Bipolar disorder is a mental illness characterized by intense mood changes, fluctuating between periods of euphoria or mania and periods of depression. It involves an alteration in the mechanisms that regulate mood, which depend on the interaction between genetic and environmental factors.

Genetic inheritance determines greater or lesser vulnerability, while environmental factors — especially stress — can trigger the onset of manic or depressive episodes.

How do genetics and environment influence it?

To understand this relationship, the example of the “glass that fills up” is often used.

Imagine that each person is born with a glass of a different size, whose capacity represents their threshold for stress tolerance. In people with bipolar disorder, this glass may be smaller from birth due to genetic factors. However, whether the glass overflows or not largely depends on the environment and life experiences.

Daily problems, losses, work demands, or stressful life situations act like drops that gradually fill the glass. When the load exceeds its capacity, the glass overflows, leading to a manic or depressive crisis.

Why can it appear in adulthood?

This explanation helps us understand why some genetically based disorders do not appear until adulthood. Their development does not depend solely on inheritance, but also on the continued influence of environmental factors, which in many cases are decisive.

Key ideas to keep in mind

• Having greater genetic vulnerability does not necessarily mean developing the disorder.

• Family history is not always known, as it may be distant or may never have manifested.

• A stable environment and proper stress management can delay or even prevent the onset of episodes.

Understanding bipolar disorder from this perspective helps reduce stigma and highlights the importance of prevention, self-care, and specialized care, promoting better adaptation and quality of life.

“Bipolar disorder is a fascinating but tragic psychiatric condition. As a clinician and researcher, I often find myself amazed by the intensity with which these individuals live and experience their lives.”

-David J. Miklowitz

Bipolar Disorder

Objectives of Psychoeducation in Bipolar Disorder

People with bipolar disorder often show greater difficulty accepting the diagnosis and maintaining adherence to treatment. For this reason, it is essential that they understand what is happening to them and receive appropriate psychoeducation, allowing them to understand the illness, recognize warning signs, and prevent relapses.

Lack of awareness of the problem may lead the person not to seek help when they feel unwell or, conversely, when they experience an excessive increase in activity. In these cases, family members are often the ones who detect the situation and alert professionals.

Early identification of risk warning signs

One of the main objectives of psychoeducation is for the person to learn to recognize the first signs of decompensation, both toward hypomania or mania and toward depression.

This work is especially effective during periods of mood stability (euthymia), as it allows reviewing previous episodes and identifying personal risk factors, such as changes in sleep patterns, activity overload, interpersonal conflicts, or prolonged stress.

It is also important to learn how to manage potentially destabilizing external stimuli, such as bad news, aggressive communication, or disrespect, promoting more conscious and protective responses.

Medication, habits, and relapse prevention

In bipolar disorder, medication is essential to prevent the onset of crises. Without it, psychoeducation and psychotherapy lose effectiveness. Both interventions, when combined, help reduce the risk of relapses and maintain long-term stability.

Psychoeducation facilitates acceptance of the illness and promotes protective behaviors, such as:

• Consistent adherence to pharmacological treatment

• Avoiding the use of drugs and stimulant substances

• Maintaining healthy lifestyle habits (sleep, nutrition, routines)

• Recognizing and reducing avoidable stress situations

All of this contributes to a more stable life with fewer crises.

Family involvement and support

Accepting the diagnosis can be difficult both for the affected person and for their environment. In some cases, family members and caregivers may ignore the illness or maintain habits that contribute to relapses, generally due to lack of information and understanding.

Psychoeducation sessions aimed at family members allow them to:

• Understand the illness and its progression

• Learn how to provide appropriate support

• Identify common reactions to the disorder without assigning blame.

• Become aware of common mistakes and learn from them

The objective is not to assign responsibility, but to promote understanding, reduce distress, and improve coexistence.

Importance of clear and accurate information

Providing precise information about bipolar disorder and the measures required for its management reduces the confusion and insecurity that often accompany the diagnosis, both in affected individuals and their families.

There are structured psychoeducation programs specifically designed for people with bipolar disorder, which have proven to be an effective tool for improving clinical outcomes and quality of life.