There are a lot of words a person could use to describe bipolar disorder — and ‘predictable’ isn’t one of them. A disorder characterized by vacillations between episodes of high energy (mania) and depression, it’s impossible to know exactly when these episodes will strike, how long they’ll last, or how severe they’ll be. However, that’s not to say that bipolar episodes are entirely unpredictable. There are a variety of bipolar triggers and warning signs that a manic or depressive bipolar episode is imminent. 

7 Bipolar Triggers & Warning Signs

The mood swings of bipolar disorder are primarily caused by imbalances of three key neurotransmitters: serotonin, dopamine, and norepinephrine. Sometimes, the encounters and experiences in our everyday lives, big or small, can further upset these imbalances and result in the onset of a bipolar episode. These are known as triggers. While many are environmental and outside of a person’s control, some bipolar triggers can be a direct result of a person’s choices. 

  1. Stress

Stress is the number one trigger for bipolar disorder episodes. It’s an emotion that causes all sorts of physiological responses by activating the body’s “fight or flight” response. This, in turn, directly affects neurotransmitter levels of the exact same trio associated with what causes bipolar disorder, serotonin, dopamine, and norepinephrine. Things like breakups, divorces, losing one’s job, or the death of a loved one can evoke drastic emotional distress and are particularly triggering. 

  1. Getting into arguments

Disagreements are never pleasant, but it’s a near-inevitable part of any relationship — those of family members, friends, or coworkers. Arguments are also a source of stress and could technically fall under that umbrella but they’re unique in that can also be a warning sign of an oncoming episode. Irritability is common with the onset of episodes and can lead to increased conflict. As such, divorces or losing one’s job can also be warning sign of a bipolar disorder as well as a potential trigger. 

  1. Not getting enough sleep

No one enjoys feeling tired or sluggish from getting too few hours of z’s, but sleep deprivation can be especially detrimental for someone with bipolar disorder and is associated with manic episodes. 

One reason is that lack of sleep interferes with dopamine production, causing an increase in its production, which results in increased energy levels, impulsivity, and euphoria — the hallmark characteristics of mania. However, inadequate sleep can heighten feelings of stress and anxiety and further lead to mood disturbances.

Sleep disturbances can also be a big problem. Disturbances in our body’s circadian rhythm can also throw the brain’s neurochemicals out of sync which will further exacerbate any existing imbalances. 

  1. Hormonal shifts

Hormonal changes and fluctuations can play a role in the onset and course of bipolar disorder. Women face the greatest risk as hormonal changes during pregnancy and menopause, for example, can influence mood stability.

  1. Seasonal weather changes

The changing of the seasons — or more precisely, the differences in the amount of sunlight — can also be a potential trigger. Shifts in sunrise and sunset can significantly alter how much natural light we’re exposed to, which can wreak havoc on our circadian rhythms. The seasons tend to correlate with the type of bipolar episode. Manic episodes peak during spring and summer and depressive episodes are most common in the winter months. 

  1. Certain medications

Prescription drugs can also increase risk factors for bipolar disorder. The most obvious culprits are the medications that affect any of the trio of neurotransmitters (serotonin, dopamine, norepinephrine) closely linked with the disorder, such as antidepressants and other mood stabilizers. These aren’t the only medications that could potentially impact the onset of an episode, however.  Corticosteroids, thyroid medications, and appetite suppressants have also been linked to inducing manic symptoms.

  1. Drug or alcohol use

It’s a very bad idea for someone with bipolar disorder to use drugs or alcohol. Even legal mind-altering substances can result in a surge in dopamine or serotonin (this is the cause of the high that makes drugs feel pleasurable) — potentially creating perfect conditions for a manic or depressive episode. If the high doesn’t trigger an episode, the impending crash in dopamine or serotonin levels after the drugs have passed creates another wave of risk that could induce an episode.

If you or a loved one is struggling to manage their bipolar disorder, talk to a mental health professional today. They can provide guidance to help you identify your personal bipolar triggers, and learn how to prevent episodes from occurring in the first place.