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David Baxter

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Recognizing - and Avoiding - Triggers in Bipolar Disorder
by G.J. Gregory
Sunday, January 13, 2008

Life isn?t fair. I can?t recall a single event causing a hypomania. Promotion? Big life event? No hypomania. Feel good, yes, excited, yes, but hypomania? Nope.

Now consider this Something bad happens? Potential depression. Something irritating happens? Potential mania. Fight with my wife? Potential depression. Frustrations around home? Potential mania.

It?s just not fair that depression triggers come particularly quickly and randomly. I?ve had depression triggered by news ? 911 triggered a terrible depression that lasted months. But it doesn?t have to be a major thing, I?ve even walked into a messy house and triggered a depression. While mania isn?t as commonly triggered for me, it still happens often enough for concern.

In the quest for increased self-awareness of my disorder I have tried to identify some of the triggers that can send me into a dangerous condition. It doesn?t much matter if it?s depression or mania, depression is more debilitating for me, mania much more dangerous. But both are usually precipitated by some sort of trigger.

I'm often guilty of assuming that everyone shares my definition of things, as twisted as my definition may often be. A "trigger", in this context is something that begins a reaction resulting in a mood swing. An event, a setting, an action - anything where the result is a bad frame of mind.

Most of us are familiar with triggers, and have experienced what they can do. But how to prevent them? This is the difficult part. And no matter how good I get at predicting and avoiding them, I won't avoid them all. But here are a few things I've picked up over the last few years.

First, being self-aware is critical. There are times I'm more susceptible to triggers, times I'm up or down, times I am stable. This all contributes to how I'll react to triggers. At the risk of sounding like a broken record, the only way I know to become truly self-aware of moods is to chart them. Mood charting is critical to this process for several reasons, but primarily because it forces me to self-evaluate every day. I can identify trends, and make notes of previous triggers.

Next, and this is obvious, but I try not to put myself in a position to trigger a mood change. Just like an alcoholic won't normally spend time in a bar for fear of triggering a relapse, someone with bipolar disorder needs to avoid similar triggers. My wife is actually more cognizant of this than I, and she's been unconsciously steering me away from triggers for many years. Not asking me to take out the trash if the garage is a mess, not allowing me to answer the phone in case it might be about medical bills (see this post for details), at times not even showing me kid's report cards. This is a well-honed survival technique for her. Not survival in the literal sense, but survival of her, and the entire family's, happiness.

Lastly, no matter how careful I am, it WILL happen - I will walk right into that inevitable trigger. I try to be ready for it. There's been many good shareposts about dealing with mood swings, and I go through and re-read some of them from time to time. Everyone has a method that works for them. For me it's like "The Little Engine That Could" - "I think I can, I think I can, I think I can..." I'll wade through a hazardous situation, head held high, smile on my face, a little voice in my head saying "I think I can, I think I can..." I'm only half joking there, a good frame of mind and a positive attitude is every bit as powerful as my Lamictal and Lithium. And a lot cheaper.
 

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