Priority 23 from the Bipolar PSP

UNCERTAINTY:What are the triggers for bipolar episodes (e.g. life events and stress) and how do these vary? (JLA PSP Priority 23)
Overall ranking	23
JLA question ID	0041/23
Explanatory note	Not available for this PSP.
Evidence	None identified
Health Research Classification System category	Mental Health

Extra information provided by this PSP
Original uncertainty examples	For full examples, see Category ID M6 on spreadsheet. What kind of life / stress factors can trigger bipolar episodes (e.g. are some factors more common than others)? ~ Role of stress management in managing bipolar illness Role of Expressed Emotions in Bipolar Disorder management . When is care and support 'too much' that it creates stress? ~ Also, what is the relationships between sleep disturbances and bipolar? (I have been a lifelong insomniac, and have symptoms of a circadian rhythm disorder. Is this related to my mood instability? ~ Can general changes such as moving home, death in a family, sudden unemployment or divorce, be a trigger? ~ Can episodes happen with no 'trigger' or definite pattern or is there always a stressful event or season of the year when episodes will occur? ~ Why do the triggers only cause mania or depression sometimes and not all the time? ~ Can isolation trigger bipolar, i.e. being alone or feeling alone within a group of people, e.g. a family?
Submitted by	Patients x 170 ~ Carers x 53 ~ Health Professionals x 19 ~ others x 9

Extra information provided by this PSP

Original uncertainty examples

For full examples, see Category ID M6 on spreadsheet. What kind of life / stress factors can trigger bipolar episodes (e.g. are some factors more common than others)? ~ Role of stress management in managing bipolar illness Role of Expressed Emotions in Bipolar Disorder management . When is care and support 'too much' that it creates stress? ~ Also, what is the relationships between sleep disturbances and bipolar? (I have been a lifelong insomniac, and have symptoms of a circadian rhythm disorder. Is this related to my mood instability? ~ Can general changes such as moving home, death in a family, sudden unemployment or divorce, be a trigger? ~ Can episodes happen with no 'trigger' or definite pattern or is there always a stressful event or season of the year when episodes will occur? ~ Why do the triggers only cause mania or depression sometimes and not all the time? ~ Can isolation trigger bipolar, i.e. being alone or feeling alone within a group of people, e.g. a family?

Submitted by

Patients x 170 ~ Carers x 53 ~ Health Professionals x 19 ~ others x 9

PSP information
PSP unique ID	0041
PSP name	Bipolar
Total number of uncertainties identified by this PSP.	363 (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop	14 June 2016