Potential triggers for bipolar disorder mood episodes can include stress, hormonal fluctuations, and changes in sleep patterns. Depending on the person, triggers may induce periods of mania or depression.

Bipolar disorder is a mental health condition that causes significant shifts in mood and energy levels. These shifts can be challenging to manage. By identifying triggers, people may be able to manage them more proactively.

This article looks at the potential triggers for bipolar disorder mood episodes and ways to manage them when they occur.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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Various factors can trigger bipolar disorder mood episodes. They can differ significantly between individuals. Some potential triggers include:

  • stress
  • disrupted sleep
  • weather changes
  • hormonal changes
  • certain drugs

Challenging life circumstances can exacerbate mood symptoms in people with bipolar disorder. Any type of stress could potentially lead to shifts in mood. Some examples include:

  • losing a close family member
  • experiencing a natural disaster
  • going through a significant relationship breakup
  • losing a job or experiencing poverty

A 2015 review of previous research confirms that adverse life events predicted increases in bipolar disorder depression.

An earlier study from 2014 found the effects of such events were most significant in bipolar I disorder.

Bipolar I disorder causes both mania and depression. Bipolar II disorder causes a milder form of mania.

There is a bidirectional relationship between bipolar and sleep. This means that bipolar disorder can disrupt sleep, but that disturbed sleep can also affect bipolar disorder, triggering or worsening symptoms.

A 2017 study looked at this relationship in 3,140 people with bipolar disorder. Researchers found a link between lack of sleep and more frequent episodes of mania, particularly in women and those with bipolar I disorder.

Researchers noted that women were 1.43 times more likely to report manic or hypomanic episodes from sleep loss than men.

Many things can disrupt a person’s sleep schedule, such as:

  • mood disorders
  • pregnancy
  • sleep disorders
  • chronic pain
  • caring for children
  • shift work

Seasonal changes may trigger shifts in mood for some people living with bipolar disorder.

Around 1 in 4 people with bipolar disorder have seasonal affective disorder (SAD). SAD may lead to episodes of depression in the fall and winter months and mania during the spring and summer months.

These changes could occur due to the decrease and then increase in light levels through the seasons, which affects brain chemistry.

According to a 2020 study, though, older research has found that people with bipolar disorder are also more sensitive to other types of weather. These include changes in temperature, rainfall, atmospheric pressure, and clouds.

The relationship between hormones and bipolar disorder symptoms is complex.

In a 2023 study, researchers measured male and female hormone levels during different mood episodes. During manic episodes, they found higher levels of:

Furthermore, a 2017 study with 158 females found that hormonal changes due to menstruation, menopause, and pregnancy affected bipolar disorder symptoms.

Certain medications and herbal supplements may trigger bipolar disorder mood shifts.

For example, antidepressants may trigger an episode of mania in some people when they begin taking them. Doctors lower this risk by prescribing mood-stabilizing medication at the same time.

Corticosteroid hormones, such as prednisone, can also have significant effects on mood, even in people who do not have a mood disorder.

Beginning a course of corticosteroids can cause symptoms of mania. Stopping can cause symptoms of depression.

Additionally, a 2023 review of previous research found some evidence that the following may trigger mania:

  • St. John’s wort
  • acetyl-L-carnitine
  • caffeinated drinks

The use of substances such as alcohol and recreational drugs can also trigger mood shifts by affecting the chemical balance in the body and brain.

This is a significant risk factor for mood episodes since substance use disorder (SUD) is common in people with bipolar disorder. SUD affects up to 50% of people with the condition.

While specific factors can trigger bipolar disorder mood episodes, they can also occur seemingly at random.

People may find it challenging to predict exactly when episodes happen. This makes it crucial to establish effective management strategies and maintain regular contact with a doctor.

The duration of bipolar disorder mood episodes can vary widely. Some may last 1–2 weeks or longer. During an episode, symptoms last for most of the day, every day.

A person’s mood typically returns to a healthy baseline between episodes. However, without appropriate treatment, episodes can occur more frequently as time goes on.

In rapid cycling bipolar disorder, a person has frequent mood shifts within a year, usually four or more.

Managing bipolar disorder mood episodes requires medications and self-care strategies.

The U.K. nonprofit Mind suggests creating a management plan for when episodes occur. It may take some trial and error to find out what works for each person.

For manic episodes, it may help to:

  • go to sleep on a regular schedule, even if a person does not feel like it
  • set reminders to eat, even if a person is not hungry
  • go somewhere quiet and calm
  • do relaxing activities or breathing exercises
  • avoid alcohol and caffeine
  • avoid overly stimulating activities or environments
  • avoid situations where a person may take risks, such as driving or gambling
  • postpone making big decisions

For depressive episodes, it may help to:

  • have meals prepared in the freezer so a person does not have to cook
  • try to stick to a basic daily routine or schedule
  • try some gentle or mindful exercise, such as yoga
  • make time for enjoyable or relaxing activities, even if a person does not feel like doing them
  • spend time outside or in nature
  • ask for practical help with tasks a person feels unable to do, such as laundry
  • talk with friends or family about how it feels
  • reach out to support groups or a therapist

Write up a plan for each of these scenarios and consider sharing it with loved ones so they know what helps.

If medications are not effective enough or cause unpleasant side effects, do not stop taking them. Instead, speak with a doctor as soon as possible about alternatives.

If a person feels they are experiencing early symptoms of a bipolar disorder mood episode, they should contact a doctor as soon as they can.

A doctor can prescribe or adjust someone’s medication to reduce the impact of the episode.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Find more links and local resources.

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Potential triggers for bipolar disorder mood episodes include stress, sleep disturbances, medications, substance use, life events, and seasonal changes.

However, even when a person has a good idea of their own triggers, episodes can occur seemingly at random. As a result, it is still important that people with bipolar disorder take their medication and have a plan in place in case episodes happen.

Medications, self-care strategies, and support from therapists, friends, or family can help a person manage mood shifts if they occur.