The Improper Use Of The Term “Bipolar Trigger”

Time and time again I see people tossing around the phrase “bipolar trigger” with disregard. Unfortunately, not understanding what a trigger is can create a number of problems in trying to figure out and manage the Disorder. It creates a misconception that causes a number of people to see their loved ones as rapid-cycling when they are not.

So what is a “trigger”? A trigger is a circumstance that kicks off an unwell cycle. It can be anything; ranging from a smell that kicks up forgotten memories, to being assaulted, to a movie. to the sky being blue. Here’s the important distinction- it kicks off an unwell cycle. It doesn’t create temporary spikes, general moodiness, or just discomfort. It is a circumstance that starts an unwell cycle.

Let’s have a look at some examples with visuals to help demonstrate this better. We’ll get to why it’s important in a minute.

Chart Legend

MOOD
10 – Full Blown “I’m The Reincarnation of Jesus” Mania
8 – Hypomania
4-6 – Normal Person Range
3 – Mild Depression
0 – Suicidal Depression

TIME
Increments shown are just for an easy visual reference. Could be hours, days, weeks, or months depending on the person.

Blue Circle denotes a trigger.

So here’s what a normal person’s moods will look like.

normal1

Notice how the person’s mood stays pretty much in the range of 4 to 6. 5 would be a fairly typical baseline for a number of people. Different people may have different baselines. Mine for years and years was about a 3. I’ve met other Bipolars who had a baseline more around the 7 mark. They were intense, volatile and constantly on the go. They were also very easy to tip into a manic cycle.

depression1

This second chart denotes a Depressive cycle. The blue circle is the “trigger”. That may have been bumping into an ex you’re still tender about, someone dying, losing your job, getting passed over for a promotion, a television commercial, the smell of a turkey dinner that reminds you of your dead mother, or again; the sky being blue. For whatever reason, your brain “triggers” and you crash straight the fuck into depression. Your baseline is now around the 1 mark, shifting slightly up and down. Depressive people don’t tend to be as chaotic as escalated people. Most of the time, your brain is lethargic and can’t think worth a shit.

manic1

This third chart shows a typical manic cycle, crash, and the start of rebalancing. The blue circle on this chart denotes the manic trigger. Notice how the person’s mood rockets upwards? There’s nothing slow or subtle about it. The person’s baseline shifts to about an 8 and starts bouncing around up in that area. Eventually, the cycle runs it’s course, and the person’s brain drops off into the abyss. Over the next little bit, the person’s brain will raise up out back to their “normal” baseline. But note how the person drops to a 0? This is common. It’s not difficult to associate suicides with this severe drop off. The person just got off a run of fucking up and destroying their life around the 8, then they fall to 0, an area that would normally make them more vulnerable to self-harm and suicide; and then it’s no difficult step to kill yourself when you weigh everything you fucked up in this cycle and throughout your life.

Why Is This Important?
Now, I’m going to take a stab at what you’re wondering.

“Dennis, is this more detail specific bullshit that only you give a shit about?”

No. And here’s why. When I was in Cognitive Behavioral Therapy, my therapist explained an unwell cycle being like a train leaving a station. You can stop it much easier as it is leaving the station as opposed to when it gets going full bore. A person that can identify their trigger and the escalation/fall in Time 3-5 can take measures to derail their unwell cycle. A Bipolar person can significantly minimize the effects of an unwell cycle or possibly avert all the bullshit that falls from about Time 5 on out.

Once you get to Time 5, you start seeing the spikes up and down. I regularly see people refer to these as “triggers”. They aren’t. Talking to your significant other and them getting pissed off at you isn’t a trigger. A good day, a suicidal day aren’t triggers.

Those things are all just a normal part of being Bipolar.

The trigger is what occurred at the Blue Circle. That’s it. Everything else is just the fallout from the cycle the person is in.

I beat the drum loudly that mental illness is AN ILLNESS. It behaves in certain predictable ways. You won’t always pick up on them but with the help of a significant other or loved one, they can point out when you’re starting to get more severe or your mood drastically changes. Unfortunately, the window of opportunity is small. Self-management is the best way to head off unwell cycles. It requires practice, practice, and more practice. I highly recommend Cognitive Behavioral Therapy to learn techniques to do so.

How Do I Use This Information?
Unwell cycles get worse the more you dwell on the triggering circumstance.

The best thing to do is shove it straight out of your mind and take some actions that run counter to the potential cycle coming.

*If Depression is looming- put on some upbeat music and exercise, watch a comedy, read a book, do some hobby stuff that will take your focus off the negative thoughts.

*If Mania is looming- slow your mind down, listen to some peaceful music, remove yourself from stress, take a nap, anything that will help you relax and shift your thoughts away from the trigger.

