Living with bipolar disorder can feel like a rollercoaster ride. The extreme ups and downs of the disorder can disrupt the lives of the patient and those around them. To make Bipolar disorder more manageable, it’s important for the patient and caregivers to know what may trigger episodes of mania and depression.

When one family member has bipolar disorder, it’s as if the whole family has the illness. Primary caregivers may need to help with medications, talk to doctors, and keep a predictable, low-stress household routine. It’s also essential for caregivers to pick up on the sometimes subtle signs that their loved one is slipping into mania or depression.


Bipolar Disorder: Mania and Depression
Bipolar disorder, also known as manic depression, is a serious mental illness that causes marked shifts in mood, energy and activity levels, according to the National Institute of Mental Health. The extreme “high” is called mania. People in a manic phase are usually full of energy, overly excited, and even irritable or jumpy. During an episode of mania, the patient may feel invincible, take risks, engage in impulsive sex, go on huge spending sprees, or even have hallucinations. What’s worse, the bipolar person may not recognize they are manic because they feel so good.

At the other end of the spectrum is depression, which can spiral into talk of, or even attempts at, suicide. Always take talk of suicide seriously. If your loved one threatens to kill himself, call a health care professional or 911 immediately.

Although bipolar disorder is a lifelong illness, it is manageable. Usually patients are treated with a combination of medication, psychotherapy, and lifestyle management. Many people go months or even years between mood episodes and report that they feel good in the meantime.


Bipolar Disorder: Tracking Triggers
Life events, anxiety, and even physical changes can cause a mood swing. What triggers an episode of mania or depression varies from person to person. Here are some typical physical triggers, according to the National Alliance on Mental Illness (NAMI).

  • Not getting enough sleep
  • Using alcohol or drugs
  • Stopping your medicine
  • Beginning antidepressant medication (this can cause a switch to mania)
  • Hypothyroidism (low thyroid function, a possible side effect of lithium medication, often used to treat bipolar illness)


Emotional stress and big or small life changes can also cause mania or depression. The Depression and Bipolar Support Alliance gives these examples:

  • Major life change like moving or starting a new job
  • Arguing with a friend or loved one
  • Financial problems


Louisa Sylvia, PhD, a psychologist at the Bipolar Clinic and Research Program at Massachusetts General Hospital in Boston says, “Changes in daily routines, such as staying up late studying or flying to another time zone, can cause a mood swing.”

Sylvia explains that bipolar disorder interferes with the body’s circadian rhythm, the 24-hour rhythms, such as the sleep-wake cycle. As a result, bipolar patients are likely to have unregulated daily routines, such as meal and bed times. For instance, they may wake up in the middle of the night or sleep late. They may not eat anything until the afternoon. So, Sylvia says, it’s imperative for the bipolar person, and the rest of the family, to maintain a regular routine to avoid mania or depression.

Since regular sleep is vital to keeping bipolar episodes in check, keep an eye on sleep patterns. Changes and disruptions in sleep are often the first indicator of illness, according to NAMI. Sleep is usually disturbed very early in an episode of mania or depression. If the mood swing is caught early, there’s a better chance it can be stabilized, possibly by adjusting medications.


Bipolar Disorder: Charting Your Moods
Mood charts provide a visual snapshot of changes in mood over the course of a month. Every day, the patient jots down medication, mood level, and significant life events. The patient, family, and doctors may be able to see emerging patterns and pinpoint triggers more accurately. Sylvia says mood charts are an “excellent resource for patients to monitor and be more aware of moods.”


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