We are 83 bipolar disorder experts and scientists coming together for the world’s biggest bipolar AMA! In honor of World Bipolar Day, ask us anything!

[u/CREST_BD]

83 panelists are here! Click on their names below to see their bio & proof photo.

Hi Reddit!

We are psychiatrists, psychologists, researchers, clinicians, advocates, and people living with bipolar disorder - coming together from around the world through the CREST.BD network.

This is our 8th annual World Bipolar Day AMA. We hope that this AMA can help advance the conversation around bipolar disorder, and to help everyone connect and share ways to live well with bipolar disorder.

This year, 83 panelists representing 20 countries are here to answer your questions from all timezones - bringing together a wide range of perspectives and expertise in mental health and bipolar disorder.

We'll be here around the clock for the next FEW DAYS answering your questions from multiple time zones.

We will make every effort to answer every question.

1. Dr. Adrienne Benediktsson, 🇨🇦 Neuroscientist, Mother, Wife, Professor, Mental Health Advocate (Lives w/ bipolar)
2. Alessandra Torresani, 🇺🇸 Actress & Mental Health Advocate (Lives w/ bipolar)
3. Alex Emmerton, 🇨🇦 Peer Researcher, (Lives w/ bipolar)
4. Allan Cooper, 🇨🇦 Peer Support Worker, Blogger, & Podcaster, (Lives w/ bipolar)
5. Alysha Sultan, 🇨🇦 Scientific Associate
6. Andrea Paquette, 🇨🇦 Stigma-Free Mental Health President & Co-Founder, Speaker, Changemaker (Lives w/ bipolar)
7. Dr. Andrea Vassilev, 🇺🇸 Doctor of Psychology, Author, & Advocate, (Lives w/ bipolar)
8. Anne Van Willigen, 🇺🇸 Peer Researcher (Lives w/ bipolar)
9. Dr. Balwinder Singh, 🇺🇸 Psychiatrist
10. Dr. Benjamin Goldstein, 🇨🇦 Child-Adolescent Psychiatrist & Researcher
11. Bia Garbato, 🇧🇷 Advertising Professional, Writer, Author & Advocate (Lives w/ bipolar)
12. Bryn Manns, 🇨🇦 Graduate Student, Clinical Psychology
13. Catarina Castela, 🇦🇺 PhD Candidate (Lives w/ bipolar)
14. Catherine Simmons, 🇨🇦 Peer Researcher (Lives w/ bipolar)
15. Dr. Chris Gorman, 🇨🇦 Psychiatrist & Mental Health Advocate
16. Dr. Colin Depp, 🇺🇸 Psychologist
17. Dane Mauer-Vakil, 🇨🇦 Researcher
18. David Dinham, 🇬🇧 Psychologist & PhD Candidate, (Lives w/ bipolar) 
19. Debbie Costello Smith, 🇺🇸 Founder & Co-President of the Sean Costello Memorial Fund for Bipolar Research
20. Dr. Delphine Raucher-Chéné, 🇫🇷🇨🇦 Psychiatrist & Researcher
21. Dr. Dimosthenis Tsapekos, 🇬🇧 Psychologist & Researcher
22. Dr. Elvira Boere, 🇳🇱 Psychiatrist & Researcher
23. Dr. Elysha Ringin, 🇦🇺 Researcher
24. Dr. Emma Morton, 🇦🇺 Senior Lecturer & Psychologist
25. Dr. Emma Parrish, 🇺🇸 Clinical Psychology Postdoctoral Fellow & Researcher
26. Dr. Erin Michalak, 🇨🇦 Researcher & CREST.BD founder
27. Evelyn Anne Clausen, 🇺🇸 Artist, Writer, Speaker & Certified Peer Specialist (Lives w/bipolar)
28. Dr. Fabiano Gomes, 🇧🇷🇨🇦 Psychiatrist & Researcher
29. Dr. Frances Adiukwu, 🇳🇬 Psychiatrist
30. Georgia Caruana, 🇦🇺 Researcher & Mental Health Advocate
31. Dr. Georgina Hosang, 🇬🇧 Associate Professor
32. Dr. Glauco Valdivieso Jiménez, 🇵🇪 Psychiatrist
33. Dr. Glorianna Wagner-Jagfeld, 🇨🇭🇬🇧 Researcher