Nowadays, I can usually catch about 90% of my shifts. They’ve gotten more subtle since I started on meds, which is both good and bad. Good in that they’re more subtle, bad in that they’re easier to miss, though the cycles are also milder. Triggers can come out of anywhere.

For example, some of mine-

“The Simpsons” movie is a severe depressive trigger. I got this movie to watch with my ex-Fiancee after she got home from work. Before the movie she said she had something important to talk to me about. After it was her “I need to leave you” conversation. So my brain associates the movie with that emotional pain.

Fight or Flight response. I’ve had several hypomanic cycles start because apparently the Fight or Flight response has a similar physiological affect on the body as a hypomanic cycle. It essentially tricks the Bipolar mind into thinking it is already in a cycle.

Using this knowledge is simple once I have it. One, I just avoid the Simpsons movie unless I’m testing my antidepressant. If someone else is watching it, I’ll just go somewhere else and focus on something else, force the thoughts and feelings of that conversation out of mind. By not dwelling, I interrupt the Depressive crashing.

It’d be great if we could all avoid Fight or Flight, but unfortunately that’s not feasible. Knowing that it will start a hypomanic cycle for me, I plan accordingly for it. After the circumstance, I will pay closer attention to my thoughts, double check any “great” ideas with people that I trust that know me well, and not make any frivolous purchases.

I know and am prepared for these circumstances because I know many of my triggers and how to identify the symptoms that indicate my brain is going to shit. You can learn those things too.

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10 Responses to The Improper Use Of The Term “Bipolar Trigger”

  1. avatar Anne Davies says:

    Great article. Has encouraged me to start charting my moods again.

  2. avatar Esther says:

    Great article, Dennis. It’s a subject I’ve certainly had to try and explain to loved ones around me more than once – clearly not very well! In future I shall refer them here. Beautifully succinct as ever. I particularly like the point that it doesn’t matter *what* the trigger is as such (except for self knowledge of course), but more that there has been one. This seems to be a tricky thing for peeps to comprehend – myself included for a long time. Thank you.

    • avatar Dennis says:

      Thanks, Esther! Glad you enjoyed the article and hopefully it will help you and your family.

      I would also point out that a Bipolar person can trigger for no visible reason at all. It could be tied to something like nutrition or lack of sleep. So there isn’t always a tangible reason for it. Personally, I don’t have that occur very often. Actually, I don’t think I’ve ever had that occur but I can’t be entirely certain due to the Swiss cheese-like retention ability of my brain-meats.

  3. avatar Dove says:

    “Swiss cheese-like retention ability of my brain-meats.” HA! I love it! 😀
    I’m new to your blog, but I’ve been reading it all day. Thanks for this. For everything you are doing here. I’ll be back to write more later. And I may even email or call you one day when things are a little less hectic in my life. Just had to say thanks. And thanks for the laugh.

    ~Dove

  4. avatar AlexaFaie says:

    I’m still, several years into my diagnosis, unsure of what my triggers are to the point that I’ve often felt like arguing that triggers are a made up thing. I’ve spent hours and hours trying to pinpoint something which could have been a trigger, but there is nothing I have been able to find which consistently provokes the same response.
    I don’t know what my baseline is as I don’t know a time when I’ve been stable enough to have one. Or at least none that has jumped up and down and yelled “Hi! I’m your baseline!” Sometimes it makes me think that I’m just really thick even though I know that I’m actually very intelligent because of how inept I seem to be at spotting this stuff.

    So far my partner has highlighted to me that I seem to have two different kinds of mood fluctuations. One is the overarching “mood” where I’m either depressed and generally can’t leave my bed or wash, or get myself to eat properly much, or sleep too much etc which can last 2-4 ish months. Then there is the other side where I seem to be somewhat manic for the majority of the time, generally overly elated mood, heightened belief in myself sometimes to the point of arrogance, less need for sleep, racing thoughts, forget to eat as seem to have all the energy in the world ever and generally have to be careful with spending as I tend to be less bothered about if I need something or just want it in the spur of the moment. Oh and heightened sexuality and all that jazz. No matter what goes on during this time, everything is fucking awesome. Everything. A relative just died? Hilariously awesome. Oh wait, no I’m meant to feel that sorry/sad thing. Except I don’t. Tears don’t work. Sad doesn’t work. But at the same time as there is all the elation, I don’t actually feel happy. Just kinda high. The longest that has ever lasted that I can clearly remember was about 6 months. But in general its only about a month or two.

