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Bipolar 1 Episodes: What Triggers Them and How Long They Last

Medically reviewed by Paul Ballas, D.O.
Written by Emily Wagner, M.S.
Posted on August 14, 2023

  • Bipolar 1 disorder is a mood disorder characterized by episodes of mania (elevated mood and energy) and depression.
  • Common triggers of bipolar 1 episodes include stress, certain medications, and seasonal changes.
  • Manic episodes can last at least seven days, while depressive episodes may last at least two weeks.

Have you found that certain events, medications, or even the weather can trigger an episode of your bipolar 1 disorder? This isn’t just in your imagination — studies show that all of these factors can bring about mania or depression. These episodes can last from several weeks to months and can interfere with your daily life.

In this article, we’ll discuss what happens during bipolar 1 episodes, some common triggers, and the factors that affect how long they last. We’ll also cover tips for managing your episodes, including when to talk to your health care provider.

What Are Bipolar 1 Episodes?

Bipolar 1 disorder is a serious mental health condition that involves intense mood swings and changes. It’s sometimes written with a Roman numeral, “bipolar I disorder.” People with bipolar 1 experience episodes of mania and depression, and some experience “mixed episodes” with features of both.

Symptoms of mania include:

  • Having abnormally high energy levels and feeling overly excited or jumpy
  • Overindulging in sexual activities, food, or alcohol
  • Needing less sleep than normal
  • Having racing thoughts and talking quickly about several things at once
  • Feeling unusually powerful or important
  • Taking on many activities at once without getting tired

On the other hand, depressive episodes are defined by intense feelings of sadness and anxiety. Other depressive symptoms include:

  • Having trouble making decisions or concentrating
  • Struggling to complete daily tasks and responsibilities, like cleaning or going to work
  • Having a hard time falling asleep or staying asleep, or sleeping too much
  • Losing interest in activities or hobbies you enjoy
  • Forgetting things more often
  • Searching for words or talking very slowly in conversations
  • Feeling worthless or hopeless
  • Thinking about death or suicide

Note: If you or someone you know needs help, you can contact the 988 Suicide & Crisis Lifeline by calling or texting 988 or chatting online.

During a manic or depressive episode, you’ll have symptoms for most or all of the day, several days in a row. When you’re not having an episode, your mood may be stable, and you can function normally.

Common Triggers of Bipolar 1 Episodes

Everyone’s bipolar 1 disorder is different, but research shows there are some common triggers that bring about mood episodes. Below, we’ll go into detail about these different triggers and ways you can manage them.

Stressful Events

Everyone experiences stress at one point or another in their lives. While some people can manage stressful events, they act as triggers for mood episodes in people with bipolar 1. One study found that stressful or negative life events like losing a job, getting a divorce, and experiencing the death of a family member can trigger episodes of depression.

If you’re experiencing a lot of stress or recently had a major life event, it’s a good idea to talk to your doctor and a mental health professional (like a therapist). They can help you process your emotions and adjust your treatment as needed.

Cognitive behavioral therapy (CBT) is a type of psychotherapy that helps you change thought patterns that drive anxiety and stress, and replace them with healthy ones. Researchers have found that CBT can be a useful treatment for managing other conditions associated with bipolar 1, including anxiety and depression.

Difficulties Sleeping

Our brains and bodies need sleep to rest and repair themselves. Without enough sleep, you’re at a higher risk of long-term health problems. A lack of sleep can also trigger bipolar mood episodes — especially manic episodes.

In a 2017 study of people with bipolar disorder, 20 percent of them reported that sleep loss triggered mania. On the other hand, 11.4 percent reported that it triggered a depressive episode. The authors also found that females and individuals with bipolar 1 were more likely to experience manic episodes compared to males and those with bipolar 2 disorder.

If you’ve noticed changes in your sleep patterns lately, talk to your doctor. They can connect you with a therapist or other specialist to help you change your sleep behaviors. You can also take steps to practice good sleep hygiene, including limiting your screen time and avoiding large meals, alcohol, or caffeine before bed.

Certain Medications

Bipolar 1 disorder is treated with a combination of antipsychotic drugs, mood stabilizers, and antidepressants. Taking an antidepressant alone without a mood stabilizer also may trigger a manic episode. Be sure to follow the medication instructions provided by your doctor to avoid this.

Other types of medications, like corticosteroids and thyroid hormone replacement therapy, can trigger manic episodes. Compared to the general population, people with bipolar disorder are more likely to have thyroid disease and may need hormone replacement therapy.

If you’ve recently started a new medication and notice symptoms of a manic or depressive episode, make an appointment with your doctor. They’ll modify your treatment plan to avoid triggering future episodes.

Seasonal Changes

It’s common to feel down or unlike your usual self in the fall and winter. Fortunately, most people start to feel better in the spring and summertime with more daylight. However, some can experience intense feelings of sadness or depression during the fall and winter that interfere with their daily lives. This is known as seasonal affective disorder (SAD), which can look similar to depression.

While SAD is uncommon in the general population, it affects around one-quarter of people with bipolar disorder. Studies show that changes in the weather — like cloudiness, temperatures, and rainfall — can all trigger new bipolar mood episodes.

If you know your moods tend to shift during a certain time of year or with certain weather, you can work closely with your doctor to create a plan. They can adjust your medication dosage in the fall or winter to prevent triggering an episode. You can also meet with a therapist to learn new skills for dealing with depression in the fall and winter.

How Long Do Bipolar 1 Episodes Last?

In order to be diagnosed with bipolar 1 disorder, your episodes have to last a certain length of time. According to the National Institute of Mental Health (NIMH), episodes of mania must last at least seven days and depressive episodes must last at least 14 days. You can also be diagnosed with bipolar 1 if your manic episodes are severe enough that you require treatment in a hospital.

The length of a mood episode varies from person to person. A 2010 study of 219 people with bipolar 1 disorder found the median length of an episode was 13 weeks. This means that half of the participants had episodes shorter than 13 weeks and the other half had episodes that were longer.

Some people may experience four or more mood episodes within one year. This is known as rapid cycling, something around half of people with bipolar disorder experience at some point in their lives. During rapid cycling, symptoms can change quickly over a few hours or a few days.

Factors That Affect How Long a Mood Episode Lasts

The main factors that affect how long your mood episodes last include whether you’re currently receiving treatment and what kind of episode you’re having. Undergoing treatment can help shorten episodes: According to Cleveland Clinic, untreated manic episodes can last three to six months whereas treated episodes typically get better within three months. If you’re not already taking medication for bipolar 1, talk to your doctor about your treatment options.

The type of bipolar episode you have can also affect how long it lasts. For example, one study found that depressive episodes last longer than manic episodes.

Talk With Others Who Understand

On MyDepressionTeam — the social network for people with depression and related mental health conditions and their loved ones — more than 144,000 members come together to ask questions, give advice, and share their stories with others who understand life with different mental health conditions.

Are you living with bipolar 1 disorder? What events trigger your episodes? Share your experience in the comments below, or start a conversation by posting on your Activities page.

    Posted on August 14, 2023
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    Paul Ballas, D.O. is an attending psychiatrist at Friends Hospital in Philadelphia, Pennsylvania. Review provided by VeriMed Healthcare Network. Learn more about him here
    Emily Wagner, M.S. holds a Master of Science in biomedical sciences with a focus in pharmacology. She is passionate about immunology, cancer biology, and molecular biology. Learn more about her here

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