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.