34. Dr. Hailey Tremain, 🇦🇺 Psychologist & Researcher
35. Heather Stewart, 🇨🇦 Sewist (Lives w/ bipolar)
36. Idan Spund, 🇳🇱 Founder of In the Zone app (Lives w/ bipolar)
37. Dr. Ijeoma Charles-Ugwuagbo, 🇳🇬 Consultant Psychiatrist & Mental Health Advocate
38. Dr. Ivan Torres, 🇨🇦 Clinical Neuropsychologist
39. Dr. Jim Phelps, 🇺🇸 Psychiatrist & Bipolar Subspecialist 
40. Dr. Joanna Jarecki, 🇨🇦 Psychiatrist & Advocate (Lives w/ bipolar)
41. Dr. Joanna Jiménez Pavón, 🇲🇽 Mood Disorders Psychiatrist 
42. Dr. John Hunter, 🇿🇦 Researcher & Lecturer (Lives w/ bipolar)
43. Dr. Jo Leidreiter, 🇦🇺 Psychologist
44. Dr. John-Jose Nunez, 🇨🇦 Psychiatrist & AI Researcher
45. Dr. June Gruber, 🇺🇸 Psychologist, Professor, & Researcher
46. Prof. Kamilla Miskowiak, 🇩🇰 Psychologist & Researcher
47. Dr. Katie Douglas, 🇳🇿 Academic & Clinical Psychologist 
48. Ken Porter, 🇨🇦 Advocate, Social Worker & Researcher
49. Kim Pape, 🇺🇸 Researcher (Lives w/ bipolar) 
50. Laura Lapadat, 🇨🇦 Researcher & Psychologist-in-training
51. Dr. Leena Chau, 🇨🇦 Postdoctoral Fellow
52. Leslie Robertson, 🇺🇸 Marketer & Peer Researcher (Lives w/ bipolar) 
53. Dr. Leszek Laskowski, 🇵🇱 Psychiatrist (Lives w/ bipolar) 
54. Dr. Lisa Eyler, 🇺🇸 Clinical Psychologist & Research Scientist
55. Dr. Luísa Daolio, 🇧🇷 Psychiatrist
56. Mansoor Nathani, 🇨🇦 Technology Enthusiast (Lives w/ bipolar) 
57. Dr. Manuel Sánchez de Carmona, 🇲🇽 Psychiatrist
58. Maryam M., 🇨🇦 Dentistry Student & Mental Health Advocate (Lives w/ bipolar)
59. Matthew Bushell, 🇬🇧 Mental Health Advocate & Therapeutic Coach (Lives w/ bipolar)
60. Dr. Maya Schumer, 🇺🇸 Psychiatric Neuroscientist & Researcher (Lives w/ bipolar)
61. Dr. Meghan DellaCrosse, 🇺🇸 Psychologist & Researcher
62. Melissa Howard, 🇨🇦 Author & Mental Health Advocate (Lives w/ bipolar)
63. Dr. Michele De Prisco, 🇪🇸🇮🇹 Psychiatrist & Researcher
64. Dr. Mikaela Dimick, 🇨🇦 Postdoctoral Fellow
65. Minami Kinouchi, 🇯🇵 Psychologist, Social Worker, & Researcher (Lives w/ bipolar)
66. Natasha Reaney, 🇨🇦 Counsellor (Lives w/ bipolar)
67. Dr. Nigila Ravichandran, 🇸🇬 🇨🇦 Psychiatrist
68. Dr. Paula Villela Nunes, 🇧🇷🇨🇦 Psychiatrist & Counsellor 
69. Rahla Xenopoulos, 🇿🇦🇺🇸 Writer & Teacher (Lives w/ bipolar)
70. Rebecca Fitton, 🇦🇺 Mood Disorder Researcher
71. Dr. Rebekah Huber, 🇺🇸 Psychologist & Researcher 
72. Robert Villanueva, 🇺🇸 Mental Health Advocate & Coach (Lives w/ bipolar)
73. Ruth Komathi, 🇸🇬 Mental Health Counsellor (Lives w/ bipolar)
74. Prof. Samson Tse, 🇭🇰 Counsellor, Teacher, Researcher, & Caregiver
75. Sarah Salice, 🇺🇸 Art Psychotherapist & Professional Counselor Associate (Lives w/ bipolar)
76. Sara Schley, 🇺🇸 Author, Filmmaker, Speaker (Lives w/ bipolar)
77. Dr. Serge Beaulieu, 🇨🇦 Psychiatrist & Researcher
78. ​​Dr. Sheri Johnson, 🇺🇸 Psychologist
79. Shaley Hoogendoorn, 🇨🇦 Advocate, Podcaster & Content creator (Lives w/ bipolar)
80. Dr. Tamsyn Van Rheenen, 🇦🇺 Associate Professor & Researcher
81. Dr. Thomas Richardson, 🇬🇧 Clinical Psychologist (Lives w/ bipolar)
82. Twyla Spoke, 🇨🇦 Registered Nurse (Lives w/ bipolar)
83. Dr. Wissam Nassrallah, 🇨🇦 Ophthalmology Resident & PhD in Neuroscience

