Bipolar Disorder: Understanding Common Triggers

If you or someone you love has bipolar disorder, you’ll know how quickly mood shifts or swings can happen. Bipolar disorder presents in a number of ways, all of which have mood instability as one of their hallmark symptoms. While bipolar episodes can be upsetting to experience or witness, the good news is that bipolar disorder can be treated with the right combination of medication and therapy.

The first step to managing bipolar disorder is to recognize the triggers for mood shifts so you can overcome, minimize, or avoid them in the future. While triggers can be different for everyone, there is a range of common issues to look out for.

Changes in sleep patterns

Your sleep patterns and mood are closely connected¹. When you don’t sleep enough, or you have poor quality sleep, you can experience irritability and mood swings. Even those without bipolar disorder typically experience negative effects from poor sleeping habits. Stress, anxiety, and depression can all impact sleep and make it more difficult to get a good night’s rest.

When your sleeping habits suddenly change for the worse, this can trigger a mood swing. If your work hours change or you are planning to travel to a different time zone, it is important to try to implement a quality sleep schedule as best as you can to minimize the effect on your sleep.

During periods of mania, it can be difficult to sleep. Your brain is often running nonstop and you may even feel like you don't need to sleep at all. Sometimes, during manic phases, patients stay awake for days at a time. However,  even if you don't feel tired, your body still needs sleep to rest and recover.

If you have trouble sleeping due to symptoms of bipolar disorder, make sure to speak to your doctor. You could also look into interpersonal and social rhythms therapy (IPSRT)² to help you to learn strategies for managing bipolar to improve your sleep quality.

Relationship stress

Our relationships can be the source of both emotional highs and lows in our lives, especially if you have bipolar disorder. If you have a fight with a friend, family member, or significant other³, you may feel that you are spiraling out of control. Many people with bipolar disorder have trouble maintaining relationships because of their unstable moods. When you're feeling irritable, you may pick fights with people you love, even if you don't intend to.

While your friends and loved ones aren't required to tolerate your mood swings, but if they reject, criticize, or avoid you because of how you are behaving towards them, it can be hurtful and seriously affect your mental state. To avoid relationship stress, focus on sticking to your treatment plan and involving loved ones in your treatment where possible. Couples counseling or family therapy can help to open up communication and understanding about your condition.

Drug or alcohol use

Substance use disorder⁴ commonly occurs alongside bipolar disorder. Many people with bipolar disorder use drugs or alcohol to help manage their symptoms, but this typically makes their symptoms worse. While drugs may mask symptoms for a short time, they do not address the underlying emotional issues that you may face if you have bipolar disorder.

Drugs and alcohol can make both mania and depression worse, and can even induce manic or depressive episodes. Depressants like opioids and alcohol can lower your mood, while stimulants like amphetamines or cocaine can trigger a manic episode. If you have a bipolar diagnosis, ensure you stay away from mood-altering substances, and only take medicine that has been prescribed by your doctor.

Seasonal changes

When the season changes, our moods can change too. Seasonal affective disorder (SAD) is a different condition to bipolar disorder, where changes in weather and daylight hours trigger mood shifts. Lower levels of sunlight during winter can interfere with our sleeping habits, and cold weather may make us feel that we are trapped indoors with nothing to do.

Winter can trigger depressive moods, and daylight savings time may alter your sleep schedule. This can make it difficult for our internal body clock to maintain a proper sleep-wake cycle because of the lack of sunlight.

Certain seasonal holidays, such as Thanksgiving or Christmas, may also be triggering if you have bipolar disorder, as they may provoke feelings of loneliness.

Medication

If you have been diagnosed with bipolar disorder, you should work with your doctor to find the right medication (or combination of medication) and dosage to treat your symptoms. If you have not been diagnosed, and your doctor does not realize you have bipolar disorder, they may prescribe the wrong medication which can worsen your symptoms.

If you visit your doctor during a depressive episode, you may be diagnosed with depression, and your doctor may prescribe antidepressants. Certain antidepressants, however, may trigger mania⁵ if you have bipolar disorder. While antidepressants can help you to deal with depressive symptoms, they should only be prescribed in conjunction with a mood stabilizer to prevent manic episodes resulting from antidepressant use.

Problems at work

Everyone can relate to feeling stressed out at work. Approaching deadlines, looming meetings, or conversations with your boss can easily make you anxious, especially if you have been diagnosed with bipolar disorder. If you are worried about losing your job, your anxiety levels can skyrocket.

Stress can trigger bipolar episodes, both manic and depressive. To lower your stress levels, it's important to use your time outside of work to rest, relax, and do things you enjoy. If you feel safe and supported talking to your boss about your bipolar disorder, this can be a helpful way to improve communication and your work environment. While there is unfortunately still stigma around mental health conditions, such as bipolar disorder, talking to your supervisor or HR department may help to promote understanding.

Major life events

Major events⁶ in your life, whether good (a wedding, promotion, birth of a child) or bad (death of a loved one, separation, or divorce), can trigger mood shifts because they can all cause some form of stress. Stress in general is a significant trigger for changes in your mood, regardless of its source.

If a big event is coming up, you can plan ahead by thinking of ways to maintain your supportive routine throughout it. However, life-changing events can often be unexpected, so no matter what you're going through, it's important to keep up with your treatment plan and seek additional support when needed.

The lowdown

A common symptom of bipolar disorder is mood shifts or swings. These emotional changes can be difficult to manage, especially if you aren't aware of your triggers. If you've been diagnosed with bipolar disorder, it's important to keep a careful eye on your moods so you can understand what is triggering your depressive or manic episodes. There is a range of common triggers, including stress from relationships, work, or major life events, or substances such as drugs, alcohol, or medication. Make sure to speak to your doctor about the best treatment for you.