Hi,

I got this email, and I wanted to share it with you, because the answer will show you something very important.

Dear Dave,

I’ve been depressed for three weeks now, and I’m starting to get really scared. I’m afraid I’m going into a depressed episode. The thing is, I have nothing to be depressed over – I’m basically

really happy with my life. Nothing’s wrong that I can figure out. No reason for me to be so depressed. So why am I still so down? Also, even though I’m sleeping, like, 10 hours a night, I’m exhausted all the time! What do you think is going on? What should I do?

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The reason I chose this email to answer is that I don’t think this is so uncommon. Sometimes people with bipolar disorder CAN get depressed with seemingly no cause for the depression.

That’s because of the chemical imbalance itself. The chemicals just flare up at times with no trigger.

Most times, we can point to a trigger as a cause for a bipolar episode, though. When you get depressed, like the person in the email, the first thing you should do is look for a trigger, and usually you will find one. But still there may be times when you just can’t find one. Those are the times when you just have to accept that, like you learned in the beginning, bipolar disorder is a chemical imbalance of the brain, and sometimes those chemicals are just going to fire off on their own.

Finding out what causes a bipolar episode sometimes is a process of elimination.

Like I said, first you look for a trigger. So, say, you go to your therapist first, and the two of you try to figure out if there was something emotionally that set you off that maybe you missed.

Second, you look for something physical. Like the person in the email was saying, about how they felt exhausted all the time. There can be physical causes that can make you go into an episode – like drinking too much water can deplete your body of sodium and potassium, confusing your mind. Or dehydrating your body if you don’t drink enough fluids. Or a thyroid condition. And there are others.

So the next place you should check should be with your doctor, because they may be able to find something you don’t know about physically that could cause an episode.

Third, it could be your medications. For this you go to your psychiatrist. You may have been on the same medications for a long period of time, and they may not be working as well any more, or maybe one of them is out of whack. You may need a dosage adjustment, or to even to change medications. Only your psychiatrist will know what to do, and can advise you what to do about that. Then they can make an adjustment in your medications that can bring you out of your

episode, if that is the cause. Even if it isn’t the cause, they can still prescribe medications to help. The point is that they can work with you to get to the bottom of the cause of your episode.

Fourth, there can be other causes. Like isolation. Isolation itself can be a trigger to a bipolar

episode. If you isolate yourself, if you are alone too much, it can cause you to go into a depression, and too much depression leads to a bipolar depressive episode. If you are alone with your thoughts, with no check and balance to control them, those thoughts can get out of control, and can even become irrational thoughts. If you have no one around you, or no one that you visit or who visits you, you have no way to check and make sure that your thoughts are rational thoughts. Irrational thoughts lead to a bipolar episode as well.

So there are many things that can trigger an episode seemingly “out of the blue.”

Well, I have to go!

Your Friend,

Dave