Experts suggest certain factors, like chronic stress, can trigger how genes associated with bipolar disorder choose to express themselves.

Bipolar disorder exists on a spectrum of severity, with three main types. It is characterized by mood and energy shifts, including depressive and manic (or hypomanic) episodes. However, many individuals experience periods of stability between episodes rather than continuously cycling between mood states.

Bipolar disorder is a common mood disorder. According to the National Institute of Mental Health, approximately 4.4% of U.S. adults have bipolar disorder.

Currently, there’s no cure for bipolar disorder. However, treatment plans and lifestyle changes can help prevent mood episode triggers.

Triggers of bipolar disorder episodes

The direct cause of bipolar disorder isn’t fully understood. However, experts believe some key social and environmental factors can trigger bipolar disorder in people predisposed to this mental health condition.

Possible triggers include:

substance use
chronic stress
bereavement
childhood trauma
childhood abuse (physical, sexual, or emotional)
chronic illness
long-term antidepressant use
exposure to certain toxins
poor sleeping habits

In some people, these factors can trigger symptoms of bipolar disorder earlier in life.

For instance, a 2020 study suggests that emotional and sexual abuse may predict if someone develops symptoms of bipolar disorder earlier. It may also increase someone’s likelihood of experiencing suicidal thoughts and behaviors.

Tips for coping with bipolar disorder triggers

The most common treatment plan for bipolar disorder is a combination of medication and psychotherapy. You’ll often have to work with a doctor or treatment team.

Outside the typical treatment plan, there are self-care and lifestyle tips that may help you lower your chances of having mood episodes. These include:

Reduce stress as much as possible

Reducing stress can benefit you in many ways, but it’s easier said than done.

If you need a little help, you might ask friends and family for assistance with household chores and other responsibilities.

You could also consider changing to a job with fewer hours or one that allows you to work remotely.

You can also try to avoid environments with lots of stimulation.

Practice mindfulness

Practicing mindfulness can be done in many ways, including:

meditating
journaling
practicing yoga
going on a daily walk

Create a routine

It may help to add more structure to your daily routine.

You may consider:

waking up and going to bed at the same time
doing meal prep at the beginning of each week
eating and exercising at similar hours each day

The key is to find ways to reduce change in your life.

Get good sleep

One possible trigger for bipolar disorder episodes is irregular sleep. So prioritizing a healthy sleep schedule is important.

Experts say to aim for eight to nine hours of sleep each night, but your needs may vary.

Avoid substance use

Substance use can trigger episodes and interfere with your ability to maintain treatment plans.

You may want to decrease your use of drugs and alcohol, especially if they interfere with your medication. Consider speaking with a medical professional to help you choose the best approach to your treatment.

You may also consider reaching out to loved ones or joining support groups, such as:

Limit caffeine intake

Caffeine is a stimulant, so many doctors recommend cutting caffeine from your diet.

At the very least, you may want to try avoiding caffeine in the evenings so it doesn’t affect your sleep.

Exercise

Exercise is a great way to boost endorphins and regulate your mood.

Consider engaging in exercises, such as:

going to the gym
taking a walk
going for a run
practicing yoga

These are just a few options. Try any movement you enjoy.

Types of bipolar disorder

There are three main types of bipolar disorder:

bipolar I disorder
bipolar II disorder
cyclothymic disorder

In bipolar I disorder, you have episodes of mania. You may or may not have depressive episodes.

People with bipolar II disorder experience episodes of depression and hypomania.

The difference between hypomania and mania involves how severe the mood symptoms are and how long the episode lasts.

Symptoms are the same and include:

increased energy levels
irritability
distractibility
a decreased need for sleep
feelings of euphoria
racing thoughts

A manic episode has to last at least a week and may lead to hospitalization. A hypomanic episode must last at least four days and often isn’t severe enough to require hospitalization.

Symptoms of depressive episodes are the same for both bipolar I disorder and bipolar II disorder.

