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The neuro chemical processes are not really known whether it be drug induced mania and psychosis or natural mania and psychosis. And no way to look into the guys brain and see what is going on and what causes what. They know much much more than ever but it is not well understood.
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I want to clarify that statement. There is a large body of evidence that points to genetics, and biological processes in many disorders. That doesn't mean it is true for all cases or that meds are the only answer. What I mean is they don't understand it in detail at a molecular, genetic, neuro pathway, receptor, level. They have lots of evidence that points them in certain directions for further study.