Irritability as a Prodromal Etiological Driver of Hypomania in Vulnerable Bipolar Patients

In this work, we propose—perhaps—a striking etiology for hypomanic phases in patients with bipolar disorder under conditions of vulnerability. Irritability, nurtured over time, can be seen as a triggering factor for hypomanic crises, as it provides a greater flow of dopamine in sensitive brain regions of patients predisposed to this condition. Based on the observation that in autistic patients, irritability is hypofunctional under antipsychotic treatment, it is determined that high levels of mesolimbic dopamine, under positive feedback through irritability, significantly decompensates patients with bipolar disorder.