Many people with bipolar disorder can trace their first mood episodes back to specific major life stresses, such as loss of a loved one, extensive use of drugs and alcohol while in college, the rigors of military basic training, a breakup with a significant other, etc. Although it’s common for the first few mood episodes of bipolar disorder to correlate with specific stresses, this becomes less true over the course of the illness, where mood episodes may occur in the absence of an identifiable stress.
While the literature on the cause-and-effect relationship between bipolar disorder and stress is inconsistent, the experience of most people with bipolar disorder is that indeed their symptoms are worsened in times of greater stress, and that learning to manage day to day stress is a crucial part of any recovery plan.
Another point to make is that stress is neither good nor bad; it’s simply a situation or change in routine or environment that somehow disrupts our sense of balance or equilibrium. For example, losing a job could certainly be considered a stress, but so too could be getting a promotion with an increase in salary and responsibilities.
So as we go on to talk about managing stress, it’s helpful to stop and think about some of the more common things that can create stress.
• Changes in daily routines, sometimes referred to as “social rhythms”
• Inconsistent bedtime and wakening time
• Work schedules that have rotating shifts
• A newborn infant with nighttime feedings
• Poor diet
• Missing meals
• Extreme diets
• Eating on the run
• Drugs and alcohol
• Lack of exercise or inadequate amounts of exercise
• Lack of regularly scheduled enjoyable activities throughout the course of the day
• Down time
• Inadequate time with friends and family
• Work related-stress
• A supervisor with whom you do not get along
• Coworkers with whom you do not get along
• Employment that is not enjoyable
• A work schedule that has either too many or too few hours
• Inconsistent work schedules
• Finance-related stress
• Debt and fear of debt
• Overdue bills
• Lack of savings and a rainy day account
• Health concerns
• Active medical problems
• Worry and concerns regarding diagnoses, medications, and treatments
• Lack of supports
• Being socially alone
• Lack of friends, family, peer supports, etc.