Bipolar disorder is characterized by extreme mood swings from mania to depression. The pattern of highs and lows varies for each person: For some people, episodes of mania or depression can last for weeks or months, while for others, mood swings are shorter and more frequent. Coping with bipolar disorder — and the mood swings it brings — can be difficult. But understanding what causes mood swings can be the first step in coping with the ups and downs of bipolar disorder.
Bipolar Mood Swings: Causes and Triggers
Bipolar disorder is thought to be caused by a chemical imbalance that alters a person's moods. This imbalance may be linked to irregular hormone production or a problem with chemicals in the brain called neurotransmitters that act as messengers to nerve cells. Because bipolar disorder tends to run in families, genetics are also thought to play a role; in fact, researchers believe that the chemical changes leading to the disorder result from a combination of genes and environmental influences. Some brain scans have revealed actual physical changes in the brains of people with bipolar disorder.
The best way to prevent mood swings is to get treatment for bipolar disorder. But it's also possible to reduce the frequency and intensity of mood swings by being aware of situations or events that can trigger them.
"A number of triggers can set off or worsen bipolar episodes," says Michael First, MD, a professor of clinical psychiatry at Columbia University and attending psychiatrist at NewYork-Presbyterian Hospital. The most common triggers for bipolar mood swings are:
- Stress from major life events, both positive and negative
- Lack of sleep
- Erratic schedules
- Caffeine and alcohol
- Certain medications, such as antidepressants and corticosteroids
- Seasonal changes (for example, winter can worsen depression, while summer can increase the risk of mania)
- Stopping bipolar meds or varying the treatment schedule
- Thyroid problems
- Substance abuse
Mood Swings: Coping Strategies
While some triggers — like seasonal changes or a stressful event — may be impossible to avoid, lifestyle changes and mood-management strategies can make a big difference. Try the following suggestions from experts for managing and coping with mood swings.
- Control stress. Stress is a major bipolar trigger. Do what you can to simplify your life and relieve stress in your work and personal life. See if your spouse, family members, and friends can help with household responsibilities. "If you have a job that requires crazy hours and lots of travel, you may want to switch to a less-stressful job," suggests Dr. First. Stress-management techniques, such as meditation, visualization, and yoga, can also help.
- Keep a regular schedule. Stick to a routine to help control mood swings. "Bipolar people don't do well with lots of changes," says First. Have meals, do errands, exercise, and go to bed about the same time every day.
- Practice healthy sleep habits. Being overtired can trigger mania in some bipolar people. Relax before bed by listening to soothing music, reading, or taking a warm bath. Experts also recommend that you make your bedroom a calming place and use it only for sleep and sex. Be disciplined about your sleep habits. "It's common for people with bipolar disorder to stay up late watching movies, playing video games, or surfing the Internet, which can make mood swings worse," says Carrie Bearden, PhD, a bipolar-disorder expert and associate professor of psychology and behavioral sciences at UCLA.
- Get moving. Studies show that regular exercise can help improve mood. Start slowly by taking a walk around the neighborhood. Gradually work up to exercising on most days of the week.
- Avoid caffeine, alcohol, and drugs. Caffeine is a stimulant, which can keep you up at night and exacerbate manic episodes. Cut back on coffee and soda, especially at night. Alcohol and drugs can affect how your medications work and possibly trigger a mood episode.
- Write it down. Keep a journal that makes note of big events, stresses, how much sleep you're getting, and what you're eating and drinking. Over time, you may see patterns emerging. By knowing what your triggers are, you may be able to prepare for times when you might be most vulnerable to mood swings.
While these lifestyle changes and coping strategies can help manage mood swings, they won't make bipolar disorder magically disappear. However, knowing what your triggers are and taking steps to manage them can help prevent a minor mood swing from becoming a serious problem.
