Paying Attention to Triggers


Depression can hit at any time when you have bipolardisorder. Last night, I couldn’t sleep. Even with all the medications I take at night, my brain would not shut off. I lay awake in bed until close to 2 a.m.

I didn’t think I was manic yesterday. I knew I had written many articles in one day and I normally can only do one a day. Yesterday, though, I had completed five before 3 p.m. I hadn’t missed any medications, though, so I thought I just must be doing really well. Writing is my passion, after all. Maybe I have been compliant for long enough that my mind is finally coming around to being used to the medications and now I am able to concentrate on my writing fully.

About midnight, though, I saw the clearer picture. What I thought had just been a good day was truthfully a hypomanic day. I lay in bed, tossing and turning. I knew that the morning was going to bring an awful state. Either I would continue on my hypomanic train to full mania or I would spend the day down in the dumps, ready to cry at the slightest comment from family and friends.

What do you do when you know you’re going to have a bad day because of a trigger?

First, I patted myself on the back because I recognized the fact that I was triggered in the first place. Remaining mindful with bipolar is half the battle. Knowing when you have tipped the balance of your compliance plan one direction or the other is key to being able to control what happens next.

Second, I like to warn those around me of my circumstance. It lets them know that I am not feeling my best. It also clues them in to what I did to trigger the episode, giving them the power to assist me in the future by also recognizing the behavior.

For instance, say I knew I didn’t sleep well but I was angry with everyone in my path. If my husband could tell I had gotten up many times the night prior, he may be able to say to me, “Tosha, is it possible you are not feeling like yourself today because of not sleeping well? And maybe some manic rage is coming through today.”

By bringing the behavior to my attention I am able to connect the dots. I can agree that what others are doing around me isn’t the problem and that I am the one who is snapping for no reason other than my balance is off. When I recognize things, I tell my family right away, but it always helps if my support system knows what to look for as well.

Third, I try to right the wrong as quickly as possible. Today may be out of my hands. I know I didn’t sleep well, but I don’t know what caused the hypomanic state in the first place. My normal triggers weren’t present yesterday. I do know that the hypomania began yesterday and that because I didn’t sleep well last night, today my emotions are out of control.

I keep myself grounded by realizing that staying on program is important. I know that the reason I am feeling emotional is because of the lack of sleep. However, I still made myself get up at my normal time. I will eat right today and go for a walk to get some exercise, and I will take my medications as I normally do. By doing all the things my compliancy plan calls for, I know that I will return back to my healthy self sooner.

While no one likes to be triggered for no reason, with bipolar it does happen. I can be as compliant as possible, but it is still not a foolproof way of making sure I don’t have a bad day. When I know that a day of non-triggered hypomania has pulled another trigger such as ending with no sleep, what is best is following these reminders so that the next day, and days to come, aren’t also bad days.

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