Bipolar disorder is characterized by periods of depression alternating with periods of elevated mood, sometimes mania that requires hospitalization. Each of these periods may last weeks or months and may change without warning. Someone can be so depressed she can hardly get out of bed and a few days later she may have a lot of energy and barely need any sleep. Neither depression nor mania is a good state to be in. While many people assume that mania means feeling good, it often comes with intense anxiety, paranoia, hallucinations, and reckless behavior. What causes these sudden shifts? Is there any way to make them less likely? There’s a lot we still don’t know about bipolar disorder, but the following factors often trigger sudden mood swings.
Stress
Stress is a major trigger of bipolar symptoms. This is particularly true of relationship stress. If you have a falling out with a friend or loved one, if you have frequent arguments, it may trigger an episode of depression. This is especially true for a breakup or divorce, which may lead to a depressive episode even for people without depression or bipolar disorder. Although relationship stress is particularly powerful, any kind of stress will do. Work stress, prolonged illness or injury, financial problems, and other stressors can cause an episode. Even good stress like getting a promotion or having a baby may cause problems.
Change in sleep schedule
Another major trigger is a changing or erratic sleep schedule. Sleep is a complicated process that involves carefully orchestrated changes in hormone levels. Disrupting this rhythm can trigger a bipolar episode. It is especially bad if you don’t get enough sleep. Inadequate sleep, even over just a few days can increase anxiety, impair cognition, and increase suicidal thoughts. Two situations that often present problems for people with bipolar disorder are jet lag from travel, and seasonal changes, especially daylight savings time.
Stopping medication
If you only use medication intermittently, or if you stop using it abruptly, it may trigger an episode. What kind of episode depends on the kind of medication. Often, bipolar is treated with an antidepressant and a mood stabilizer. Taking an antidepressant without a mood stabilizer might cause a manic episode. Stopping medication entirely will have unpredictable results.
Using drugs or alcohol
Just as quitting medication can unbalance your brain chemistry and cause unpredictable mood changes, using drugs or alcohol can disrupt the balance of neurotransmitters in your brain, triggering a bipolar episode. This is an especially important factor to pay attention to because more than half of people with bipolar disorder also have some degree of substance use disorder, which only makes their condition worse.
Changes in weather
Changes in weather can have significant impacts on mood. In the winter, when days are shorter and you often have to get out of bed before the sun is up, depression becomes much more common. On the other hand, the hotter weather and longer days of summer have been shown to increase the risk of a manic episode.
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