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Psychological Causes of Bipolar Disorder

Psychoanalysts view mania as an extreme defence mechanism to counter unpleasant emotional states or unacceptable impulses. Katan, for example, suggested that as periods of mania frequently follow states of depression, the conflct in mania may be of a similar nature to that in depression. People who pass from depression into mania maintain their preoccupation with a real or imagined loss. In the manic state, this anxiety is externalized. Aggressive drive is directed outwards, and the individual reacts to external objects in the same manner as introjection directs anger inwards in depression.

Cognitive models

The cognitive model of unipolar depression has been adapted to explain bipolar problems by two research groups. Newman et al. suggested that schemata can act in a ‘bidirectional’ manner in people with bipolar disorder. A schema related to being loved, for example, may have two poles – ‘I am totally unlovable’ versus ‘Everybody loves me.’ Depending on mood and any relevant life-events, both positive and negative, either one of these poles may be activated.

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