Being Triggered into a Mood vs a Bipolar Episode

Hello everyone!

What I guess I'm asking about is 'situational' depression or hypomania (I think it's best to take mania out of the equation) vs a Bipolar 'episode' of depression or hypomania.

How good are you at distinguishing these? Do you increase or make changes to meds (per pdocs' recommendations) when it's situational?

I hear here and there that Bipolar episodes can actually *be* triggered. So how, in this context, can you distinguish between BP reactions and emotional reactions (being reactionary and/or emotionally labile)?

I've heard of people devolving into deep depressions, and then only later indicating that x, y, z happened to trigger it, after initially thinking it came out of the blue. I have been guilty of that myself, but therapy has helped a great deal in delving deep and figuring out what caused a certain mood. How do you figure this out in your life?

I also happen to believe that one can be triggered into hypomanic symptoms as well that turn out to just be wonderful happiness, joy or, on the other hand, anger at someone or a situation. Again, how to tell the difference?

I personally believe it is very important to make these distinctions because, first of all, having BP does not exempt any of us from being triggered into emotions that have nothing to do BP. Also, I don't think any of us want to change meds when it's not truly necessary, when the trigger and resulting emotions will not last, when they will dissipate, depending on the circumstances, without the help of increased dosages or changes in meds.

I think therapy can help enormously with these distinctions, I know it's the one thing that has helped me. What do you guys do to figure these things out?

I don't think there's always a clear-cut answer, but I do find that mood charting and journaling are helpful to figure out the difference, at least after the fact.

I know that stress (especially medium/long term) can make me unstable and cause episodes. What causes stress will differ from person to person. The difference between a stress-induced bipolar episode and a situational mood is that with a stress-induced episode I generally wouldn't be able to tell you in advance which way I'll go, up or down. The nature of the episode can be the opposite of what you would "logically" expect.

Sometimes it's a combination. It may start out as a situational mood and then the stress and/or lack of sleep from whatever happened causes me to spiral further out of control and the situational mood can transition into a bipolar episode. Sometimes I start out having an episode and something situational happens to make it worse.

For me, I would associate a situational depression with more conventional feelings of sadness, which is different from what I feel in a bipolar depression, although again, sometimes the lines get blurred and it can get complicated to figure things out.

I think situational depression -because I do not experience situational hypomania, although I’m sure it’s a thing - is not going to be helped by medication. However, I also believe if the trigger goes on for too long, such as prolonged stress, it can develop into an actual episode that is hard to get out of.

My triggers are extreme stress. I took a job back in 2017 that I absolutely should not have. It caused me immense stress. Eventually I broke under the stress and had a depressed psychotic episode. That was an actual episode triggered by stress. However, I took another job in September that stressed me out and sent me into depression and anxiety, but I knew enough to quit early so when I did all the anxiety went away. So that was situational and I did not allow it to become a true episode.

This year, I experienced a severe depressive episode triggered by all the coronavirus upset. Because there was no way to escape that trigger, it sent me into an actual depressive episode that required medication to help.

I don’t know if any of that made sense, but that’s been my experience.

I am sorry if I am sounding ignorant here because I am genuinely curious: does situational (hypo)mania actually exist? I have never heard of that concept before. I have only heard of a stressful event (or multiple stressful events) triggering your dopamine receptors to cause hypomania, but that the malfunctioning receptors can be treated with meds. Usually situational depression does not respond to meds, no? So that would suggest that situational hypo/mania (if it exists) would not respond to meds. But I have not heard of someone's (hypo)mania being completely treatment resistant. Usually a heavy hitter like Zyprexa, Clozapine, ECT, TMS, etc. will knock someone down.

I do not believe situational hypomania, whatever that is, exists.

I think situational stressors could possibly cause bipolar episodes, but you make a good point that sometimes we are just plain experiencing sadness or grief, or just a lot of excitement. As FluffyDinosaur wrote, my depressions are a bit different than just my periods of sadness or grief. They have different characteristics. If my depressions do stem from something situational, it morphs a bit. The last time I had extreme situational sadness was when my pet died this past year. A couple years before that, my family lost my nephew and I lost my previous pet. It's just horrible! Horrible! But it was different than my depressions that were clearly mental illness.

Unlike many, I do not call mood elevation "blips" episodes. People can argue with me about the DSM-5, but I do go by that when labeling episodes that I've had. Sure, some excitement can occasionally take me beyond what would normally be experienced without bipolar disorder. But if lasts only hours to one or a few days, I don't call it hypomania/mania. I call it mood lability or the "blips" I mentioned. I guess an exception would be if that one day or two was so extreme that I ended up in the psych hospital. Then I guess I'd call it an episode. Again, that is allowed according to the DSM-5. Please no rotten tomatoes for me actually agreeing with some of what's in that guide. So so often people say "I'm manic" when in reality they've had what I call a "blip". Or their moods fluctuate up and down for a few days, and they label themselves "rapid cycling" or in a "mixed episode". I guess people can label as their heart desires, but I don't label that way, for myself.

I wish that I could clearly answer a question like this one. The reason I have a hard time doing so is because of medication.

For example, I had a very tough time last week because of having to change my therapy sessions from in office to teletherapy. My mind was severely upset, and I couldn't stop it. Things got worse. I began constantly ruminating about the issue. Even in my sleep (after being knocked out by meds) I was ruminating over the situation.

By the 3rd or 4th night I was having hypomanic symptoms. Constant sounds in my mind, including a whirring sound, like a machine whirring. The whirring never stopped.

Without meds, I believe (I am sure, actually) that I would have continued on into a hypomanic, then fully manic, episode. But I spoke with my pdoc, told her what was happening, and she increased my AP. It was a small increase. Even so, within a day my mind was quiet again. I was able to have an online session with my therapist and worked things out pretty well.

I'm sorry, I'm not doing a very good job of explaining. I think what I'm trying to say is that in my experience, episodes can just happen or they can be triggered. Either way, the end result is bound to be really bad/disastrous - unless medication and possibly therapy interventions occur.

Good post

Fuzzy is correct, you've described stress meets bipolar disorder very well.