Question: What is the connection between stress and bipolar disorder?
Answer: Well, I think it's important to start by recognizing that what most people think of when they think of bipolar disorder is manic euphoria. And while that can certainly characterize a bipolar episode, it by no means is the norm. It's far more likely actually that people experience irritability and anger and other negative symptoms of depression as a bipolar episode.
Now having said that, we know that stress can trigger depression, and researchers have hypothesized that there is an effect of an early experience of depression that sensitizes the brain to be more likely to experience depression another time. They call this the kindling effect. It is in essence a mechanism that hypothesizes that a single episode makes it more likely that you'll experience a later episode.
Now, since there is this stress relationship potentially to bipolar illness onset, it's important to recognize that the medications that we use to treat bipolar illness and the psychotherapies that we use to treat bipolar illness can act as intermediaries between stress on the one hand and another depressive episode on the other.