Biological Etiologies
The neurotransmitter theory suggests bipolar is a result of chemical imbalances in the brain. Neurotransmitters take responsibility of communicating information between the various brain parts and nervous system. According to many studies, three brain chemicals — noradrenaline (norepinephrine), serotonin, and dopamine — are involved in both brain and bodily functions (Bright). Noradrenaline and serotonin have been consistently linked to psychiatric mood disorders such as depression and bipolar disorder. Another brain chemical, dopamine, is commonly linked with the pleasure system of the brain. Disruption to the dopamine system is connected to psychosis and schizophrenia, a severe mental disorder characterized by distortions in reality and illogical thought patterns and behaviors.The brain chemical serotonin is connected to many body functions such as sleep, wakefulness, eating, sexual activity, impulsivity, learning, and memory. Researchers believe that abnormal serotonin levels contribute to mood disorders (depression and bipolar). Dopamine, chemical that helps the control of pleasure, is at significantly higher levels in bipolar patients’ mania period. They are also relatively at lower level during depressive episodes (WebMD).
Genetic predisposition to bipolar is another widely accepted etiology. In recent Swedish studies that bipolar will be passed down in families due to hereditary nature. A study led by Genetic Epidiomologist Paul Lichtenstein in a January 2009 focused on psychiatric records of bipolar disorder. By examining the 30 years of psychiatric records he found out a person had 6 times the chance of having Bipolar Disorder if either parent had it (Bright). The genetic influence on bipolar is increasingly advanced by the technology. For example, the launch of the bipolar disorder phenome database scientists are allowed to link visible signs of the bipolar disorder with the genes that might influenced them. So far, the researchers concluded that according to the database most people with the disorder have other illness such as alcohol and substance abuse, panic disorders at the same time, have received medical help, and have family history of psychiatric record. Nonetheless genes are not the sole factor for the development of bipolar. According to several twins studies the twin of the person with bipolar illness does not always develop the disorder despite they share all of the same genes. This suggests that different genetic information and environment mutually affect each other regarding the development of bipolar (NIMH).
Cognitive Etiologies
The cause of bipolar disorder is largely accounted by the biological factors and moderately by sociocultural factors. The cognitive factors may influence the development of bipolar to a certain extend while remaining relatively less influential than other level of analysis. The development of the disorder can be accelerated by certain cognitive processes such as traumatic experiences and memory, emotional imbalance and so on.

Social/cultural Etiologies
Along with a genetic association with bipolar, researches reveal that children with parents with bipolar are subjected to significantly stressful environments. In other words, children living under a parent who has an unpredictable mood changes, alcohol or substance abuse, financial and sexual indiscretions, and hospitalizations will create substantial stress factors that can attribute to the development of bipolar in the future. Many children of bipolar parents may progress not only bipolar but also an entirely different psychiatric disorder such as ADHD, major depression, or substance abuse.
Environmental stressors can also greatly stimulate bipolar episodes in genetically predisposed populations. For instance, children growing up under families with bipolar disorder may experience a parent who lacks control of moods or emotions throughout their life. Some children may have to endure verbal or even physical abuse frequently if the parents do not receive effective medication to treat bipolar disorder. This environmental condition can further accelerate the genetic predisposition to bipolar(WebMD).
It is also suggested that people with bipolar disorder have a genetic predisposition to have irregular sleeping patter that can trigger major symptoms of depression and mania. Sleep loss may precipitate a mood episode such as mania in some people. Worrying about inefficient sleep can add to cognitive arousal and increase anxiety. In one research studies, researchers interviewed 39 bipolar patients with manic or depressed episodes to determine the presence of social rhythm disruptions, a disturbance in routine that affects the sleep cycle,during the two months prior to the onset of the mood. When comparing the results with volunteers in the control group, researchers concluded that most people with bipolar disorder experience at least one social rhythm disruption prior to a major mood episode. In addition, the researchers found that social rhythm disruption affected more bipolar patients with mania than the patients with depression. Their findings concluded that 65% of the patients with bipolar disorder had at least one disruption in their daily rhythm in the eight weeks before the onset of a manic episode (WebMD).

