What Is a Bipolar Depression Crash? And How to Prevent It

A bipolar depression crash is usually the emotional fallout of a hypomanic or manic episode. It can also occur when something triggers bipolar depression or as a result of chemical or hormonal changes in the brain. Many people with bipolar disorder experience these extreme highs and lows with no obvious patterns, whereas others describe the feeling of “waiting to crash” during mania or hypomania. Either way, it can be difficult to control bipolar depression's shifts in mood, but could there be a way to pre-empt and even prevent a bipolar depression crash?

Bipolar Depression Crash: Definition and Symptoms

Crashing into bipolar depression looks different for everyone – there is no clear-cut definition of what this looks like. Some people cycle between depression and mania (or hypomania, in the case of bipolar II), whereas others have prolonged "normal" periods in-between depressive or manic episodes. There is no defined pattern to these mood changes, and one doesn’t always occur before the other.

If you have bipolar disorder, a depression crash can be triggered by the following factors:

• A change in medication or missing doses
• Stress, grief or change
• The after-effects of alcohol or drugs
• Changes in sleep habits or routine
• Hormonal changes, such as menstruation, pregnancy or giving birth
• The after-effects of a manic or hypomanic episode

Feelings of guilt and shame following mania can also contribute to a bipolar depression crash. For example, during mania you might have acted out of character, spent a lot of money, made comments you now regret, taken on responsibilities you’re not equipped for or made questionable decisions about sex and relationships. Being manic or hypomanic can also be exhausting, and you may have little memory of what occurred during this period.

Restarting After a Bipolar Depression Crash

Restarting after a bipolar depression crash can be difficult for a number of reasons. Many people lack energy and motivation during a depressive episode, so they let their usual responsibilities slide. You may not have cleaned your apartment or washed your clothes, for example, or you may have missed work or canceled meetings you needed to attend.

It's important not to be too harsh on yourself for how you acted during mania or depression. You have an illness, and it's not your fault. Punishing yourself will only exacerbate feelings of guilt and make your bipolar depression worse. How would you treat a friend in your position? Try to extend the same kindness to yourself, and don’t pressure yourself to get your life back together right away.

There may be certain things you need to take responsibility for or people you should apologize to. Do this as soon as you feel well enough. Try to be as open about your condition as you can. Explain that you don't always feel in control of your words and actions, but that you're working on getting better.

How to Avoid a Bipolar Depression Crash

Avoiding a bipolar depression crash is the key to minimizing the impact bipolar disorder has on your life. Trying to keep symptoms of mania or hypomania to a minimum and keeping all of your support avenues open will help facilitate this.

Ways to avoid a bipolar depression crash include:

• Sticking to your medication schedule: Try to take your medication at the same time every day and avoid missing doses.
• Monitoring your symptoms and reporting them to your doctor: There may be triggers you could avoid, or you may need to change your medication if it’s not easing your symptoms.
• Limit the damage during mania or hypomania: When you’re well, try to put some safeguards in place to limit the fallout of a manic episode. Give your credit cards to someone you trust and only allow yourself a small amount of money, for example.
• Stick to a sleep schedule: Changes in sleep patterns can trigger both mania and depression in bipolar disorder, so try to go to bed and get up at roughly the same time each day.
• Explore other treatment options: If your current treatment plan isn’t helping you manage your symptoms, it may be time to talk to your doctor about other options. Your doctor may suggest new medication combinations, a different form of therapy, or brain stimulation treatment like ECT.

There is only so much you can do to prevent a bipolar depression crash, but a little can go a long way. Over time, as you get to know your triggers and understand your mood patterns better, you may be able to identify ways of minimizing your symptoms and alleviating the challenges of bipolar depression.