Avoiding Top Bipolar Triggers
Bipolar disorder is characterized by extreme shifts in mood — from high moments of grandeur to deeply depressed lows.
And when those shifts are severe enough, they can have a profound effect on your life.”It may take months or years to piece your life back together after the damage is done”, says psychiatrist Jeffrey Bennett, MD, an assistant professor of psychiatry at the Southern Illinois University School of Medicine in Springfield.
But can they be avoided? Perhaps. Understanding what triggers mood swings and planning ahead to deal with them can help you avoid a damaging episode of mania or depression.
One of the most common bipolar triggers is stress. In a study published in June 2014 in the Journal of Affective Disorders, negative or stressful life events seemed to trigger mood swings. “People with bipolar disorder are seven to eight times more likely to experience an unwanted, extended period of extreme mood shift — failure of their ususal coping mechanisms — in response to a stressful life event,” says Dr. Bennett. The events that cause serious stress are highly individual, but certain key life events and lifestyle patterns may act as triggers.
Watch out for these common bipolar triggers.
Skimping on Sleep
A change in your sleep pattern is a hallmark symptom of bipolar disorder — but it can also be a trigger.
Shift workers, people who work long hours, and students who are short on sleep are all at risk for bipolar mood swings related to a lack of sleep. Social rhythms therapy is the most effective prevention, Bennett says. This treatment approach, available in group as well as individual sessions, helps you develop an orderly life schedule surrounding sleep, diet, and exercise habits to make you more effective at managing bipolar disorder.
Broken relationahips 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 signals an upcoming bipolar mood swing, or it could trigger a bipolar episode. Any type of relationship conflict — whether it’s with your partner, co-worker, 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.
A Bad Breakup
A number of people with bipolar disorder — especially those with a history of manic episodes — have failed marriages.
If you’re going through a divorce, working with your therapist through what is often a drawn-out — and extremely stressful — process can help. Bennett also says you might consider a durable power of attorney that allows someone else to make major decisions for you, such as financial ones, when you are going through bipolar mood swings because of a breakup.
Boozing and Using Drugs
Abusing drugs and alcohol doesn’t cause bipolar disorder, but it can set off a serious bipolar episode. What’s more, about one in five people with bipolar disorder have a substance abuse problem, according to an analysis of data on young adults with mental illness published in February 2015 in the journal Social Psychiatry and Psychiatric Epidemiology.
Drugs such as cocaine and amphetamines may trigger mania, while alcohol is strongly linked to depressive episodes.
Antidepressants and Other Medications
Can antidepressants make you manic? While recent studies have not done much to prove that antidepressants lead to mania in people with bipolar disorder, many psychiatrists say they’ve seen patients enter a manic phase after starting antidepressants — and some feel uncomfortable prescribing them to their bipolar patients.
What should you do about bipolar depression? Until more research is available on long-term safety, Keming Gao, MD, PhD, a professor of psychiatry at Case Western Reserve School of Medicine, suggests the following: Antidepressants should only be used as a last resort for more serious symptoms of bipolar depression that have not responded to mood stabilizers; they should never be used for bipolar treatment alone; and patients and doctors should consider removing antidepressants once symptoms have responded.
Other medications that have been linked to manic episodes include corticosteroids, thyroid medications, and appetite suppressants.
A Brand-New Season
About 20 percent of people with bipolar disorder experience fluctuations in 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, according to a research review published in October 2014 in the Journal of Affective Disorders.
Experts chalk this up to sunlight: Your circadian rhythm, the body’s internal response to changes in a 24-hour day, responds to the amount of sunlight. 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.
A Visit From the Stork
The American College of Obstetrics and Gynecology estimates that women with bipolar disorder have up to a 67 percent chance of bipolar mood swings in the postpartum period — the weeks and months after birth.
Changing sleep patterns, altered medication prescriptions, and shifting hormones after delivery can combine as bipolar triggers, according to research published in November 2014 in the journal The Lancet. Use the nine months of pregnancy to work with your entire medical team — your bipolar disorder specialists and your ob-gyn — on treatment approaches you can try during and after pregnancy to help prevent postpartum depression.
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 may the most stressful life event any of us will ever face. Many people continue managing bipolar disorder successfully through their mourning, but others develop “funeral mania,” says Dr. Bennett. This occurs when someone with controlled bipolar disorder attends the funeral of the loved one and almost instantly has a manic episode.
Prevention of a bipolar mood swing is possible if you and your therapist prepare in advance.