Bipolar disorder is a mental health condition characterized by extreme shifts in mood and energy levels. Bipolar symptoms can range from depressive lows to manic highs. While bipolar disorder is a chronic condition, many people can manage their symptoms with lifestyle changes and medication. However, some people find their bipolar symptoms get worse over time. There are several potential reasons why bipolar disorder may worsen, which this article will explore.
Stopping medication
One of the most common reasons bipolar symptoms get worse is stopping medications. Bipolar disorder requires long-term treatment with mood stabilizers and sometimes other drugs like antidepressants or anti-anxiety medication. When people stop taking their bipolar medications, either by choice or by forgetting, their symptoms are likely to recur and intensify. Going off bipolar drugs usually leads to worsening mood swings, depression, and mania.
Substance abuse
Abusing drugs or alcohol can definitely make bipolar disorder worse. Substances like marijuana, cocaine, prescription stimulants, and alcohol can all trigger manic episodes or deep depression in someone with bipolar. Continued substance abuse may also make standard bipolar medications less effective. Quitting recreational drug or alcohol use is an important step in stabilizing bipolar disorder.
Inadequate treatment
Sometimes bipolar gets worse when people do not receive adequate long-term treatment. They may be prescribed medications but take them inconsistently. Their doctors may not prescribe the right drugs or doses to properly control symptoms. Some people do not stick with psychotherapy or make recommended lifestyle changes. Inconsistent treatment leads to recurring mood episodes and instability over time.
Life stress
High stress often exacerbates bipolar disorder. Things like job loss, divorce, moving, financial problems, or grief can spur depressive and manic phases in someone with bipolar. Even positive life changes like a promotion or marriage can worsen symptoms due to the stress. Managing stress through relaxation techniques, therapy, medication adjustments, and support can help minimize its impact on bipolar disorder.
Hormone changes
Shifting reproductive hormone levels may worsen bipolar disorder, especially in women. Times of hormonal fluctuation like puberty, before menstruation, after childbirth, and during perimenopause or menopause can severely disturb bipolar moods. Birth control pills can also affect symptoms. Working closely with doctors and adjusting medications during hormonal changes may help.
Sleep deprivation
Lack of quality sleep often disrupts bipolar disorder. Episodes of insomnia or hypersomnia can kick off manic or depressive phases. Disrupting the body’s circadian rhythms through shift work, frequent travel across time zones, or poor sleep hygiene may exacerbate mood instability. Focusing on getting regular, high-quality sleep helps manage bipolar.
Medical conditions
Certain medical problems potentially worsen bipolar disorder. Thyroid disease, neurological disorders, vitamin deficiencies, chronic pain, obesity, diabetes, and heart disease are linked to poorer bipolar regulation. Effectively treating these and other physical health conditions may improve bipolar symptoms.
Progressive brain changes
Some research indicates that bipolar disorder may alter brain structure and function over time, causing symptoms to worsen. Multiple mood episodes may gradually damage areas of the brain that regulate emotions. These progressive neurological changes might make the condition less stable and predictable. However, more research is needed on this theory.
When to Seek Help
If your bipolar symptoms seem to be getting reliably worse over weeks or months, discuss it with your doctor and therapist. Worsening bipolar may require changes to your treatment plan. Reach out for help promptly when you notice the following signs:
| Signs Your Bipolar Disorder May Be Worsening |
|---|
| – Mood episodes increasing in frequency, severity, or duration |
| – Severe shifts in sleep, energy, or appetite |
| – More thoughts of self-harm or suicide |
| – New psychiatric symptoms like hallucinations |
| – Increased drug or alcohol use |
| – Inability to work or strain on relationships |
| – Medications becoming less effective |
Do not hesitate to seek an urgent evaluation if you have dangerous thoughts of harming yourself or others. Sudden mood swings, paranoia, risky behaviors, psychosis, or major impairment in functioning are also signs to get immediate assistance. Ongoing worsening of bipolar disorder should be evaluated right away.
Treatments to Stabilize Worsening Bipolar
If bipolar disorder gets worse, your doctor may recommend the following treatment changes:
Modify medications
They may adjust the dosage, switch medications, or add different drugs to your bipolar prescription regimen. Making careful tweaks to mood stabilizers, antipsychotics, antidepressants, and anti-anxiety drugs often helps stabilize worsening bipolar disorder.
Add psychotherapy
Starting therapy or increasing session frequency can help someone cope with and manage intensifying bipolar disorder. Cognitive behavioral therapy and dialectical behavior therapy are two research-backed options.
Improve healthy habits
Diet, exercise, sleep, and stress management strongly influence bipolar symptoms. Your treatment team may advise lifestyle changes like regulating bedtimes, increasing activity, modifying your diet, or practicing meditation.
Prevent substance abuse
If substance use is worsening your bipolar, your doctor will likely recommend quitting all drug and alcohol abuse. They may refer you to rehab or support groups. Sobriety helps control psychiatric symptoms.
Try ECT or TMS
For severe worsening of bipolar disorder that does not respond to medications or therapy, doctors might suggest electroconvulsive therapy (ECT) or transcranial magnetic stimulation (TMS). These procedures stimulate the brain to improve symptoms when other treatments fail.
Increase support system
Having the help and accountability of close friends, family members, and support groups can help you adhere to the above treatments and stabilize when bipolar gets worse. Rely on your support network.
Hospitalization
In urgent cases with thoughts of hurting yourself or others, a psychiatric hospital stay may be needed to immediately stabilize acute bipolar symptoms and ensure safety.
Preventing Worsening of Bipolar Disorder
While bipolar disorder is prone to worsening over time, the following strategies may help slow progression and protect your stability:
| Tips to Help Prevent Worsening of Bipolar Symptoms |
|---|
| – Take medications consistently as prescribed |
| – Avoid recreational drugs and limit alcohol |
| – Maintain a regular sleep schedule |
| – Control stress through peaceful hobbies, social support, therapy |
| – Stick with your treatment plan and attend appointments |
| – Ask for medication adjustments if symptoms worsen |
| – Develop a relapse prevention plan for mood episodes |
| – Join a bipolar support group |
| – Foster lifestyle stability and avoid excess stimulation |
While there is no cure for bipolar disorder, long-term dedication to a comprehensive treatment plan offers the best protection against worsening symptoms. Be vigilant about your mental health and ask for help quickly when needed. With proper care, many people learn to successfully manage bipolar disorder long term without significant deterioration.
When to See Your Doctor
Contact your psychiatrist or primary care provider right away if:
– You need to adjust your medications due to returning or intensifying bipolar symptoms
– You or a loved one notices your condition worsening
– You struggle to take your bipolar medications consistently
– You increase substance use to cope with symptoms
– New concerning psychiatric symptoms emerge
– Suicidal thoughts become strong or frequent
Do not hesitate to call your doctor’s office with bipolar concerns, even if you just had an appointment. Getting ahead of symptom changes is key to preventing significant worsening. They may want to evaluate and modify your treatment plan. Prioritize your health and stay in touch with your care team.
Conclusion
Bipolar disorder is an unpredictable, lifelong condition. It is common for symptoms to worsen periodically, especially if treatment is interrupted. Stress, hormones, poor self-care, inadequate medication, and other factors can cause bipolar to become less stable. If you notice your disorder getting reliably worse, promptly consult your treatment providers. They can adjust your treatment plan to help regain control of your symptoms and improve your quality of life. While bipolar tends to fluctuate over time, sticking closely to your maintenance regimen offers the best hope of managing this serious illness and protecting your mental health over the long-term.