These symptoms include:

low mood
decreased energy
trouble sleeping or sleeping too much
feeling numb
hopelessness
low self-esteem
a lack of interest in life or activities

Cyclothymic disorder (aka cyclothymia) is similar to bipolar II disorder, except that you don’t fit the full diagnostic criteria for a mood episode. You must also have symptoms lasting at least two years (or one year in children).

Causes of bipolar disorder

Scientists haven’t found one root cause of bipolar disorder. While bipolar disorder appears to stem largely from genetics, there isn’t one gene responsible for bipolar disorder.

Instead, research notes that several genes are associated with bipolar disorder. When found together, they can contribute to a higher chance of developing bipolar disorder (known as polygenic risk).

Since there are several genes associated with bipolar disorder, it has the potential to be inherited.

For instance, a 2015 study found a 5% to 10% risk of bipolar disorder for those with a first-degree relative with bipolar disorder.

The study also suggests a 40% to 70% risk of bipolar disorder for those with an identical twin with bipolar disorder.

Environmental factors

The study of bipolar disorder with identical twins suggests that while bipolar disorder may largely stem from genetics, it doesn’t solely stem from genetics.

Instead, research suggests that environmental factors also contribute to bipolar disorder. Some of these factors include:

Prenatal influences (e.g., maternal infection, stress, substance use during pregnancy)
Early-life stress or trauma (e.g., childhood abuse, neglect, parental loss)
Major life events (e.g., severe stress, relationship problems, financial difficulties
Substance use (e.g., alcohol, drugs, especially stimulants)
Sleep disturbances (e.g., irregular sleep patterns, shift work)

Additionally, a 2017 study found that high stress levels or exposure to toxins, such as metals or air pollutants, could also trigger bipolar disorder in some people. This exposure can cause changes in gene expression.

While a pair of identical twins appear to have the same genes, their genes may behave differently depending on differences in their life experiences. So one twin may develop bipolar disorder, and the other may not experience the condition.

In short, there’s a wide range of causes for bipolar disorder. Although genetics seem to play a major role, it often takes other environmental factors to cause changes in:

brain structure
brain function (chemical imbalances in the brain)
gene expression

Recap

The cause of bipolar disorder isn’t fully understood, but genes play a big role.

Why some people develop bipolar disorder, and others don’t may have to do with triggers, like experiencing chronic stress or childhood trauma.

If you’ve been diagnosed with bipolar disorder, you may consider lifestyle techniques to lower your chances of mood episodes.

You may also consider reaching out to a healthcare professional if your treatment plan isn’t working.

Many people with bipolar disorder live meaningful and healthy lives with the right combination of therapy, medication, and self-care. You’re not alone.

Bipolar disorder. (n.d.). https://www.nimh.nih.gov/health/statistics/bipolar-disorder
Fullerton JM, et al. (2015). Assessment of first and second degree relatives of individuals with bipolar disorder shows increased genetic risk scores in both affected relatives and young at-risk Individuals. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5054905/
Mullins N, et al. (2021). Genome-wide association study of more than 40,000 bipolar disorder cases provides new insights into the underlying biology. https://www.nature.com/articles/s41588-021-00857-4
Quide Y, et al. (2020). The impact of childhood trauma on developing bipolar disorder: Current understanding and ensuring continued progress. https://pmc.ncbi.nlm.nih.gov/articles/PMC7751794/
Rowland TA, et al. (2018). Epidemiology and risk factors for bipolar disorder. https://journals.sagepub.com/doi/full/10.1177/2045125318769235
Ruzicka WB, et al. (2017). Epigenetic mechanisms in the pathophysiology of psychotic disorders. https://pmc.ncbi.nlm.nih.gov/articles/PMC5547575/

This article originally appeared on PsychCentral. © 2025 Healthline Media LLC. All rights reserved. Our website services, content, and products are for informational purposes only. Healthline Media does not provide medical advice, diagnosis, or treatment.

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