Bipolar disorder is a condition characterized by both depressive episodes and manic or hypomanic episodes. The pattern of these symptoms is different for everyone. Some people may feel relatively normal much of the time, occasionally tipping into a manic or depressive episode and some people may cycle more quickly from one to the other. There are several triggers that can cause an episode, even if the condition is controlled with therapy and medication.
Changes in Sleep Patterns or Lack of Sleep
Disturbed sleep is a major trigger of bipolar symptoms. Typically, getting too little sleep leads to manic or hypomanic episodes. Your body recognizes it’s not well-rested so it boosts your levels of adrenaline and cortisol to keep you going. In addition to this, your prefrontal cortex, which helps regulate emotions, can’t function at full capacity with too little sleep. As a result, you might slip into a manic or hypomanic episode. A smaller percentage of people might slip into a depressive episode instead. Both manic and depressive episodes can make the problem worse by disturbing sleep even more.
There are many ways sleep gets disturbed that people with bipolar should watch out for. One is just leaving too little time for sleep or dealing with some kind of emergency. Seasonal changes, especially Daylight Savings time can throw off your sleep and cause an episode. Travel is also something to watch out for, as jet lag can disturb your sleep cycle for weeks.
Drugs And Alcohol
Drugs and alcohol affect your brain chemistry and can cause an episode. This may seem obvious when dealing with a drug like cocaine, but it may be less obvious when it comes to alcohol. Not only can alcohol powerfully disrupt your balance of neurotransmitters, but it can also make your bipolar medication less effective. Prescription medications may also cause an episode. Antidepressants, when not counterbalanced by mood stabilizers can cause manic or hypomanic episodes.
Stress can cause a depressive episode even in someone with no history of mental health issues. A divorce, the death of a loved one, or the loss of a job can lead to an episode of major depression and these are all major triggers for bipolar disorder. Even good stress can lead to an episode, typically a manic episode. Achieving a goal or an unexpected windfall can lead to excitement that gets out of control. The brain can’t regulate positive emotions, so it spins into a manic episode.
Blowout Arguments With Partners, Coworkers, or Friends
Broken relationships are too often the result of untreated bipolar disorder.
But getting into a spat with a loved one could also be a red flag: Your argument could be due to the irritability that often occurs during a manic or depressive episode, or could itself cause stress that becomes a contributing factor for a recurrent episode.
Any type of relationship conflict — whether it’s with your partner, coworker, family member, or friend — can trigger stress and send you over the edge. In a study published in May 2015 in the Journal of Affective Disorders, people with bipolar disorder said negative social experiences were among the events that triggered suicidal thinking for them.
Hormones can play havoc with your brain chemistry. The shifting hormonal landscape is one reason women are more prone to depression than men and it can be a trigger for bipolar symptoms. The premenstrual phase may trigger or worsen an episode of depression. Pregnancy and childbirth are especially challenging for women with bipolar disorder because it combines hormonal changes, life stress, and sleep disruption. You can’t always avoid these triggers, but you can try to get enough sleep and avoid drugs and alcohol. Being aware of triggers helps you adapt when you encounter them and prepare when you see them coming.
A Brand-New Season and Abnormal ‘Clock Genes’
About 20 percent of people with bipolar disorder experience fluctuations in the mood when the weather changes. Specifically, they’re more likely to undergo seasonal depression during the early winter, and mania or hypomania during the spring or summer.
Your circadian rhythm, the body’s internal response to changes in a 24-hour day, is affected by the amount of sunlight you experience. This response is controlled by a complex set of genes commonly referred to as “clock genes.” If some of these genes are abnormal, you could be at risk for seasonal bipolar disorder.
Financial and Emotional Strains Due to a Job Loss
One of life’s most unpredictable stressors? Losing your job.
And the emotions you may feel about your job loss can be equally unpredictable. People who weren’t satisfied with their work can find it liberating. For others, the financial and emotional strains involved can trigger major stress. Either way, the dramatic shift in emotions could trigger a bipolar episode.
It may be a good idea to put away three to six months of savings to help with the transition, should you lose your job.
The Death of a Loved One and Bereavement
The death of a loved one may be the most stressful life event any of us will ever face. Many people continue managing the bipolar disorder successfully through their mourning, but it may have extreme consequences for others, who can develop “funeral mania”.
This occurs when someone with controlled bipolar disorder attends the funeral of the loved one and has a manic episode over the course of the following week. The period of bereavement should be one of increased monitoring and heightened support.
There are many life-changing events that can serve as a bipolar trigger. For example, giving birth to a child, getting divorced, and even falling in love can trigger bipolar disorder.
While any trauma (which is essentially severe stress) can trigger a bipolar episode, childhood trauma is associated with severe bipolar clinical symptoms. Rapid cycling, in particular, is strongly linked with sexual abuse.
Prevention of bipolar mood episodes may not be possible, but understanding triggers may help you better manage your illness.
Recognizing Bipolar Triggers and Warning Signs
There are many factors that trigger bipolar episodes. Each person living with bipolar disorder will have their own specific triggers they are more susceptible to and every person will display warning signs differently. Over time, a person will come to recognize their own bipolar triggers and warning signs.
Some warning signs might include:
- Insomnia (sleep disturbances)
- Trouble concentrating
- Impulsive behaviors and decision making
- Feeling sad
- Decreased (or increased) energy
Remember, the warning signs of bipolar disorder will differ based on whether a manic or depressive episode is about to begin.