12 |doi=10.3389/fgene.2021.686666 |doi-access=free |pmid=34262598 |issn=1664-8021|pmc=8273311 }}</ref> Recent life events and interpersonal relationships likely contribute to the onset  and recurrence of bipolar mood episodes, just as they do for unipolar depression.<ref name="Geddestreatment" /> In surveys, 30–50% of adults diagnosed with bipolar disorder report traumatic/abusive experiences in childhood, which is associated with earlier onset, a higher rate of suicide attempts, and more co-occurring disorders such as [[PTSD|post-traumatic stress disorder]].<ref name="Brietzke2012">{{cite journal | vauthors = Brietzke E, Kauer Sant'anna M, Jackowski A, Grassi-Oliveira R, Bucker J, Zugman A, Mansur RB, Bressan RA | title = Impact of childhood stress on psychopathology | journal = Rev Bras Psiquiatr | volume = 34 | issue = 4 | pages = 480–488 | date = December 2012 | pmid = 23429820 | doi = 10.1016/j.rbp.2012.04.009 | doi-access = free }}</ref> Subtypes of abuse, such as sexual and emotional abuse, also contribute to violent behaviors seen in patients with bipolar disorder.<ref>{{cite journal | vauthors = Bal NB, Özalp E, Teksin MG, Kotan Z, Karslıoğlu EH, Çayköylü A | title = Childhood Trauma as an Environmental Determinant of Risk of Violence in Bipolar Disorder | journal = Noro Psikiyatri Arsivi | volume = 60 | issue = 4 | pages = 344–349 | year = 2023 | pmid = 38077849 | pmc = 10709710 | doi = 10.29399/npa.28340 }}</ref> The number of reported stressful events in childhood is higher in those with an adult diagnosis of bipolar spectrum disorder than in those without, particularly events stemming from a harsh environment rather than from the child's own behavior.<ref>{{cite journal |vauthors=Miklowitz DJ, Chang KD | title = Prevention of bipolar disorder in at-risk children: Theoretical assumptions and empirical foundations | journal = Development and Psychopathology | volume = 20 | issue = 3 | pages = 881–497 | year = 2008 | pmid = 18606036 | pmc = 2504732 | doi = 10.1017/S0954579408000424 }}</ref> Acutely, mania can be induced by [[sleep deprivation]] in around 30% of people with bipolar disorder.<ref>{{cite journal | vauthors = Young JW, Dulcis D | title = Investigating the mechanism(s) underlying switching between states in bipolar disorder | journal = [[European Journal of Pharmacology]] | volume = 759 | pages = 151–162 | date = July 2015 | pmid = 25814263 | pmc = 4437855 | doi = 10.1016/j.ejphar.2015.03.019 }}</ref>