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8 Times Life Might Trigger a Bipolar Episode

It’s impossible to live a stress-free existence, but knowing how to navigate these key moments may help you prevent a BD-I episode. By Amy Marturana Winderl Life comes with plenty of unexpected and stressful situations. When you have bipolar I disorder, they can feel impossible to take in stride—and may even trigger a BD-I episode. “When a big life event happens, people with bipolar disorder can feel ill-equipped to deal with it and overwhelmed by their feelings,” says Renee Solomon, Ph.D., a clinical psychologist and clinical director and CEO of Forward Recovery in Los Angeles, CA. “This can lead to extreme depression or mania.” While any major change can potentially be triggering, here are a few biggies that you may encounter—and how to deal.
Job Change or Loss
A job change can upend your daily routine—which is important to keep consistent for helping people with bipolar disorder to stay steady, says Philip Lam, D.O., an assistant clinical professor of psychiatry at the University of Arizona College of Medicine in Tucson. Even a promotion or other positive change may be triggering if it leads to more work and messes with a regular structure that you’ve come to rely on. Meanwhile, losing a job can cause financial hardship and hurt your self-esteem, notes Solomon, and these vulnerabilities may also trigger BD-I depression or mania.
Breakup or Divorce
When a relationship ends, your life is thrown into transition, often including where you live and when, or even if, you see your kids— all potential triggers for a major depressive or manic episode, says Solomon. “If the person with bipolar did not want the divorce, it can be even harder for them to feel stable,” she adds. “They are going to be living on their own, which can also create fears of loneliness and isolation, as well [bring on] financial issues.” Social support, individual therapy, and group therapy can all be helpful during this time, Solomon advises.
Physical Health Issue
Experiencing any new health issue or diagnosis can feel overwhelming, and like you’ve lost control, Solomon says. That sense of vulnerability can cause people with bipolar to start a negative thought spiral, she notes thinking, for example, “I broke my ankle, so I will never be able to exercise again.” But just like you’ve learned to manage your BD-I, you can learn to keep other health conditions in check, too, with expert medical guidance. Work with your doctor to make sure any new treatments don’t interfere with your bipolar meds.
Death of a Loved One
Death can upend your mental health—especially if the deceased was a source of stability in your life, Solomon says. When the death of a loved one triggers a manic episode, it’s called grief mania or funeral mania and may result in aggressive attitudes, hyperactivity, insomnia, and increased risk-taking. “It occurs due to the denial of the loss,” she explains. It’s often impossible to prepare for death, so Solomon stresses the importance of finding support (like a bereavement group) as you grieve, since it can be “helpful to be around others also experiencing loss,” she notes.
Traveling and Disrupted Sleep
Dr. Lam says that sleep deprivation may provoke a bipolar episode—mania, in particular. “For some people, that happens when they’re traveling to another time zone,” he notes. Why? Changing time zones affects the body’s circadian rhythm, or the internal clock that regulates our sleep-wake cycles. Research shows that circadian rhythm dysfunction plays a big role in bipolar I disorder. While traveling, Dr. Lam suggests factoring in time to rest and adjust instead of going straight into an activity that exacerbates your sleep debt. He also recommends asking your doctor if you can take a sleep aid or melatonin.
Moving and all that comes with it—packing up your whole life, a big financial investment, endless logistics—is often a high-stress endeavor. “This can be a trigger, as it is very overwhelming, upsets your routine, and can make you feel very chaotic,” Solomon says. Moving from a place you feel attached to can also feel like a loss, contributing to mood instability, she adds. Hiring movers, asking friends to help, being extremely organized, and setting realistic expectations (not everything has to be unpacked in one day!) can all help reduce some of the stress, Solomon says.
Having a Baby
Welcoming a new baby is a joyous occasion that also upends your routine and sleep schedule, both of which can trigger BD-I. Research also shows that women with BD-I are at a high risk of postpartum psychosis, and those with a history of sleep deprivation-induced mania may be especially vulnerable. It’s important to speak with your doctor about mood changes that occur in pregnancy and the postpartum period, and to discuss safe treatment options to address them, Solomon says. Recruiting help postpartum is also essential—whether from family, friends, partners, or a night nurse—so that you can get some R&R.
Heading Off to College
“College is the most common time for mental illness, especially bipolar disorder, because it’s the first time a young adult has to balance social pressures, academic pressures, and living on their own,” Solomon says. (Lack of sleep is par for the course, too.) As a parent, talk to your child about how to identify a manic or depressive episode coming on, and make sure they know where to seek psychological help on campus if they need it, Solomon recommends. Being continually involved in your student’s life after they leave home is important, she adds, so you can step in when needed.
Self-Care and a Routine Can Do Wonders
There’s no way to avoid life’s upending events entirely, but you can make sure you’re equipped to handle them when they happen. “Taking care of yourself is important,” Dr. Lam says. That means exercising regularly, eating a balanced diet, getting enough sleep, going to therapy, and following your treatment plan, notes Solomon. “Planning and discussing the stressors related to the transitions can also be helpful to avert a bipolar episode,” she adds. And by sticking to a routine, you’ll have space to process your emotions and cope when life throws a curveball your way.

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