    And then, completely separate to that I can experience huge extremes. So I could be in a manic kind of phase and suddenly out of the blue, bam rock bottom for a few days. Then immediately back up to the mania as if it never happened at all. Or conversely during a depressive phase I could get an odd period of mania where suddenly I am not just amazing, I’m the most amazing person in the world, probably some kind of evil goddess everyone else is inferior to and they should probably worship me or something stupid like that. I’ve thought I could fly on a few occasions, once trying to fly out the window which luckily was closed at the time so all I did was get a very sore head. Or I will get hallucinations out of the blue where I see things which aren’t there or feel stuff rubbing up against me. Its scary as anything. If I close my eyes it doesn’t help, I just get weird ass images like melting faces or just random objects which normally are just mundane objects, but in that moment they are the scariest thing ever. And then I get mixed episodes too which for me are the most dangerous. I will be feeling rock bottom depressed with all the usual suicidal thoughts which have accompanied me since nearly as young as I can remember (prior to school age as my first suicide attempt was whilst I was still using a booster seat in the car and before my brother was born though after my Grandma died so probably aged 4-5) and yet have the drive and ability to act out those thoughts from the mania as I only have that kind of drive when I’m some kind of manic. That has led to stopping dead in front of oncoming traffic (bonus points to the driver who reacted quickly enough to brake and swerve out of the way) and taking ALL the tablets I had access to at the time (a variety of the different meds I’d been trialled on, and all painkillers plus a ton of strong alcohol to wash it all down) which led to me being hospitalised for the overdose.

    The very acute short-lived periods *sometimes* seem to have general triggers. Like extra stress from being trialled on a ton of different meds whilst trying to hold down part time work, but more recently my life hasn’t had the same kinds of stressors as I no longer work. Noone really expects me to do very much at all really so there isn’t much pressure on me other than from myself.

    I still get the shifts every few months from high to low, not quite like clockwork because then it could be easily predictable, but its there as low, high, low, high, low high. Usually with the lows being longer. And I still get the total crazy ass dizzying highs where I am clearly not in my right mind. I have no idea what would make me manic like that. Sometimes I just wake up like it. Maybe I had a really good lucid dream the night before? But I can’t really be expected to be able to control my unconscious mind whilst I’m asleep. And the worst of the depressive periods can sometimes be because something stressful has happened, or sometimes everything is going great, I’m feeling pretty ok, I’ve managed to be quite productive for a change in a more sensible less OMG! I have to clean everything in the next 5 mins kind of way and then boom that voice in my head is all “you want to die”, “everything is shit, you should just end it all, except you don’t even deserve that release you worthless piece of shit”. And I’m like “where the fuck did you come from?

    I’m sure some kind of talking therapy would be very useful for me to help identify what exactly might be going on and maybe highlight some triggers. I tried to get access to something called “Steps to Wellbeing” which offers some talking therapies and CBT, but was told that they can’t help people with bipolar disorder, only depression and generalised anxiety as they can’t deal with chemical imbalances by talking them away. When I tried to push for getting help with general management of how I react to situations in the hopes of it helping me find my triggers, they just apologised and said to see what my doctor can suggest instead. The doctor I had a few years ago gave me a link to a website which was meant to be a CBT course you could follow yourself online, but unfortunately I found it only made me feel worse. It was basically only filled with those kind of “nobody can make you feel inferior without your consent” comments which to me is basically like saying “oh no, that bully isn’t at all responsible for those hurtful comments hurting you, its all your fault. You should just toughen up. No we won’t talk to the bully about maybe not being a jerk, its your fault for being weak willed.” Which didn’t exactly help me out and gave me a very bad impression of CBT. But then I have a bit of a problem with taking things literally, even when things are meant as a joke. So maybe I would need an actual person to go through it with me to tailor it to me better?

    I don’t know. All I know is I need far more help than I can currently get access to. So much so that I’ve posted long winded responses to two of your threads now. You must be sick of me by now.
    In between the posts I have read the free sample amazon provides of your book. I’m going to have a word with my partner to see if he thinks its ok for him to buy it for me as it can’t be given as a gift so I don’t know why I put it on my wishlist for Christmas and it would probably be more help sooner rather than later. For all I know there is something in there which makes some part of my experience click and I go “ah!” and gain a little bit more insight.

    • avatar Dennis says:

      Everyone experiences mental illness in their own way. We are bound by symptoms, but what is relevant to one person may not be relevant to you. As was pointed out, Bipolar Disorder is rooted in chemical imbalances. That means that anything that can potentially affect the chemical balances in your body could be contributing to your instability. You mention Body Dysmorphia in your other post. Are you taking any kind of hormonal anything? That would contribute. Sunlight. What you eat. Smoking. Drinking. Over the counter medications. Literally, anything that can affect the chemical balance in your body could be contributing.

