Bipolar disorderis characterized by symptoms including unusual shifts in mood and energy. These mood shifts or episodes last at least a week in the case of mania, and at least two weeks in the case of depression, according topsychiatristJeffrey Bennett, MD, an associate professor of psychiatry at the Southern Illinois University School of Medicine in Springfield.
There are several types of bipolar and related disorders. In order to be diagnosed with bipolar I, you must have had at least one manic episode that may have been preceded or followed by hypomanic or depressive episodes. In the case of bipolar II, you must have had at least one major depressive episode and at least one hypomanic episode, but never experienced a manic episode.
Both mania and hypomania share the same symptoms, which include feeling unusually upbeat, euphoric, or irritable, with increased energy, mood elevation, a decreased need for sleep, racing thoughts, trouble concentrating, and poor judgment. In cases of mania, these symptoms are severe enough to be causing significant problems in your day-to-day life.
For example, you might be unable to go to work or school, or you may be compulsively spending money. Hypomania is considered a less severe form of mania. In cases of hypomania, your daily functioning isn't significantly impacted. For example, you are able to work and socialize.
When mood shifts are severe enough, they can have a profound effect on your life. Some episodes of depression and mania are accompanied by loss of reality or psychosis, characterized by hallucinations or delusions. "And unfortunately, suicide is common, with some sources estimating it to be as high as 10 to 15 percent," explains Dr. Bennett.
Can these episodes be avoided? Perhaps not. But understanding certain triggers can help you better manage bipolar disorder.
One of the most common bipolar triggers is stress. In astudy published in June 2014 in theJournal of Affective Disorders, negative or stressful life events were associated with subsequent mood swings. Earlier in their course, episodes of depression or mania in bipolar disorder appear to be triggered more often by stressful life events.
In addition, with recurrent episodes, some people with bipolar disorder may experience less complete periods of remission and a greater likelihood of relapse, either to depression or mania, according to Bennett.
Whilecauses of stressare highly individual, certain life events and lifestyle patterns may act as triggers. Watch out for these common culprits.
Changes in Sleep Patterns or Lack of Sleep
A change in your sleep pattern is a hallmarksymptom 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 having a recurrence of a mood episode related to a lack of sleep. "In addition, travel beyond one's time zone can be another trigger for a mood episode," says Bennett.
Interpersonal and social rhythms therapy (IPSRT)是在e of the most effective preventions, Bennett says. This treatment approach, available in group as well as individual sessions, helps you develop an orderly life schedule of sleep, diet, and exercise habits, to make you more effective at managing bipolar disorder.
Other forms of therapy, includingpsychoeducationandcognitive-behavioral therapy (CBT), can also be helpful in managing the illness.
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 ordepressive 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 astudy published in May 2015 in theJournal of Affective Disorders, people with bipolar disorder said negative social experiences were among the events that triggeredsuicidal thinkingfor them.
The Stress of a Bad Breakup or Failed Marriage
A number of people with bipolar disorder — especially those with a history of severemanic 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.
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 an episode of depression or mania in relation to or during a breakup.
In fact, assigning a durable power of attorney could be useful for anyone who might be experiencing an episode of bipolar disorder.
Alcohol Abuse and Drug Intoxication, and the Aftereffects
Abusing drugs and alcoholdoesn’t cause bipolar disorder, but it can cause an episode to suddenly occur, or it can worsen the underlying illness. What’s more, about one in five people with bipolar disorder have asubstance abusedisorder, according to an analysis of data on young adults with mental illness from anarticle published in February 2015 in the journalSocial Psychiatry and Psychiatric Epidemiology.
Intoxication with drugs such as cocaine andamphetaminescan cause or worsen manic symptoms, while the aftereffects of cocaine or use of alcohol are associated with worsening of depressive symptoms.
Antidepressants, Corticosteroids, and Other Medication
Canantidepressantsmake you manic?
Thetreatment of bipolar disordercan trigger episodes of mania by further setting off unstable moods and behaviors. Many psychiatrists say they've seen patients enter a manic phase after starting antidepressants — and some feel uncomfortable prescribing them to 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 in Cleveland, suggests the following: For bipolar I depression, antidepressants should only be used with amood stabilizeror stabilizers after symptoms haven't responded to FDA-approved treatment options (such asmood stabilizers).
Dr. Gao says that while some recent studies suggest that using an antidepressant alone is as effective aslithiumtaken alone for some bipolar II patients (those who haven't experienced a manic episode), they should never be used alone for bipolar I depression, and patients and doctors should consider discontinuing use of antidepressants once symptoms have responded.
Other drugs that have been linked to manic symptoms includecorticosteroids,thyroidmedication, and appetite suppressants.
A Brand-New Season and Abnormal 'Clock Genes'
About 20 percent of people with bipolar disorder experience fluctuations in mood when the weather changes. Specifically, they're more likely to undergoseasonal depressionduring the early winter, and mania or hypomania during the spring or summer, according to aresearch review published in October 2014 in theJournal of Affective Disorders.
Experts chalk this up to sunlight: Yourcircadian 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.
A Visit From the Stork Along With Altered Sleep Patterns and Shifting Hormones
The American College of Obstetrics and Gynecologyestimates that women with bipolar disorder have up to a 67 percent chance of experiencing an episode ofbipolar disorder in the postpartum period— the weeks and months after birth.
Changing sleep patterns, altered medication prescriptions, and shifting hormones after delivery can combine to serve as risk factors for a postpartum mood or psychotic episode, according toresearch published in November 2014 in the journalThe 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 preventpostpartum depression, postpartum mania, orpostpartum psychosis.
Bipolar disorder is also strongly associated with postpartum psychosis, a severe mental illness characterized by an inability to respond emotionally to one's newborn, or thoughts of harming one's baby.
Financial and Emotional Strains Due to a Job Loss
One of life’s most unpredictablebob bet体育 ? Losing your job.
你可以感受和情绪yourjob losscan be equally unpredictable. People who weren’t satisfied with their work can find it liberating. For others, thefinancial and emotional strainsinvolved 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 bipolar disorder successfully through theirmourning, but it may have extreme consequences for others, who can develop “funeral mania,” says Bennett.
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 heightenedsupport, advises Bennett.
Prevention of a bipolar mood episodes may not be possible, but understanding triggers may help you better manage your illness.
