Stress, Pressure and Bipolar Disorder: A Perilous Mix

Stress is a normal part of life. When living with bipolar disorder, stress can cause problems that may increase symptoms and make life more difficult.

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By Karl Shallowhorn


Stress. You can’t get away from it. Relationships. Work. Physical health. The jerk that just cut you off on the highway. It’s everywhere. If you’re like me, stress comes from all sides.

When I was first diagnosed with bipolar disorder 35 years ago, even the slightest amount of stress was enough to exacerbate my symptoms. Not to mention that I was abusing drugs and alcohol like a character from a Cheech & Chong movie (and in a strange way there were times I looked like Cheech). I thought I was managing my stress well, however the reality was the more I abused chemicals, the worse I got.

As time went on things did improve, albeit slowly. The first thing I had to do was to stop using. Everything. Drugs, alcohol, and everything in-between. In the spirit of full disclosure, I do have a co-occurring addiction disorder so abstinence was a must for me to stabilize. But with time my condition did improve; enough that I was able to become employed.

But uh-oh: When I entered into the “real world” of work, there were many significant stressors I had to contend with. At this time, I was employed as an Alcoholism Counselor at a Buffalo area hospital. This is when I had to face challenges such as working with clients who, many times, did not want to be in treatment, or regulatory standards that tied into Medicaid payment, hospital accreditation and the Office of Alcohol and Substance Abuse Services for New York State. On top of this, I was newly married with a child on the way. Finally, my mother was in poor health and required extra care.

I think you get the idea. I’m just like anyone else who has to, as the saying goes, “live life on life’s terms.” But unlike in my former life, I didn’t have the convenience of smoking a joint or grabbing a beer to self-medicate. Conversely, I was still in therapy and was in the care of a psychiatrist. I also attended a drug recovery support group which has been the cornerstone of my personal self-care program.

So, back to stress. In the course of my life with bipolar disorder, I have had to learn to deal with stress and pressure. There have been times when I felt like I couldn’t take anymore; like if just one more thing was added, I’d crumple like a piece of tissue paper. However, in many ways I’d describe my ability to withstand stress and pressure like lifting weights. I didn’t start with the 100-pound dumbbell. It began with the 5-pounders. By incorporating the basic coping skills such as developing a healthy support system, incorporating exercise, practicing my faith and developing proper sleep patterns, I started to realize that I could withstand more stress as time went on. And this is exactly what happened.

One prime example is my behavior at work. Years ago, when I was under the gun and things were tough, I’d want to run. It was my way of not wanting to deal with the stress associated with my job. This resulted in several changes in employment and even a total career change into a different profession than addictions counseling. But one thing that has helped this immensely is doing work that I love. I am a passionate advocate and mental health educator. I also perform a number of administrative functions. While this work can be very stressful at times, the pleasure I derive from it counters any stress I experience.

Another thing that has been affected by stress and pressure has been my personal relationships. I vividly recall several times when I blew up with my family. One occasion was when my family was the primary caregiver for my ailing father. We were preparing to go to church and we were going to take my dad to his church first, as was our custom. It was a stormy winter day and I got stuck in a snow bank in my driveway. I totally lost it. This is completely unlike my usual behavior. But the stress got the best of me. Fortunately, I was able to connect with a couple of my friends from my recovery program who served as a shoulder to cry on (literally).

In the end, we all have our particular sensitivities to stress. Some can handle more than others. And unfortunately, for some, the stress can be a major trigger for a manic or depressive episode. But hopefully, if the proper stress management tools are employed, then the effects of any pressure that is experienced can be minimized.





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