Bipolar and stress

FAQs about stress and bipolar

• How does stress affect bipolar?

  All sorts of stressful situations can affect bipolar, but the picture is complex because many people say that they were dealing with more than one stressful situation before an episode.

  More research is needed to better understand how stress can affect bipolar, but some studies suggest people with bipolar may:

  • have a more intense response to stress due to differences in brain development that may lead to changes in the way the body produces and responds to the stress hormone cortisol
  • find it harder to deal with change and disruption – many life events that cause stress are linked with significant change, such as bereavement, moving house or a relationship break-up
  • find it harder to switch back into ‘rest and digest’ mode after a stressful event when body and mind return to a more relaxed state
  • experience low mood in between mood episodes that doesn’t meet a mood disorder episode level, but that can make pessimistic thought processes more likely, including thinking constantly about negative things, which in turn creates a feeling of threat and creates stress
• Does having bipolar mean you’re more likely to get stressed?

  It’s not yet fully understood why having bipolar can mean you’re more likely to get stressed, but research shows that some people living with bipolar:

  • have unhelpful negative thoughts and ruminations (where you repeatedly think the same thoughts over and over again) during periods of depression and mania
  • get symptoms of paranoia and delusions during mania which both cause extreme stress
  • are more at risk of behaving in ways that can negatively affect relationships, or financial and job security
  • may worry about when another episode might happen.
  • may feel concerned about stigma and whether to tell colleagues, new friends or partners about their diagnosis
  • are more likely to interpret events as stressful, that people without a mood disorder might not view in the same way
  • are more likely to have a negative outlook than a positive one – this is especially likely if you also have an anxiety disorder
• Can stress trigger bipolar episodes?

  Extremely challenging life events like bereavement, trauma and divorce are known triggers in both manic and depressive episodes.

  A Bipolar UK survey of over 2000 people found that one in five people said the stress linked to positive events – such as going on holiday, meeting a new partner, getting married, or being promoted at work – had also triggered a mood episode.

• What are the common triggers of stress in bipolar?

  Negative triggers include divorce, bereavement, work stress, money worries, debt, physical health issues, loneliness, experiencing discrimination, change, doing exams, moving home, physical illness and leaving a job.

  Severe negative life events are associated with an increased risk of relapse and a longer recovery. They are more associated with depression than mania.

  The association of life events with a mood episode appears to be stronger in people who have bipolar type 1, according to one piece of research.

  Positive triggers include getting a promotion at work, getting married, starting a new relationship or going on holiday, had been major triggers.

  Many people experience a stress response during events or activities they also say are pleasurable – such as sexual activity, a rollercoaster ride or a scary film.

  Some studies show positive life events are more likely to be associated with mania than depression, though others suggest mania and depression can both be triggered.

• Can stress cause bipolar?

  You may hear some people talking about stress-induced bipolar disorder.

  Some research shows that stressful events may contribute to brain changes that increase the chance of developing bipolar disorder.

  And stress is one of the risk factors for a first episode.

  However, stress alone does not cause bipolar. It runs in families, so there is a genetic risk factor too.

• What are the signs of stress in someone with bipolar?

  The signs of stress in someone with bipolar are the same as in people without bipolar. However, someone with bipolar may have a stronger reaction, or view more things as threats that other people might not see in the same way.

  Symptoms of stress to look out for include things that can also signal the move into a mood episode – so keeping an eye on your stress levels and symptoms using the Bipolar UK Mood Tracker app is a helpful way to notice any early warning signs.

  Psychological symptoms of stress

  • Irritable, angry, tearful
  • Anxious, worried, racing thoughts or feeling panic
  • Sad, hopeless, or scared
  • Overwhelmed, struggling to make decisions

  Physical symptoms of stress

  • Aches and pains including tension headaches
  • Chest pain or a racing heart
  • Exhaustion or trouble sleeping.
  • Dizzy, sick, or faint
  • Muscle tension or jaw clenching.
  • Stomach or digestive problems.
  • Trouble having sex
  • More colds due to a weakened immune system
  • Stress rashes, when you get red raised bumps called hives – more common in females

  Behaviour changes of stress

  • Change in how much you see people
  • Turning to alcohol, smoking or drugs – or using them more
  • Turning to gambling or gambling more
  • Changes in your appetite – over or under eating
  • More compulsive sex, shopping or internet browsing
• What’s the link between post-traumatic stress disorder (PTSD) and bipolar?

  Post-traumatic stress disorder (PTSD) is a mental health problem that some people develop after experiencing or witnessing a life-threatening or deeply distressing event.

  While it’s normal to feel upset or anxious after trauma, PTSD is diagnosed when these feelings and symptoms last for more than a month and interfere with daily life.

  Some research suggests as many as one in two people who live with bipolar also have PTSD.

  People who live with both conditions may have a greater frequency of rapid mood cycling, a poorer quality of life, find it harder to function socially and at work, and be more likely to have more suicide attempts.

  In most cases, symptoms of PTSD start within a month of a traumatic event, although some people experience a delay of months or even years.

  Some people have times when symptoms are better or worse, while others have severe symptoms all the time.

  Common symptoms of PTSD include:

  • Re-experiencing the event – without trying to, you get vivid flashbacks, nightmares, images and sensations of fear or panic.
  • Avoidance or emotional numbing – where you do all you can to stop being reminded about the event, even withdrawing from social life or numbing all your emotions to try not to feel anything at all.
  • Hyperarousal – feeling on edge all the time, where you see threats all around you and may be easily startled. This is a heightened level of stress that can mean you feel anxious, angry, lose sleep and find it hard to focus.

  If you are experiencing any of these symptoms, it’s important to tell your healthcare team so you can get the support you need.