6 Common Bipolar Triggers to Steer Clear Of

Life events and habits can make bipolar episodes worse, or even prompt a relapse.

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About 5.7 million adults have been diagnosed with bipolar disorder, a condition that causes changes in mood—and of those cases, over 4.7 million have severe bipolar disorder. Otherwise known as manic depression, bipolar disorder affects men and women equally, and while it can occur at any age (even during childhood), the average age of onset is 25.

There is no single known cause of bipolar disorder, but experts agree that certain factors, like genetics, stress and brain structure may increase a person’s risk. And even though there are many treatments for bipolar disorder, certain life events and habits can make bipolar episodes worse or cause a relapse, reoccurrence of episodes.

There are different types of bipolar disorders and episodes

2 / 6 There are different types of bipolar disorders and episodes

There are three different types of mood episodes, times of intense emotion, changes in sleep, activity levels and unusual behaviors, associated with bipolar disorder; most episodes can occur for weeks at a time. Here’s a breakdown:

  • Manic: These episodes can bring about insomnia, concentration problems, racing thoughts and may make you feel like you can conquer the world, or on the flip side, may make you feel irritable.
  • Hypomanic: You’ll have symptoms similar to manic episodes, but not as severe.
  • Depressive: You’ll feel a strong sense of sadness and hopelessness for at least two weeks at a time. And may feel a loss of interest or pleasure in things you once enjoyed.

In addition to the various episode types, there are different types of bipolar disorders, too. Bipolar I disorder is when a person has a manic episode, bipolar II is diagnosed when a person has at least one depressive episode and one hypomanic episode, and cyclothymic disorder usually involves a combination of depressive symptoms, mood swings and hypomanic episodes; it’s considered the milder form of bipolar disorder.

And regardless of the bipolar type, you’ll have to lookout for everyday triggers. “Bipolar disorder can be exacerbated by many different factors,” says Cesar Figueroa, MD, of Coliseum Medical Center in Macon, Georgia. Here are some of the things Dr. Figueroa says can prompt an episode, some common treatments and ways to avoid these episodes. 


3 / 6 Stress

In general, people with bipolar disorder are more prone to stress than the average person. They have trouble coping with situations and may interpret insignificant events as stressful. High stress levels can cause depressive, manic or hypomanic episodes, anxiety and anger.

To avoid stress-related bipolar issues, try incorporating stress reduction techniques into your lifestyle. Recognizing patterns in your episodes will help you partner with your doctor in identifying the best treatment plan. Psychotherapy, a treatment where your psychologist will help you build healthy habits, is often the preferred method of treatment.

Journaling—writing down stressors or other things on your mind— may be one of the exercises your psychologist suggests, says Figueroa. Taking note of the events, people or places that cause you stress may help you understand the triggers, that might go unnoticed otherwise.

And always remember to surround yourself with people who lift your mood. A healthy relationship with a more relaxed friend or family member can help you stay calm, as opposed to a friend who constantly causing drama or stress, which can exacerbate bipolar episodes. 

Lack of sleep

4 / 6 Lack of sleep

Although a significant change in sleep patterns is also a symptom of bipolar disorder, changes to your sleep-wake cycle, or circadian rhythm, can also trigger a bipolar episode. Furthermore, one study argues that problems with circadian rhythm may be related to genetic causes of bipolar disease. For those with bipolar disorder, shift work, travel and restless nights may lead to an increased risk of unstable mood episodes. According to one small study from Penn State College of Medicine and University of Michigan Medical School, lack of sleep can trigger undesirable mood in women with bipolar disorder, specifically, the number and severity of depressive and manic episodes.

If you notice any changes in your sleep, Figueroa says to talk with your healthcare providers to discuss what may be interrupting your sleep.

And remember that on the flip side, getting too much sleep can cause your energy levels to drop; it’s best to aim for 8 hours of sleep per night. Here are some ways to keep your sleep-wake cycle consistent:

  • Maintain a regular sleep schedule, including waking and sleeping at the same time every morning and night.
  • Get some sunlight first thing in the morning; opening your blinds or taking a quick walk around the block will do.
  • Exercise daily.
  • Limit caffeine and alcohol consumption.
Drug and alcohol use

5 / 6 Drug and alcohol use

According to one Norwegian study, about 20 percent of people with bipolar disorder have a substance abuse disorder. And while this may not be representative of the world population as a whole, it is easy for the two conditions to co-exist: many times, those with bipolar disorder try to self-medicate with drugs or alcohol in an attempt to ease the difficulties, like anxiety, pain, depression and sleeping problems. In general, alcohol and drugs cause more emotional instability. And mixing these drugs or alcohol with other antidepressants or anti-anxiety medications can cause:

  • Unusual behavior
  • Weakened motor control
  • Increased feelings of sadness
  • High blood pressure
  • Memory issues
  • Liver damage

Specifically, marijuana, opiates and alcohol can temporarily ease mood swing symptoms, but will only make things worse later on. Other substances like speed and cocaine can send people with bipolar disorder into a manic episode, and later depression. Hallucinogens such as LCD and PCP can trigger symptoms, too.

Alcohol depresses the central nervous system, and contributes to depressive symptoms. And, because alcohol alters a person’s awareness and inhibition, it’s especially dangerous for people with bipolar disorder.

If you have bipolar disorder, it’s best to abstain from alcohol completely. If you do choose to drink, stick to one glass a day or less. And if you’re taking any medications for bipolar disorder, it’s best to consult with your healthcare provider about whether or not you can have a drink.

Reaching for alcohol or drugs when times get difficult or when you’re in situations that make you feel uncomfortable? The first thing you need to do is seek treatment from a mental health professional, like a counselor. You can also contact the Substance Abuse and Mental Health Services Administration National Helpline at 1-800-662-HELP, to learn about treatment centers and local support groups near you and for other resources like free publications and information. 

Pregnancy and childbirth

6 / 6 Pregnancy and childbirth

Every year, about 500,000 pregnant women have or develop some sort of psychiatric conditions like major depression, bipolar disorder or anxiety while they’re pregnant. Pregnant women who have bipolar disorder have a real risk for relapse. There’s a 32 to 67 percent chance that women who have bipolar disorder will relapse after their child is born.

During pregnancy, most women, not just women with bipolar disorder, typically experience normal—and very understandable—worries or anxieties about becoming a parent, the health of their baby and the financial commitment it takes to raise a family. Changes in hormone levels, fatigue and metabolism changes can all contribute to such feelings. These same anxieties continue (and may even escalate) postpartum, triggering a relapse of bipolar episodes.

In general, it can be difficult to weigh the risk and benefits when it comes to pregnancy and birth, mental illness and treatment options. That’s why it’s important to talk with your OBGYN, mental health care physician and pediatrician to determine the right treatment plan. Common bipolar medications, like lithium, valproic acid, paroxetine and carbamazepine are all associated with an increased risk of fetal abnormalities and problems, so experts recommend that other pregnancy and postpartum treatments be made before conception. You can try these natural ways to help control bipolar-related mood swings, too:

  • Take some time to relax.
  • Get regular exercise.
  • Take naps when you’re feeling tired.
  • Try yoga or meditation classes.
  • Practice healthy eating habits.

Having a child when you have a mental health disorder is a very important decision, but knowing that your treatment plan may have to be adjusted shouldn’t discourage you from starting a family. Know that your condition is manageable both during pregnancy and postpartum.

And when it comes to bipolar disorder, following your treatment plan is very important. That, along with minimizing your exposure to these triggers when you can, can help prevent frequent episodes.

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