Last week, I went to an Italian restaurant. This restaurant was an autoimmune patient’s dream—clean, good food, and very few diners. But when we approached the host, there was a dog standing next to him. A huge black dog with its mouth wide open, revealing fangs teeth as big as my fingers. His eyes were glowing and not in a good way. I let out this blood-curdling scream that could rival Janet Leigh in Psycho.
It was something like, “EEARRRGGGGGGHHHHHHHHH.” The dog was fake, but still, a very life-like decoration for Halloween. When I was a little girl, my cousin’s dog turned on me while I was taking the dog out for a walk. I don’t remember the moment he bit me but I remember what happened before and after. He was a black dog like the one in the restaurant. After my heart started beating normally again, we ordered. Dinner was delicious. The next week, we decided to eat there again because the lamb was so good. Surely, I had it under control. After all, I’d already seen him. But upon seeing the dog, my heart started beating fast again and I started breathing the way I do at the beginning of one of my asthma attacks. Clearly, I underestimated the impact that childhood event had on me. Similarly, some of us keep exposing ourselves to “triggers.” Triggers are harmful for people with conditions like depression, bipolar disorder, panic attacks, post-traumatic stress injury (PTSI), and anxiety disorders, among others.
What are triggers?
They are external events or circumstances that can make us feel anxiety or relive traumatic moments. Triggers are also things that can catalyze depression such as toxic relationships. In people with bipolar disorder 1 and 2, some triggers catalyze mania and hypomania, respectively. When people don’t know their triggers, they can make their conditions worse. Thankfully, there are ways we can manage triggers.
Identify Your Triggers
The first step to managing triggers is identifying what yours are. Seeing a therapist regularly is important. When you are consistent, your therapist can see patterns and help you discover your triggers. For my bipolar disorder, mood charts have helped me identify my triggers. With mood charts, I rank and track my moods. On my chart, 5 = mania and 1 = severe depression. I can see patterns that show events that usually precede depression and hypomania. Some events that typically precede depression include the beginning of winter, too many deadlines, and arguments with loved ones. For the first trigger, I have been using light box therapy, an excellent tool for people with Seasonal Affective Disorder (SAD), which is common in people with bipolar disorder. My SAD symptoms are much less severe than they were years ago. When it comes to deadlines, which are inevitable for students and employees, I know to schedule an appointment with my therapist before things get out of hand. She helps me manage the stress. As for arguments, I avoid toxic friendships. With family members, it’s harder but I try to explain to difficult members how their behavior impacts me. Finally, many years ago, I lost a friend to suicide. As a result, I avoid movies with suicide scenes.
Once you’ve identified your triggers, make a list so you won’t forget them.
Develop An Action Plan
The second step is to develop an action plan. When you face triggers, will you see your therapist? If you are stressed by toxic relationships, are you going to cut some of those people out or minimize contact? What resources you will use—support groups, close friends and family, faith, exercise, rest, asking for accommodations at school or work? It helps to share your triggers with people close to you so they can help you avoid them (example: lack of sleep leading to depression or mania) and notice when you are entering a depressive (or manic or hypomanic) episode.
Do you have any triggers? How are you managing them?
–Your Stylist, Jessica Gimeno
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