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. Learn more.
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
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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.
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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.
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- testosterone
- estradiol
- progesterone
- C-reactive protein, an inflammation marker
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
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
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.
Help is out there
If you or someone you know is in crisis and considering suicide or self-harm, please seek support:
- Call or text the 988 Lifeline at 988 or chat at 988lifeline.org. Caring counselors are available to listen and provide free and confidential support 24/7.
- Text HOME to the Crisis Text Line at 741741 to connect with a volunteer crisis counselor for free and confidential support 24/7.
- Not in the United States? Find a helpline in your country with Befrienders Worldwide.
- Call 911 or your local emergency services number if you feel safe to do so.
If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.
If you’re not in the same household, stay on the phone with them until help arrives.
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.