What triggers episodes?

Identify your own triggers

Episodes can appear to happen without a reason but it could be that something actually triggered them. Try reflecting what led up to past episodes. It is useful to keep a mood diary (my favourite is the Daylio app) and write down your moods, thoughts and feelings to keep track of your state of mind. Look back to see if you can find any obvious triggers. Knowing your triggers will help you prevent episodes.

I think I am having an episode

Seek help and guidance from your support structure. It is a good idea to speak to your psychiatrist to get professional help. If you are on medication, it may need to be changed.

Common triggers

Lack of sleep


Skipping hours of sleep can trigger mania in people with bipolar. Worrying about losing sleep can lead to anxiety. 

People in manic states can be so excited that they don't need to sleep and aren't tired the next day. This may sound appealing however it can cause them to be moody, make it difficult to concentrate or make decisions, feel sick, tired, worried and even depressed. 

In drastic cases, it could lead to accidental death due to the nature of these side effects.

Seasonal changes


Episodes can be triggered during the changes of seasons. The effects of sunlight and the activities you do during those seasons can have an impact on your mood.

Your body's sleep circadian rhythms is based on light and is the "+/- 24 hour fall asleep and wake up on time" cycle. Problems with sleep patterns can be caused when the rhythm is disrupted.

Think about the holidays you celebrate and the excitement and anticipation that leads up to it. You could hit a low after the celebration of that season.



Drastic or sudden changes; getting married or divorced; moving away especially to a foreign country; losing a loved one or not getting something that is important; having problems at work; intense arguments; feelings of unfairness; losing a job or not getting the promotion that was wanted or needed; financial strain; falling in love; traumatic events like abuse, rape or physical violence.

This list is not complete. Stress can trigger manic and major depressive episodes depending on what it is. These triggers are especially common with people with a genetic vulnerability.

Certain types of medication


There are medications that can trigger manic episodes. This can include antidepressants, over-the-counter cold medicine, appetite suppressants, caffeine, corticosteroids - used to treat rheumatoid arthritis, lupus, asthma, allergies and many other conditions. They also treat Addison's disease, a condition where the adrenal glands aren't able to produce even the minimum amount of corticosteroid that the body needs - and thyroid medication. 

A dip in your physical well-being


The body is fragile when the immune system is weak. It is more vulnerable to illness and unstable moods. This can lead to depression. 

Other factors, like hormonal imbalances, caused by organs such as the thyroid can also trigger or mimic episodes. Be sure to take blood tests at least every six months.

Taking drugs and alcohol


Recreational drugs such as cocaine, ecstasy, and amphetamines can trigger mania, while alcohol and tranquillisers can trigger depression. 

Drugs and alcohol change certain chemicals in the brain. People may notice reckless behaviour as one's judgement and decision making is poorly affected.