Triggers for Mood Swings in Bipolar Disorder

If you have bipolar disorder, it’s important to stay vigilant for common mood swing triggers and have a plan for dealing with them. Here’s what you should know.

Much is still unknown about bipolar disorder. But avoiding highs and lows — the primary symptoms — can help manage it.

We all benefit from becoming aware of our own shifts in mood. Are You "hangry”? Are you short of sleep and becoming irritable? For people with bipolar disorder, the mood swings are bigger, so it’s important to be mindful of common triggers.

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A few triggers to keep an eye on:

1. Sleep patterns. When someone has depression, needing unusual amounts of sleep is common, but if you start needing less sleep, it may be a sign of mania onset. Be sure to keep to a regular sleep schedule — and if you start to veer from it, pay attention.
2. Energy level and self-esteem. Are you feeling more hyped up than usual, as if you can do anything? Are you struggling to get out of bed in the morning and feeling down on yourself? You should notify your support system if severe or heightened feelings last for longer than a day.
3. Alcohol or drug use. Stimulants and depressants can exacerbate bipolar symptoms or even cause a shift into full mania or depression. Never take street drugs. Use alcohol only in moderation — two drinks a day for men, one a day for women. If your desire to drink or use drugs increases precipitously, it’s a sign to seek help.
4. Sex drive. As with other mood shift triggers, mania can be accompanied by increased sex drive, while depression is often characterized by lack of it. If you’ve lost interest after having a healthy appetite, or suddenly feel much more interested in sex than usual, consider seeking help.
5. Concentration. Watch for hypomania — a form of lower-level mania that may improve concentration — since it can escalate to mania or be followed by depression. If you’re having trouble concentrating or getting things done, common symptoms in depression, reach out to your support system.
6. Stress levels and significant relationships. Let’s say you’re working overtime or have upcoming final exams. Too much stress is hard for anyone. Meanwhile, a breakup, divorce, or even a funeral is often a major life event. Take extra time to monitor your moods when things are tough.

Sometimes you can’t avoid some triggers, such as a serious illness or the death of a family or friend. But you can prepare for taking steps when you notice your signs of a coming mood swing. Reach out for help; don’t wait for your mood swing episode to ebb on its own.

Meditation may be helpful, observes William Marchand, MD, a professor of psychiatry at the University of Utah and author of the book “Solving the Bipolar Puzzle: Discover How Mindfulness Is the Powerful Missing Piece in Managing Your Bipolar Disorder Symptoms.” Marchand, an ordained Zen monk, helps people with bipolar disorder apply ancient techniques. The scientific evidence supporting meditation for bipolar patients is still mixed, but it is safe and can be enjoyable.

There are many kinds of meditation. The kind people in the West describe as “mindfulness” usually involves focusing on your breath. As you breathe, you may notice thoughts and emotions passing through your mind. Your job is to let them pass without judging yourself. Ten Percent Happier is a good app to experience this type of meditation.

With practice, you may become less reactive to emotions when they occur while you are not meditating.

Simply being more aware of moods in the beginning stages seems to be important.

“It's really that awareness,” Marchand says. “A lot of times what happens is that we don't really pay enough attention to our mood state and our stress level, and so we don't get those very early warning signs when we might be able to do something to prevent a mood episode from coming on.”

Marchand urges people with bipolar disorder to have a plan in place before something goes wrong. Discuss your action plan with your treatment providers and friends and family. A provider can adjust your medication or see you for an extra psychotherapy visit.

At the first sign of a mood swing — either up or down — put your plan into action and reach out.

Increasing awareness doesn’t take the place of treatment, Marchand cautions. “But if someone can start to notice when they're getting in a situation that can lead to a mood episode, and take action at that point, it can make a big difference for them. That's for sure.”

Consider adding a few minutes of meditation to your daily routine, then try keeping a journal to track your moods.

Ultimately, the best way to manage mood swings is to prevent them. To help stabilize moods, keep a regular schedule that includes plenty of time for sleep, and eat nutritious, healthy foods. Marchand also recommends exercise, since it has significant antidepressant effects on bipolar disorder.

“Bipolar disorder is a very difficult condition to treat,” Marchand says. “People do the best if they have the most tools in their toolbox — so not only professional treatment, but exercise, a good diet, meditation.”

“That's what we're trying to do, is have as many tools as possible for people to stay as well as possible.”

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