Bipolar disorder: strategies for managing stress

There is no cure for bipolar disorder, but the condition can often be managed with treatment. Most often, a treatment plan will include medications (such as mood stabilizers and neuroleptic drugs) and therapy (such as cognitive behavioral therapy).

Bipolar disorder cannot be managed through lifestyle changes like following a more nutritious diet, exercising more, or following a consistent sleep schedule. But these lifestyle changes can sometimes help a person get more out of their treatment plan. Lifestyle changes can also improve many aspects of overall health.

For people living with bipolar disorder, one lifestyle change worth paying attention to is reducing stress.

What is stress?

Stress is a normal physical and mental response to anything that can be perceived as a challenge, threat, or pressure. This can be a deadline at work, an argument with a partner, a moment of embarrassment, or a major life decision. Stress is also how the body responds to sudden changes in the environment—it’s what enables people to react quickly when playing sports or find a boost of energy when they need to finish a task.

Stress affects different people in different ways. Everyone experiences acute stress at some point. Acute stress is short-term stress that resolves once the thing that caused stress has been resolved. For example, a student may feel stressed leading up to an important test, but the stress will fade once the test is over.

Many people experience what is called chronic stress, which is stress that lasts for long periods of time. This type of stress often occurs when there is no relief from the stressors—for example, poverty or being overworked at a job. Chronic stress is associated with many different health problems, including weight gain, sleep disorders, anxiety, and depression.

How can stress affect bipolar disorder?

The relationship between stress and bipolar disorder is not fully understood. There is research that supports the idea that stress affects a person’s risk of having bipolar disorder, and that stress can affect the course of the disease.

• Chronic stress is considered a risk factor for bipolar disorder. Stressful life events—especially stressful life events experienced during childhood and adolescence—may increase a person’s risk of having bipolar disorder.
• Stress may trigger bipolar episodes. Many adults living with bipolar disorder report stressful life events before manic episodes and depressive episodes.
• Chronic stress is also associated with anxiety disorders. Anxiety disorders are separate mental health conditions that sometimes occur alongside bipolar disorder.
• Chronic stress can make any health condition more difficult to manage. Stress can be disruptive to taking medications on schedule, keeping regular appointments for therapy and checkups, and maintaining consistent schedules.
• Stress may also make it more difficult to avoid unhealthy coping mechanisms, like tobacco, alcohol, junk food, and recreational drugs.
• People with bipolar disorder may be more vulnerable to stress.
• A person experiencing an episode of mania or depression may react to stressors differently than they do at other times.
• Any medical condition can be stressful to manage. Having bipolar disorder and keeping up with managing bipolar disorder can be a source of stress.

What can you do to reduce stress?

Stress and how stress impacts your daily life are important topics to discuss with your healthcare providers. Talk to your healthcare team about healthy ways to reduce stress. Here are some suggestions:

• Making time for things you enjoy
• Mindfulness activities, like deep breathing and meditation
• Exercise and other forms of physical activity
• Participating in a support group where you can connect with other people living with bipolar disorder
• Spending time outdoors in a park or natural setting
• Spending time with friends and loved ones who help you feel less stressed