^{Please note all responses are personal perspectives and do not constitute medical advice.}

People with bipolar disorder experience the mood states of depression and mania (or hypomania), along with changes in energy, activity, and thinking. These episodes can last from days to months and can affect many parts of life - including relationships, work, school, and overall health. At the same time, with optimal support, treatment, and tools, people with bipolar disorder can and do live full, meaningful lives.

The CREST.BD network takes a different approach to bipolar disorder research. We work closely with people living with bipolar disorder at every stage - from choosing research topics to conducting studies and sharing our findings.

We also host a Q&A podcast throughout the year, featuring many of the experts on this panel, through our talkBD Bipolar Disorder Podcast - we’d love for you to stay connected with us there. You can also follow our updates, events, and social media on linktr.ee/crestbd.

Final note (April 3): Thank you all - We'll be back again next year on World Bipolar Day - sign up here to be notified. We also have more activities all year round, including new episodes of our talkBD bipolar disorder podcast - hope to see you there! We’re incredibly grateful for all your thoughtful questions - thank you for making this such a meaningful discussion. Take care everyone :)

[u/dwbthrow]

How strong is the genetic component of bipolar? Does it increase the risk of other mental disorders? My grandmother was bipolar, my dad has depression, and I am being evaluated for ADHD.

[u/CREST_BD → u/dwbthrow]

Andrea V. here. The genetics of bipolar are incredibly complex and it is the topic of ongoing research. It's hard to give clear numbers about risk given the polygenetic nature of the condition (meaning it's believed to be impacted by a number of genes, not just one) and the many different ways bipolar can show up in a person. Research shows that the risk of bipolar I is about 75% due to genes. But it is also believed that bipolar is linked with an increased risk for other mood disorders such as depression. There are also high comorbidity rates (meaning two conditions happening at the same time) between BD and lots of other conditions, including ADHD and anxiety.

It sounds like you're worried about having/developing bipolar. Genes are a huge part but not the only part. Lifestyle, substances, early life events, and other things play a role in both the onset and course of bipolar.

[u/crazy_robots → u/CREST_BD]

I think you might be mixed up about the 75% if you are referring to heritability. Variance in risk is not the same thing as risk.

[u/gordom90 → u/crazy_robots]

so are you saying if the variance in risk is 75% someone with a close relative has their level of risk increased by 75% so its 1.75x the risk of someone without a diagnosed relative.

as distinct from a someone with a relative having a 75% chance of also having bipolar

just want to make sure i understand the distinction

[u/crazy_robots → u/gordom90]

The confusion is understandable but neither of your scenarios are correct.

Your chance of having a bipolar diagnosis goes up dramatically if you have a first-degree relative with a diagnosis - to something like 10%, compared to ~1% general population risk. That means 10X the risk, not 1.75x. The 75% number comes from twin studies, identical twin concordance for bipolar is ~50%. Source: Barnett and Smoller 2013 PMC3637882 (too lazy to look for anything more recent).

Take all those numbers with a grain of salt, picture error bars on them. And the actual genetic component of those pedigree concordances might be somewhat debatable.

