The intervention also considered environmental elements that might lead to the cause as well as the progression of bipolar affective disorder in Christopher’s case. Such include potential childhood trauma, loss of loved ones, unemployment, work pressures, and many others. The socio-environmental factors have also been shown to contribute to bipolar affective disorder and must be considered during an intervention (Haslam, et al., 2018). Since the patient reported having lived on the street during his teenage age, it was thought possible that he might have experienced childhood abuse and trauma at one point in his life, which could also contribute to bipolar affective disorder.
Childhood abuse is high among individuals with the bipolar affective disorder compared to the over-all population (Haslam, et al., 2018). Henceforth, some features of emotional regulations characteristic of bipolar affective disorder patients may not be bipolar affective disorder-specific. However, they may indicate early trauma’s impacts (Rice, et al., 2019). Researchers have observed heterogeneity in emotion regulation trends among the bipolar affective disorder population, partly attributed to variation in early childhood experiences (Tremain, et al., 2019).
The experience of childhood trauma among bipolar affective disorder patients is linked to long-term outcomes such as an increased rate of bipolar episodes, early age onset, high risk of suicides and suicidal isolation, and high prevalence of substance abuse (Haslam, et al., 2018). It has also been observed that childhood trauma in bipolar affective disorder, particularly emotional abuse, appears linked to later affective liability as well as heightened dysfunctional emotional regulation mechanisms in bipolar affective disorder patients (Koenders, et al., 2020). Due to the higher heritability rate of bipolar affective disorder, the link between bipolar affective disorder and childhood trauma can be influenced by genetic factors that impact parental neglect and abusive behaviours in the parents of the patient with bipolar affective disorder (Koenders, et al., 2020).
Besides childhood trauma, other chronic stressors, including those linked to family poverty, impact an individual’s adaptive coping and self-regulation mechanisms and alter brain regions that regulate emotions (Rice, et al., 2019). Children and young adults with bipolar affective disorder family history tend to face elevated chronic stress levels as compared to those without such a history (Rice, et al., 2019). As such, people who grew up in bipolar affective disorder-prone environments and family settings are vulnerable to specific emotional regulation challenges caused by higher levels of chronic childhood stress, such as parental mental health challenges and their influence on parenting behaviours (Haslam, et al., 2018).
Bipolar affective disorder interventions for the patient and future studies on emotional regulations specific to bipolar affective disorder must consider the possible influence of childhood trauma on the patients and whether effective mechanisms were employed to counter them (Haslam, et al., 2018). These early life traumas may be addictive and interactive, in which early life experiences and pre-disposition to bipolar affective disorder determine emotional regulations in specific ways (Haslam, et al., 2018).
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