Stress and cycling
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Stress and cycling (Debbie)

Dear Dr. Phelps,
I am wondering about the relationship of stress and increased symptoms. I had been doing very well but have recently begun cycling. I work full time, go to graduate school, and have two great little boys. My plate is full and I wondered if that can make an impact on the stability I was enjoying. Thanks! Debbie

Dear Debbie
The first manic or depressed episode in bipolar I is often clearly associated with a major stress, like losing a loved one, or even a job.  In a recent study citing this same finding, the authors also note "Bipolar patients with high constitutional vulnerability have an earlier age of onset and need less stress factors to become ill".  They mean that people with a strong family history of bipolar disorder may be more susceptible to stress-related recurrences, i.e. a little stress can do it if you have a lot of vulnerability, and vice versa.

So, to answer your question, "yes": there seems to be a fairly clear relationship between stress and bipolar recurrences.  This has not been specifically studied in bipolar II to my knowledge.  If you alter your lifestyle (granted that you would be paying quite a price for doing so -- one of those things on your list of three full-time gigs would have to go to half-time, for example), can you expect a decrease in cycling?  The social rhythm therapy project folks (e.g.) seem to be thinking that: keeping a regular schedule (including 7-8 hours of predictable sleep, and a very consistent morning routine, in particular) may help maintain stability.  Too bad none of these theories comes with a guarantee though, isn't it?

Dr. Phelps

Published September, 2000

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