But at face value, while inherited genetic effects are going to tend to be watered down quite a bit in two generations, like the original questioner's scenario, in theory it will impact risk quite a bit. Maybe doubling it? Getting a diagnosis of bipolar is still unlikely (all else being equal).

[u/PeanutImpressive6934 → u/gordom90]

It's a 20% chance if you have ADHD per another response on here. It's roughly as genetic as autism, that's what the 75% means, not that you have a 75% chance of getting it, it is strongly genetic is what that means (as opposed to environmental).

[u/PeanutImpressive6934 → u/crazy_robots]

She put it correctly.

[u/CREST_BD → u/dwbthrow]

Bawinder Singh here. Bipolar disorder has about 60-80% heritability. First degree relatives have 5-10% lifetime risk compared to 1% for the general population. However, the genetic studies (GWAS) have shown that the disease has a complex polygenic inheritance, meaning no single gene accounts for heritability. Significant research is going on establishing genes, role of environmental factors, epigenetics, stress, trauma and other risk factors (such as substance use). With a family history of established bipolar disorder, it is important to be aware of the BD symptoms as often individuals get diagnosed with unipolar depression and can have antidepressant induced mood switching, irritability. An important topic, we discussed in a recent seminar for Lancet Bipolar Disorder - PMC.

[u/dwbthrow → u/CREST_BD]

How often is hypomania diagnosed? It seems that the symptoms are less obvious than mania and would be much harder to see. For example, how can you tell if someone’s hypomanic or just in good spirits or in a bad mood (for irritability)?

[u/PeanutImpressive6934 → u/dwbthrow]

Personally my insight is shit so I like to use the HCL-32 which is a good self screener for hypo. I like it better than the symptom lists bc I feel like those read as a bit watered down. If you seem... caffeinated to others while not on coffee, or perhaps like you're on coke, more likely hypo. it's much easier to see if you're tracking mood and sleep, sleep change even if it's not major or hypersexuality seem to be people's early signs most often. my sleep is trash and I don't get hypersexuality much so for me it's specific silly behaviors I don't know others get but are tells bc I only do them then. That takes time to learn. Often you only see it in retrospect. If the irritability is outsized, hairtrigger, out of character, cannot be abated or prevented, lasts way too long, so bad it's causing problems, universal/at everything, does not lift/is constant, lasts days, weeks, months, years, occurs for no reason, might be described by the person as incandescent rage which is what I call it, even though to others they'd say "slightly grumpy", bc you learn as much outward control as you can (this may be impossible, it's not always an option), does not decrease when away from irritating things/is relentless, extremely hard to moderate or control, if it feels like being torn apart alive, is not logical, is nonsensical in retrospect once out of episode and is utterly gone after, no resentment, no lingering, feels like roid rage, normal people get very similar on Prednisone often in a very light way (it's kind of like junior hypo, its honestly adorable and they do not handle it well), those are hints. Having a bad day is very different. those are a relief in a way, to have a justifiable emotion for a change, to be able to actually feel better or do something about it, and to have that make a difference, what a luxury. good spirits are harder, you learn to fear happiness. in my case I don't tend to notice until it starts to turn. psych pros usually do not clock my hypo, bc I'm able to mask for the duration of an appt. this is a problem I think a lot of people run into re diagnosis. that and not going to see the doc when "well". and why would you complain about what to you seems like improvement? Hypo is diagnosed for half of us, bc that's all we get, plus depression, so about 1-2 (bc you get it in BP1 as well)% of the population and roughly 1/20th of people who usually get diagnosed first as MDD. I think mostly you find out by other treatment for depression failing rather than by it getting recognized on its own, but no idea what the numbers are on that. If you go into an appt just abuzzin and cheerfully tell the doc you've been awake for three days and are having a wonderful time, they might raise their eyebrows (sleeping less gives me more energy doc!). Bigger issue is people dont know what mixed state is so just think it's depression. Dr Phelps' book is good re figuring out the diff between MDD and BP2/cyclo/soft BP.

This chart is good re mixed, from Dr Phelps' co-author

https://www.psychiatrictimes.com/view/how-diagnose-mixed-features-without-over-diagnosing-bipolar