Depression-Hypomania Bipolar II for 17 years. Is the depression external event caused or chemical imbalance.

Question

Can a tramatic event, although seeming managable at the time cause depression. Or is a chemical imbalance (low sertonin) eventually lead to depression with or without external causes. Is hypomania bipolar II mixed state bipolar difficult to diagnose? Can a person with the above suffer from a "lack of insight" much more common with bipolar I than II. I am skeptical a event of 17 years ago can cause a slow but consistent slide in a quality of life issue. I am in therapy. With revealing talks with old friends my behavior did change (slowly) but consistently almost two decades ago! Is this posible?

Answer 1

I have bipolar.  I think the answer is yes to all of your questions.  A traumatic event can trigger depression in anyone and ppl with bipolar are more susecptable.  For those with bipolar, depression can kick off for no reason just as can hypomania, mania or mixed states.  Bipolar II mixed states can be very hard to diagnosis since for some they can appear more like anxious depression.  Sometimes it is much more extreme but creeps up slowly enough to be unclear what it is.  This alone is a good reason to see a psychiatrist instead of a GP.  Pdoc's are more attuned to the difference.  Yep, anyone with bipolar with lack of insight.  Personally, I think the more dramatic the swings, the easier it is for a person and their friends/family to tell something serious is wrong.  Your behavior probably started to change due to both the event and perhaps the start of symptoms.  The lines between illness and life events often are not clear or clean.  Whether that started your bipolar is hard to say, but there's a good chance that it didn't.

Btw, all mood states are chemical as is everything that goes on in the brain.  In the case of bipolar, it is not clear which neurotransmitters (including GABA) play what roles and what others systems are involved (calcium and ion channels, etc).

Answer 2

I've done a lot of research on bipolar and I haven't really found a consistent cause for depression, just the mania. But anit-depressants don't work on the depression because in a study they found a placebo was more effective than the antidepressant. So it's not particularly chemical. So it is very possible that an event 17 years ago could have triggered it. It's called diathesis stress model. You could have been predisposed to bipolar, but had a supportive environment and nothing to trigger it, but this even disrupted everything.