Bipolar - Help prevent common triggers

Feeling stressed, missing sleep, skipping your bipolar disorder medication — these are some of the common triggers that can prompt a bipolar mood episode. They also can be a warning sign of an existing episode.

That's why it's important to recognize your common triggers and stressors – the external factors that can change your moods. When you are aware of disruptions in your "Social rhythm" or the other events most likely to trigger bipolar mood swings, you can work with your doctor and family to plan strategies to help you stay well.

A bipolar disorder wellness plan includes:

- Medication
- Regular doctor visits
- Psychotherapy
- Understanding your triggers – recognizing, avoiding and responding to them

Here are common triggers of bipolar episodes — and how you can help manage them.

Stress

Few people live stress-free lives these days, and having a serious illness like bipolar disorder can add to the pressures. Individuals with bipolar disorder are at additional risk for episodes since certain life events can precipitate mood swings. Stressors include:

- Social rhythm disruption such as going on vacation, staying up late, moving to a new city
- Negative life events including divorce, job loss, death of a family member
- Other less severe life events such as a fight with a family member or other family conflict
- Positive life events such as starting a new job or graduating from school

Your wellness plan. Make a list of the major stressors in your life and work together with your doctor to create a wellness plan to manage the stressors. Physical activity, meditation, guided imagery (positive thinking) and spirituality — these are just some of the methods that can be used to calm yourself. Find the ones that work best for you. Also, keep to a regular schedule, including the times you go to bed and eat meals.

Irregular sleep schedule

Sleeping too much or too little are typical symptoms of bipolar disorder. Not enough sleep can actually precipitate a manic episode as well. Even a single night of lessened sleep can create the problem.

Your wellness plan.
Arrange your schedule so you don't need to stay up late studying or working on a project for your job. Also pay attention to your late night socializing, Internet surfing or video watching. Develop a sleep schedule that includes going to bed and rising at approximately the same times each day. If stressors are keeping you from getting sufficient sleep, ask your doctor for advice. Insomnia is both a trigger and a symptom of a manic episode.

Effects of Sunlight

Bipolar disorder symptoms can increase with a rapid rise in bright sunshine. Bright light can affect the pineal gland and trigger depression and mania. The pineal gland produces the hormone melatonin, which may modulate wake/sleep patterns (called the circadian rhythm.)

Your wellness plan.
Talk to your doctor if increased sunlight during springtime and early summer seems to be a mood trigger for you.

Alcohol or drug abuse

Substance abuse and bipolar disorder often coexist. People with bipolar disorder may use alcohol during manic episodes to "self medicate" — extending their euphoric state or dampening their agitation. Substance abuse, however, greatly worsens bipolar disorder. Individuals with bipolar disorder who abuse alcohol or drugs are also more likely to skip their medications.

Your wellness plan.
If you are abusing alcohol or other drugs, talk to your doctor about the best ways to treat the addiction. You also may want to consider a self-help group such as Alcoholics Anonymous.

Not taking your medications

When you are feeling well, you may not believe it's necessary to continue taking your medications. But skipping your therapy, which is called "noncompliance," makes a mood relapse more likely.

Medications are the cornerstone of treatment in bipolar disorder. Staying on treatment, even during the times you feel well, can help you keep your disease under control and reduce the chance of worsening, recurrent episodes.

Your wellness plan.
Take your medication as your doctor prescribes. If you are experiencing side effects that are making you skip doses, contact your doctor for advice. Your doctor will work with you to adjust your therapy to relieve side effects.

Illnesses that may co-exist with bipolar disorder

People with bipolar disorder often have abnormal thyroid function. Too much or too little thyroid hormone could be a risk factor for mood changes.

Your wellness plan.
Your thyroid levels should always be monitored by your doctor. If appropriate, you may be prescribed a thyroid supplement.
Managing your triggers

Recognizing and managing your triggers — plus working with your doctor — can help prevent mood swings and help you lead a full, productive life.

- Keep track of your moods.
- Learn about other resources to help manage bipolar disorder