title: Triggers of mania and depression in young adults with bipolar disorder.
abstract: BACKGROUND
  Early intervention significantly decreases the impact of bipolar disorder. However, there is little research investigating triggers that may be unique precipitants of manic/hypomanic episodes, and how these may differ from triggers specific to bipolar depression, in young adults with the disorder.
  
  
  METHODS
  Individuals aged 18 to 30 years who had been diagnosed with bipolar disorder (n=198) completed an online survey to identify triggers unique to mania/hypomania and depression, as well as triggers which were common to both. Respondents rated how frequently a series of situations and behaviours had precipitated either a manic/hypomanic episode or a depressive episode in the past. Survey data was supplemented by in-depth face-to-face interviews (n=11).
  
  
  RESULTS
  Triggers specifically associated with the onset of manic/hypomanic episodes included falling in love, recreational stimulant use, starting a creative project, late night partying, going on vacation and listening to loud music. Triggers associated with depressive episodes included stressful life events, general stress, fatigue, sleep deprivation, physical injury or illness, menstruation and decreases in physical exercise. A further set of triggers were identified as being common to both manic/hypomanic and depressive episodes. Consistent themes arose from the analysis of face-to-face interviews, which extended and illuminated the findings of the survey data.
  
  
  CONCLUSIONS
  Identification of a unique set of triggers for mania/hypomania and a unique set for depression in young adults with bipolar disorder may allow for earlier identification of episodes, thus increasing opportunities for early intervention.
authors.affiliation: School of Psychiatry, University of NSW and Black Dog Institute, Hospital Road, Randwick, NSW 2031, Australia. j.proudfoot@unsw.edu.au
authors.forename: Judith
authors.initials: J
authors.lastname: Proudfoot
authors.forename: Alexis
authors.initials: A
authors.lastname: Whitton
authors.forename: Gordon
authors.initials: G
authors.lastname: Parker
authors.forename: Justin
authors.initials: J
authors.lastname: Doran
authors.forename: Vijaya
authors.initials: V
authors.lastname: Manicavasagar
authors.forename: Kristy
authors.initials: K
authors.lastname: Delmas
mesh_terms: D000293:Adolescent; D000328:Adult; D001714:Bipolar Disorder / Q000209:etiology* / Q000523:psychology; D003405:Creativity; D003863:Depression / Q000209:etiology* / Q000523:psychology; D005260:Female; D006693:Holidays / Q000523:psychology; D006801:Humans; D008016:Life Change Events; D008149:Love; D008297:Male; D009146:Music / Q000523:psychology; D011998:Recreation / Q000523:psychology; D012307:Risk Factors; D012737:Sex Factors; D013315:Stress, Psychological / Q000523:psychology; D019966:Substance-Related Disorders / Q000523:psychology; D055815:Young Adult