Can a severe physical injury later lead to bipolar disorder?
Most agree there’s a genetic component to BP. Studies suggest that some environmental factor causes the genes responsible for the disease to express themselves before bipolar disorder develops.
But how long before? And what kind of factors?
Countless published research papers seem to throw everything up against the wall to find what sort of things are common in people with bipolar disorder. A lot sticks, and one who studies the NIH database is tempted to say nearly everything causes BP.
A few recent studies focused on physical trauma and found some strong connections.
One study published in 2016 that received a lot of attention found that people who suffered physical abuse as a child were nearly 3 times as likely as the control group to develop bipolar disorder.
Another looked at head injuries suffered by kids between the ages of 11 and 15. This study found that such injuries resulted in deficient inhibitory control and poor attention span within one year in many of the children who experienced head injuries. A significant number went on to develop bipolar disorder.
Severe injury in childhood, especially head injury, was also found to be a precipitant to later substance abuse and suicide attempts.
I remember when I entered the psychiatric clinic at the University of Pennsylvania. An attending physician and a few residents sat with me around a large table. They peppered me with questions as they took an exhaustive medical history.
When I told them about a severe mouth injury I received when I was an 18 month-old they all perked up.
I was dancing with my brother to “Happy the Clown” when I fell and smashed my teeth on a rocking chair. My front baby teeth were driven back into my head. When they re-emerged they were shattered and dark and I had to undergo oral surgery.
My mother tells the story of being kept from the surgery room. She heard my screams down the hall as the doctors removed the teeth and repaired the sockets.
Only it didn’t work. My mouth became severely infected and another surgery followed.
To let you know how different things were in the mid-1960s, the surgeon sat with my parents and said, “every doctor has his bad results. George is mine.” Malpractice wasn’t a thing back then.
I remember growing up with no front teeth. Mom had to cut the corn from the cob for me in the summer, and I’m smiling wide and toothless in my elementary school pictures. I had spacers and root canals before I ended up with a full, albeit crooked, set of teeth.
Does this have anything to do with why my genetic predisposition to bipolar disorder became full blown BP? The doctors at Penn suggest it does. People with childhood physical trauma such as head injury develop BP at high enough a rate that researchers believe they may be causal factors.
This could be important as it gives doctors and families a reason to carefully monitor a child in the years following physical trauma in order to discover the emergence of mental illness or any other related condition. Early intervention may be possible, thus improving the child’s or the young adult’s prognosis.
That rocking chair stayed in the family for years. I remember seeing it at my uncle’s house. The imprint of my tiny little teeth was still on the seat. The chair’s gone now, but I wish I still had it. One clumsy moment and that chair may have led to all these years of struggle with bipolar disorder.
Photo by ryan.dowd