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In this article, I’d like to go over the main four triggers, and I’d like to do it a little differently. I want you to see these triggers from both points of view – from both the survivor and the supporter’s views.
Just to review, in general, a trigger is something external which can set in motion an oncoming bipolar episode. Everyone has different triggers. For some people, it might be excess stress. For others, it might be frustration at work or a major disappointment. For some people who are highly susceptible, even a seemingly “wrong word” can cause them to go into a bipolar episode.
The person who has Bipolar Disorder should try to determine what those triggers might be for them, and go over these triggers with their supporter, so both of you are aware of these triggers. “Knowledge is power,” so the saying goes, and having this knowledge beforehand can help both of you to avoid an episode before it begins.
Once you identify some key triggers, you can both work on handling those triggers more effectively so they will “lose their power,” being less likely to disrupt the stability of the disorder that you both have worked so hard to attain.
Even if you (the survivor) are on medication now and it is keeping you stable, you should still both identify bipolar episode triggers and watch for indications of new bipolar episodes because, unfortunately, sometimes even a medication that has worked for years may stop working properly. As I always advise, if this does happen, contact your psychiatrist immediately for his/her advice, so that you don’t go into a bipolar episode.
A list of triggers should be a list of those things from past episodes that you’ve both noticed which signal when things are becoming more serious for the person who has Bipolar Disorder. For example, when my mom refused to leave her room (isolated), this should have told me and my family to take action then. If we had known that her desire for complete isolation meant that her Bipolar Disorder was getting much worse, we would have taken action sooner.
One of the best ways you can prevent future episodes – besides simply staying on the bipolar medication and following the doctor’s treatment plan – is to avoid triggers. Since everyone is different, everyone has different triggers. However, there are some that are most common and which you can begin avoiding now that will help both you (and your supporter who is helping you) to maintain long-term stability of your Bipolar Disorder.
1.Sleep irregularities –
SURVIVOR: Sleeping too little or too much are not only signs of an episode, they can also trigger them. You should get 8-9 hours of sleep a night, even if it means adjusting your schedule in order to give you enough time.
SUPPORTER: Help your loved one to maintain good sleep habits. Make sure they go to bed at a reasonable hour and that they get a full night’s sleep, not waking up during the night. This is very important for their “body clock.”
2.Poor nutrition –
SURVIVOR: When our bodies don’t get the nutrients they need or when we substitute sugar and caffeine for vitamins and minerals, we can cause physiological problems. Work on eating a balanced diet. Avoid caffeine, sugar, and alcohol. Another reason to take these steps is that they can prevent you from developing other health problems, such as heart disease or Diabetes, which can further complicate the treatment of your Bipolar Disorder.
SUPPORTER: You can help your loved one by cooking meals that are nutritious and healthy. Encourage them to stick to a balanced diet. You should be able to get samples of a healthy diet from your loved one’s doctor, or from the Internet. You can also make sure that they drink only decaffeinated coffee. Try to limit snacks around the house, and if you do have snacks, limit them to sugar-free ones.
SURVIVOR: Some stress in our lives is good, because it drives us to work hard and to better ourselves. Most of us, however, have too much stress in our lives. Stress is one of the number one triggers to bipolar episodes; therefore, you need to take action to reduce the stress in your life. Your therapist can help you identify areas of stress and can give you suggestions for stress reduction. Relaxation tapes/CD’s can help. Regular exercise can also help you deal with stress.
SUPPORTER: You can help your loved one by reducing the stress in their life. For example, by taking steps to reduce their exposure to bad news such as calls from collection agencies or medical bills. By screening their calls and mail, you can help shield them from unneeded, negative stress. You can also help them decrease their stress by encouraging them to exercise, or even going to exercise classes with them.
4. Isolation –
SURVIVOR: Many people with Bipolar Disorder try to shut themselves away from everyone. Feelings of loneliness and despair can trigger episodes, so you should fight against that desire to become a hermit. Instead, join Support Groups, become active in your spiritual community, or spend time regularly with your friends and family members. Keeping a Journal may help you to get your thoughts and feelings out into the open, if you feel you can’t share these with anyone else.
SUPPORTER: Try to keep the lines of communication open with your loved one, so they will talk to you about their feelings of despair and loneliness, before they begin to isolate. If you see them start to isolate, encourage them to spend more time with their friends and family members, church, Support Group, etc. If they do isolate, encourage them to write their feelings out in a Journal.
These are only four possible episode triggers. In my Bipolar Survivors Manual, here is the full list of bipolar episode triggers I listed:
• Trigger #1-Problems with Sleep and/or Poor Sleep Quality
• Trigger #2-Increase in Stress
• Trigger #3-Physical Problems
• Trigger #4-Alcohol and Substance Abuse
• Trigger #5-Inconsistency in Taking Your Medication
• Trigger #6-Going off Medication
• Trigger #7-Lack of Proper Treatment
• Trigger #8-Problems at Work
• Trigger #9-Problems in Your Relationship
• Trigger #10-Problems with Yourself
• Trigger #11-Other Mental Disorders
• Trigger #12-The Kindling Effect
As I said earlier, one of the best ways you can prevent future episodes – besides simply staying on your medication and following your doctor’s treatment plan – is to avoid triggers. Keeping a Journal and/or a daily Mood Chart so that you can determine what other triggers may cause you to go into an episode will also help you and your loved one to determine your own individual triggers.