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The Role of Stress in Bipolar Disorder

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Bipolar Disorder: From Neuroscience to Treatment

Part of the book series: Current Topics in Behavioral Neurosciences ((CTBN,volume 48))

Abstract

Stress is a major risk factor for bipolar disorder. Even though we do not completely understand how stress increases the risk for the onset and poorer course of bipolar disorder, knowledge of stress physiology is rapidly evolving. Following stress, stress hormones – including (nor)adrenaline and corticosteroid – reach the brain and change neuronal function in a time-, region-, and receptor-dependent manner. Stress has direct consequences for a range of cognitive functions which are time-dependent. Directly after stress, emotional processing is increased at the cost of higher brain functions. In the aftermath of stress, the reverse is seen, i.e., increased executive function and contextualization of information. In bipolar disorder, basal corticosteroid levels (under non-stressed conditions) are generally found to be increased with blunted responses in response to experimental stress. Moreover, patients who have bipolar disorder generally show impaired brain function, including reward processing. There is some evidence for a causal role of (dysfunction of) the stress system in the etiology of bipolar disorder and their effects on brain system functionality. However, longitudinal studies investigating the functionality of the stress systems in conjunction with detailed information on the development and course of bipolar disorder are vital to understand in detail how stress increases the risk for bipolar disorder.

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Authors and Affiliations

  1. Faculty of Medicine, University Center Unicerrado, Goiatuba, GO, Brazil

    Eduardo H. L. Umeoka

  2. Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands

    Judith M. C. van Leeuwen

  3. Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands

    Christiaan H. Vinkers

  4. Amsterdam UMC, Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam, The Netherlands

    Christiaan H. Vinkers

  5. Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands

    Marian Joëls

  6. University Medical Center Groningen, Groningen, The Netherlands

    Marian Joëls

Authors
  1. Eduardo H. L. Umeoka
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  2. Judith M. C. van Leeuwen
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  3. Christiaan H. Vinkers
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  4. Marian Joëls
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Editors and Affiliations

  1. PO72 De Crespigny Park, King’s College London, London, UK

    Allan H. Young

  2. PO72 De Crespigny Park, King’s College London, London, UK

    Mario F. Juruena

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Umeoka, E.H.L., van Leeuwen, J.M.C., Vinkers, C.H., Joëls, M. (2020). The Role of Stress in Bipolar Disorder. In: Young, A.H., Juruena, M.F. (eds) Bipolar Disorder: From Neuroscience to Treatment. Current Topics in Behavioral Neurosciences, vol 48. Springer, Cham. https://doi.org/10.1007/7854_2020_151

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