Good Stress vs. Bad Stress: How stress can trigger a bipolar episode
In the news lately, Catherine Zeta Jones has openly shared her story of being treated for bipolar disorder that may have been caused by the stress of her husband, Michael Douglas, struggling with cancer.
People are wondering about stress and its relationship with bipolar disorder. By no means do I believe I have “the answer”. However, I do have a perspective that comes from my own experience that may shed some light on the types of stress that trigger an episode.
Good Stress vs. Bad Stress
Good stress comes from the combination of responsibility, goals and purpose with having a plan and structure to manage it.
Good stress is external, meaning it comes from doing something in the world.
Good stress may not cause a bipolar manic or depressive episode.
An example of good stress is, “I want to be successful in life. In order to be successful I need to develop my abilities to do something that is meaningful to me. In order to develop my abilities I need to learn information and develop the skills to apply them. To learn information and develop skills I need experience. In order to get experience, I need to get educated. In order to get educated I need to study. In order to study I need to pay attention in to my teachers and learn. etc…”
This example is full of stress and one that we all go through. In my opinion, the stress of having to do these things is not what causes an episode for someone living with bipolar disorder.
This is productive stress that is goal oriented and task based. This stress is emotion contained by a plan of action.
Bad stress is caused by internal pressures in response to overwhelm, urgency and fear.
It is caused by thoughts and feelings playing on each other without a plan of action.
Bad stress welcomes and ignites episodes of bipolar disorder.
BAD STRESS can take on multiple forms that build upon themselves:
- Overwhelm
Overwhelm is a temporary state that occurs when we simply don’t have the interpersonal resources and information to achieve a goal.
In the example of good stress, there was a plan of how to reach a goal. With bad stress there is no plan of how to achieve a goal. As a result, a person may experience so much overwhelm that mania or depression gets invited as a coping mechanism. Mania takes action or depression shuts you down.
Overwhelm is simply shouting, “I don’t know what I’m doing!” “This is too much!” “I can’t handle this right now!”
So mania kicks in and the brain says, “Yay! I can do anything!” And it’s thoughts race a million miles a minute causing a person to focus on a goal for 20 hours straight using all of their brain power, even if the result makes no sense.
Or depression kicks in and the brain says, “I think and feel nothing. I’m not getting out of bed. Lights are out, no one is home. Go away.”
- Overwhelm + Urgency
Urgency is a real or imagined perception that something has to be done, RIGHT NOW.
This is a recipe for disaster for someone living with bipolar disorder because the imagined perception of urgency is a part of daily living. Therefore, when it combines with overwhelm it can easily lead to mania or depression.
Overwhelm + Urgency are simply screaming, “I don’t know what I’m doing, but I have to do it RIGHT NOW!”
Mania kicks in and gets the job done or depression does nothing and simply shuts down. Either way it is a coping mechanism to conquer overwhelm combined with urgency.
- Overwhelm + Urgency + Fear
This is the worst. Not only do you not know what you’re doing and it has to be done right now, but you have to deal with all of the “could’s”.
Example: “I could fail.” “I could be humiliated.” “I could disappoint everyone.” “I could lose.” “I could lose the person I love the most in the world.”
When overwhelm, urgency and fear combine, which they tend to do eventually, you have the perfect storm for mania or depression. It is a combination that is just asking for it in a person with bipolar disorder.
Bipolar disorder is interesting because it often causes many people to live with a sense of urgency regardless of an external source causing urgency.
In my own experience, I have to consciously remind myself that there is no external urgency in what I am doing. I have to slow myself down.
The Hidden Stress
That doesn’t feel like stress at all
Excitement
When people think of excitement, they often don’t think of it as a stress response. However, for a person living with bipolar disorder excitement is the match…or even easier a torch loaded with fuel.
People often ask me why that is…here’s what I believe.
We do not get excited about things that are familiar to us.
We do not get excited about things we know how to do well.
We do not get excited about things way off in the future.
Excitement is simply the really fun form of overwhelm and urgency.
Therefore, it is very common for people to experience excitement and have it lead to mania and possibly even depression.
What a beautifully organized article to help people understand how different types of stress can affect bipolar disorder!
However, I must disagree with the assertion that the “good stress” is “not emotional.” Indeed, all decision-making is emotional — even rational decisions require the appropriate emotions to be in place before they can be executed. Bipolar individuals know this better than most, in those moments when even the most basic rational choices become impossible to execute in acute mania or depression!
The reason I bring this up is that I believe this distinction can aid a bipolar individual in those moments when they feel a “swing” coming on in one direction or the other. In that spirit, I would propose that what you are describing are varying levels of ability to act on the stress. In each case, the “stress” is defined by a disconnect between current reality and what the person would like reality to look like.
For “good stress”, the person is able to create specific action plans to change the world around them. For “bad stress”, they are not. As you already eloquently put it, “we simply don’t have the interpersonal resources and information to achieve a goal.” The addition of urgency only strengthens the emotional response to this disconnect between desire and reality, adding a time component as well!
To me, I feel it is valuable to acknowledge the vital role emotions play in all decisions. In essence, to rethink emotions and rational thought not as separate entities we turn on and off as needed, but rather as two parts of decision-making that are both always active, always taking part. The trick is not choosing one instrument over the other, but rather creating harmony via the entire orchestra.
Thank you my dear friend! Very good point. To make sure that gets heard I will update the blog and with your input.
Your thoughts are much appreciated.
Much Love,
Robin
I help take care of my 87 year old aunt. She can’t hear but she will not go to the ear spechialist.My mania has come forward but my husband says it is not because I have this stress it is because of my bipolar disorder.I am 71 and I was diagnosed at17.Can you help with answers? Thank You
iv only recently been put through to have the bipolar condition. id just like to know if bad stress cuses alot wider bad bipolar episodes. i have chronis depression aswell and have done for years along with insane insomnia i can go weeks on end with no sleep and be wide awake then ill sleep a hour and will be awake again. do you think my insomnia is linked to bipolar? sorry im 23 years of age so this is all pretty new just glad im gettin a diagnosis.