Expert: Jennifer - 6/24/2008

Question
My friend is in the adoption process.  She has been presented with a situation where the birth mother is bipolar, but indicates no other family members have a history of mental illness.  We understand that family history plays a significant role in determining the risks for bipolar, but would this baby have the same risk factor as that of a child of a bipolar parent who had a previous family history of the disease?

Answer
"1st degree biological relatives of individuals with bipolar I have elevated rates of type I 4-24%, type II 1%-5%, and major depressive disorder 4-24%.  Individuals with mood disorders in their first degree biological relatives are more likely to have earlier age at onset.  Twin and adoption studies provide strong evidence of a genetic influence for bipolar disorder I."
DSM IV-TR page 386, mood disorders

"Some studies have indicated that 1st degree biological relatives of individuals with bipolar II disorder have elevated rates of Bipolar I, Bipolar II, & major depressive disorder compared with the general population."
DSM IV-TR page 395, mood disorders

The information above is taken directly from the diagnostic and statistical manual of mental disorders, fourth edition text revision, and is the current edition in use until the fifth edition is published and available which is expected in 2010.  This particular section indicates that from what was known about the genetic predisposition of bipolar disorder and heredity within families has occurred when an individual has a first degree biological relative with the disorder.  
 The only other source of information that I was able to locate, that speculates on whether the rate of occurrence increases with an individual who has multiple first-degree biological relatives who have/had some type of mental illness such as bipolar, schizophrenia, major depressive disorder, or unspecified mood disorder would be "Touched by Fire: Manic Depressive Illness and the Artistic Temperament" written by Dr. Kay Redfield Jamison.  In this book, there are several families from which many of the greatest writers, painters, composers, and other creative minds that the world has ever known had come from.  These family trees are used to illustrate the significantly higher number of individuals with mental illnesses, that have been found in the medical history of individuals like Lord Byron, Samuel Taylor Coleridge, T.S. Eliot, Georgia O'Keefe, Michelangelo, Robert Schumann Alfred Tennyson and so forth.  

Essentially, there is no way to know with absolute certainty, what the future will hold for an unborn child.  This can be said in any situation, even when there is no family history or a parent who is bipolar.  The part of the condition that is genetically influenced is accompanied by the part which is environmental.  Certainly, a child who has been given a loving home, parents who encourage their interests and curiosity about the world around them, and never feeling unwanted because they were adopted -- certainly that child would have a better chance of not letting something like bipolar disorder prevent them from leading as normal of a life that anyone can expect to have.