What Can Trigger a Bipolar Episode?

Bipolar Disorder TreatmentBipolar Disorder is a genetic condition but it may not express itself even if you carry the gene(s) for it. It is widely believed that a triggering event in the environment coupled with a genetic predisposition towards the illness is needed for the disorder to express itself. The disorder can remain dormant for many years. Although it often begins to rear its ugly head in late adolescence.

After the initial trigger(s) activate the genes and the illness, it then presents as major mood swings that come and go over varying periods of time. These are called episodes. Every individual has their own unique triggers that can activate  an episode. Although everyone is different and there are a variety of manifestations of the illness, many of the triggers are common and shared. For example, lack of sleep is often a trigger for a manic episode.

Again, even though the illness has a strong genetic component thought of as the underlying cause of the disease it may take a triggering event for the Bipolar Disorder to actually manifest itself. Trauma can trigger the disorder as well as travelling to a different time zone. Other common triggers include stress, hormones, and even taking street drugs. I’ve found that mood stabilizing medications are the key to keeping the episodes from recurring so quickly, and key to keeping them less intense and shorter in duration.

Bipolar 1 Disorder Diagnosis

Bipolar ExtremesI knew that I was moody, but a few years back, I was diagnosed with Bipolar I Disorder also known as manic-depressive disorder. A person affected by bipolar I disorder has had at least one severe manic episode in his or her life. A manic episode is a period of abnormally elevated mood, accompanied by abnormal or out-of-character behavior that disrupts life. I have “euphoric manic moods” that typically last several months. My most disruptive manic episode lasted for several months. As far back as I can remember, in retrospect, I’ve  had hypomanic episodes.

Some prominent experts insist that bipolar disorder is found in a disproportionate number of people with creative talent such as actors, artists, comedians, musicians, authors, performers, and poets. Several recent clinical studies have also suggested that there is a positive correlation between creativity and bipolar disorder. A 2005 study at the Stanford University School of Medicine showed for the first time that a sample of children who either have or are at high risk for bipolar disorder scored higher on a creativity index. Children with bipolar parents who were not bipolar themselves also scored higher. That’s some bit of comfort I suppose.

Most people but not all people with bipolar I disorder also suffer from episodes of depression. Often, there is a pattern of cycling between mania and depression. In between episodes of mania and depression, many people with bipolar I disorder live relatively normal lives. My experience seems to run from mixed anxious episodes to manic episodes with periods of being somewhat down occasionally. There are fleeting moments of calm and stability but it never seems to last very long.

During a manic episode, elevated mood can manifest itself as euphoria “feeling high” and having tons of energy, or it can manifest itself as irritability. It often includes both feelings at the same time. Behavior during manic episodes can include but does not necessarily have to include all of the following:

  • Flying suddenly from one idea to the next (easily distracted)
  • Pursuing unrealistic plans
  • Impulsive behaviors
  • Increased energy, with hyperactivity and decreased need for sleep
  • Inflated self-image
  • Excessive spending
  • Rapid or pressured speech
  • Behaving in ways that are out of character
  • Hypersexuality
  • Engaging in high-risk behaviors (unprotected sex, etc.)
  • Being overly focused on one project, goal, or activity (almost obsessive compulsive)
  • Having to get out of situations or commitments that you created when manic

When manic, people may spend money far beyond their means, have sex with people they wouldn’t otherwise, or pursue grandiose, unrealistic plans. Untreated, an episode of mania can last anywhere from a few days to several years. Most commonly, symptoms continue for a few weeks to a few months. Depression may follow shortly after but doesn’t always. A period of exhaustion and confusion and disbelief in my choices is the follow up to my out of control manic episodes. Many people with bipolar I disorder experience long periods without symptoms in between episodes. A minority have rapid-cycling symptoms of mania and depression — even alternating between mania and depression in the same day.

Depressive episodes in bipolar disorder are similar to “regular” clinical depression, with depressed mood, loss of pleasure, low energy and activity, feelings of guilt or worthlessness. Depressive symptoms of bipolar disorder can last weeks or even years. I usually stick with mania but occasionally hit a down mood. But it doesn’t last long and then I’m riding the wild crest of the wave again. Now, on Lithium, I stay somewhere in limbo but it’s better than being manic and making devastasting and destructive choices.

What is the difference between bipolar I disorder and bipolar II disorder? Bipolar I disorder encompasses the behaviors described in the list above. These manic symptoms can lead to serious disruptions in life – for example, spending sprees, having extramarital affairs, and engaging in other high-risk behaviors. The symptoms of elevated mood in bipolar II disorder never reach full-on mania. They often appear as extreme cheerfulness, even making someone a lot of fun to be around. This less-severe mania is called hypomania. People experiencing hypomania are often extremely creative and productive. I completed my entire Ph.D. program while hypomanic. This less-severe mania is not so bad, you might think– except that bipolar II also features episodes of significant depression.

Managing and learning to live with bipolar disorder is a challenge. The highs are extremely seductive and the creativity that comes with hypomania is exhilarating; however, the disruption and chaos that follows is exhausting. I wish I’d been diagnosed at a younger age. I sometimes grieve for the loss of all the opportunities that I was unable to grasp because of the illness. If you suspect that you or your loved one may have bipolar disorder don’t hesitate to seek out appropriate medical care.