There are several triggers for episodes of Bipolar Disorder. In 'Triggers for Bipolar Episodes – Part Three,' we will discuss the last four episode triggers:

Trigger #9—Problems in Your Relationship: Problems in your relationship can definitely be a trigger to a bipolar episode, especially if your partner does not have Bipolar Disorder, which is usually the case. It’s difficult to explain bipolar to someone who doesn’t have the disorder, for example. It takes someone who is very patient, understanding, and compassionate to handle the mood swings of someone who has Bipolar Disorder. The pressure upon a bipolar/non-bipolar relationship can be so stressful that it can become a trigger to a bipolar episode for the partner with bipolar. Any problems in your relationship, even small problems, can be episode triggers.

Trigger #10—Problems with Yourself: You may have problems with yourself—such as poor self-esteem and other psychological symptoms—that can trigger a bipolar episode. Although depression in a person with Bipolar Disorder is considered a bipolar depressive episode, having negative thoughts and a negative self-image can still be as damaging and depressing before the actual episode itself and be a trigger to the episode. Therapy is a very important part of treatment for Bipolar Disorder, aimed at improving self-image and the emotional part of the disorder. Although medication is still the most important part of treatment for bipolar, there are psychological aspects that medication cannot control and that can be triggers to episodes.

Trigger #11—Other Mental Disorders: Having other mental disorders along with Bipolar Disorder is called 'co-morbidity.' It is not uncommon to have another mental disorder, such as schizophrenia, along with bipolar. When the symptoms of the other disorder are active, they can trigger a bipolar episode. In addition, side effects from medications you need to take for another disorder can cause you to have side effects that may trigger a bipolar episode. It is very important that you work with your psychiatrist to manage both the psychological and physical aspects of co-morbid mental disorders—as well as the medications needed to control them—so they don’t trigger you into a bipolar episode.

Trigger #12—The Kindling Effect: The kindling effect is a theory that each bipolar episode triggers future episodes, making them both more likely and more severe. In case studies, it appears that, even with medication, the episodes of some patients still become both more frequent and worsen as the patient gets older. One opinion is that triggering of bipolar episodes happens because the patient develops a tolerance to the medication; however, another recent theory is that the kindling effect may have a bearing upon this.