Social Anxiety Disorder / Social Phobia
Biological Etiologies
There is now a good deal of evidence to suggest that genetic factors play a modest but significant role in the development of social phobia in both children and adults. Early researches identified relatively high rates of social phobia from family members of patients of social phobia. And children with social phobia were more likely than their non-affected peers to have parents with social phobia (Rapee). Today, several twin studies with large sample sizes substantiate the significant genetic influence in the development of social phobia.
Kendler et al. reported a significant genetic influence of social phobia, 0.31 in 2163 female twin pairs. In addition, related features of social phobia such as shyness, fear of negative evolution, anxiousness, submissiveness and social avoidance demonstrated a strong environmental effect, heritability estimate of 0.48, in 437 twin pairs (Stein et al. 2002). These data substantiate the fact that heritability is greatly involved in the development of social phobia and further indicate that the persistence of social phobia is strongly under genetic influence.
Cognitive Etiologies
Social phobia is characterized by biases and distortions that occur during processing and thoughts about social information. Individuals who were engaged in a series of biased past social interaction that can generate anxious emotion and may impair social performance can trigger social avoidance and adverse social outcomes. And these outcomes reduce their opportunity to alleviate their anxiety. A persistent negative social outcomes, or traumatic social experiences, could contribute some variance to the development of anxiety to social situations. A study with social phobic adults provide some evidence to suggest that adverse social experiences during childhood may play a role in the development of their social phobia. Adult social phobic frequently recall memories of criticism, humiliation, bullying, and other adverse social consequences (Rapee). Many studies indicate that these cognitive phenomena are evident in social phobic and socially anxious children as young as 8 years.
Spence et al. (1999) examined cognitive distortion and in social phobic children. The subjects were required to complete reading aloud and social role-play tasks and were asked to rate the quality of their expected performance before each task, their performance after task completion, and then to recall their cognitions relating to task performance using a video-mediated procedure. Social phobic children showed a similar pattern of cognitive negativity regarding social self-evaluation as shown by adults with social phobia. In comparison to a matched sample of non-socially anxious peers, social phobic children tended to anticipate negative outcomes, evaluated their own performance more negatively, and showed a higher level of negative cognitions on social evaluative tasks. Furthermore, the effect was limited to social events. Although the social phobic children were rated as performing less well on the social task, they did not differ from controls in performance on the reading task. The social phobic children rated their performance poorly on both reading and social tasks, suggesting that their negative evaluation of their own performance is not always reflect their actual performances (Rapee).
Social/cultural Etiologies
As mentioned previously on the cognition, negative past social experience can trigger social phobia, perhaps particularly more likely to occur for individuals with interpersonal personality. For around half of people diagnosed with social anxiety disorder, a specific traumatic or humiliating social experience seems to be associated with the onset or worsening of the disorder. This kind of experiences is particularly related to specific social phobia. In addition to personal experiences, observing or hearing about socially negative experiences of others or verbal warnings of social problems and dangers, may also cause the development of a social anxiety disorder. Social anxiety disorder may be caused by the longer-term effects of not fitting in, or being bullied, rejected or ignored (Beidel and Turner, 1998). Shy adolescents or adults have distinguished humiliating experiences with peers or childhood bullying or harassment (Gilmartin, 1987). In one study, popularity among peers was detected to be negatively correlated with social anxiety, and children who were rejected by their peers reported higher social anxiety. Socially phobic children appear less likely to receive positive reactions from peers and anxious or inhibited children tend to isolate themselves.
The prevalence data on social phobia suggests the different rates of its occurrence across different cultural groups. For instance, in some South-East Asian countries such as Korea and Taiwan reported relatively low rate of social phobia. These differences in rate of social phobia suggest the presence of cultural influences on the cause, expression and even reporting of social phobia.
One possible reason for the dissimilar prevalence rate across culture is the difference in the expression of social anxiety disorder in each culture. The difference in social expectation and norm results in the creation of culture-bound disorders; in regard to social anxiety the offensive type can emerges in Japanese culture, called taijin kyofusho. Taijin kyofusho is characterized as one is excessively overwhelmed by worries about the humiliation or offense they may cause to others. Even though there is some discussion about whether taijin kyofusho is distinguished or equivalent to social phobia, the two features exhibit significant relatedness (Kleinknecht, Dinnel, & Kleinknecht, 1997; Lee & Oh, 1999; Russell, 1989.
Taijin kyofusho raises the possibility that the way basic social anxiety is expressed can be influenced by culture. Theoretically, it has been suggested that in a collectivist society like Japan one is more likely to put emphasis on distress to others while in individualistic societies one is more likely to focus on one’s own distress (Rapee).
Alternative explanation for different rate of social phobia is that the difference in social expectation about individuals’ behavior results in different threshold and definition of same symptoms. In other words, in a collectivist society some degrees of social anxiety can be considered as advantageous and adequate in a way to express modesty and to fit into community; thus only significantly high levels of social anxiety would be classified as disorder. According to Weisz’s research study, Thai parents view externalizing behaviors in their children are more problematic than internalizing behaviors while the result was exact opposite to American parents. Therefore, internalizing symptoms such as social anxiety may not be considered significant and distinguished in some culture.

Works Cited
Weisz, J. R., Suwanlert, S., Chaiyasit, W., & Walter, B. R. (1987). Over- and under controlled referral problems among children and adolescents from Thailand and the United States: The Wat and Wai of cultural differences. Journal of Consulting and Clinical Psychology, 55(5), 719 – 726.
Kleinknecht, R. A., Dinnel, D. L., & Kleinknecht, E. E. (1997). Cultural factors in social anxiety: A comparison of social phobia symptoms and Taijin Kyofusho. Journal of Anxiety Disorders, 11(2), 157 – 177
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Bright, Paul. “Etiology of Bipolar Disorder.” EHow. Demand Media, 02 June 2009. Web. 28 Feb. 2012. <>.
Rapee, Ronald. “The Etiology of Social Phobia: Empirical Evidence and an Initial Model.” Science Direct. ELSVIER, 2004. Web. <>.