      Now, you mention that you don’t feel you are under as much stress in this post. In the other, you mention things that may point to an anxiety disorder. If you have an anxiety disorder, then minor stresses can easily get exploded into more severe ones as you dwell more and more on it. And from the sounds of your posts, you ARE under a great deal of stress. Lack of money. Lack of ability to get quality services. Lack of ability to stay stable. Fear, uncertainty. All of these are factors that could be contributing to the general instability you experience. In my case, I am logical and analytical to a fault. It made it easier for me to run down and nail down external triggers as I worked backwards through the unwell cycle to the point where I felt fine versus when I triggered. If yours are driven by mostly chemical processes, then you may not have triggers that are nearly as clear. Chemical imbalances caused by excessive stress (either from general life circumstances or Anxiety) can certainly be triggers. They may not be tangible or easy to see. But that could be why you’re not able to concretely identify any, especially if you’ve been looking for years and have nothing to show for it. The way you express yourself in your posts suggests that you are a very self-aware person who has a fairly firm understanding of who you are and what isn’t quite normal about you. I don’t think there is any reason that you wouldn’t have been able to identify your triggers unless there were no concrete triggers to identify.

      About CBT. I hear so many people express a similar sentiment to yours. But let me point something out. Humanity is and has always been completely awful to each other. There has been no point history where everyone has just “gotten along” or treated each other well. Now, take your example of the bully and talking to them about their behavior. What does that actually accomplish? Nothing. Because a majority of people are not evil or necessarily started off as bad people; they were molded into that through abuse, hatred, being bullied themselves, or mental illness. “Talking to” that person about their behavior doesn’t actually do anything to fix any of the breaks that caused that behavior. It just alienates that person, reinforcing their differences and confirming whatever negative shit is already in their head.

      That changes when you cease to allow other people and circumstances to dictate your emotional state. This is a major failing of advocacy and acceptance movements. Forcing other people to be silent doesn’t actually fix the problem. It just causes the other side to be silent and start acting on those shitty thoughts in silence. And then everyone is so shocked and surprised when it bubbles back to the surface.

      Now let’s take it out of the context of social justice for a moment. I regularly talk to mentally unstable people. People confide a lot of things in me because I put myself out there for it. So how would that work out if I allowed their anger and rage to make me angry? Or allowed their depression and hopelessness to make me sad and drive me into depression? Would I be able to retain clarity of thought to effectively communicate and help that person find resources they may need? Or am I going to waste my breath arguing with a mentally unstable person about how them calling me a piece of shit or mother fucker hurts my feelings? No. I don’t allow unstable or awful people to dictate my feelings. And so many people do. The person that cares the least in that situation wins. All I have to do is utter a “bad” word and someone will come out of the wood work to be enraged and offended by it. And that person will have that disruption, continue to tell themselves how awful the world is, and whatever else for however long it bothers them. Meanwhile, it still doesn’t mean shit to me because being infuriated over a few words or actions is a waste of time and energy.

      The world is not a safe space. The world will never be a safe space. Humans are greedy, selfish, self-centered creatures. You can’t change everyone else. But you can change how you respond to the stresses and circumstances. That is the point of CBT.

      Now, in your case, I suspect it would be a bit more difficult because your cycles tend to not have any identifiable rhyme or reason to them. So defusing those thought processes is likely to be more difficult since they don’t appear to have tangible starts to them. And with the chemical imbalance, it’ll be much more difficult to reign in those negative feelings that can come from external stimuli. I know that I wasn’t able to effectively use CBT techniques until I had experienced some success with medications to calm down the irrational emotional responses to benign situations.

      Regardless of your feelings, agreement, or disagreement with the whole idea; I would still recommend going through and learning whatever you can. You may disagree with it and not like it now, but you’ll at least have that body of knowledge available to you if things smooth out for you a year or two down the road.

      Given the context of your posts, the way you describe yourself experiencing the disorder, and the self-awareness you exhibit; I feel like talk therapy may not be very helpful for you. Talk therapy can be incredibly useful if a person needs a safe place to vent or has specific goals to work on. From the sounds of things, it’s more likely that you’re going to need a medication solution to get things under greater control. Were I in your situation, knowing what I know about the Disorder, with the information you shared here, and the limited resources I had available; I would opt to spend that money on getting back to the doctor and trying other meds.

      Also, check your email that you registered with. I sent you a direct mail from my account dennis@bipolarmanifesto.com with the subject header Bipolar Manifesto. Make sure it didn’t get caught in your spam filter.

      • avatar AlexaFaie says:

        Hi, I can’t find the email, not in junk or my inbox. I don’t know if its because I don’t have a registered wordpress account (or rather if I have but its a different email address) or if its just playing silly buggers.
        I’ve added your address to my contacts just in case, so feel free to resend it if you can. 🙂

        • avatar Dennis says:

          So hey, turns out I’m dumb. I accidentally sent it to alexafaiefaie thanks to a mental hiccup of my own. Sent again to your registered email account. Please let me know if you do or do not get it.

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