It is very important for your wife to realize that triggers are the seed that creates bipolar symptoms. If we stop fueling the car (triggers), we can not drive (symptoms). Most of the medical help is given to help treat the symptoms, because that is usually the most dangerous part of bipolar episodes when they are unstable. We must help our wives make a trigger list, and become consciously aware of their common, high triggers. It is not uncommon for a small trigger to get set into motion and not manifest into symptoms for days or weeks. In fact it is extremely common for bipolar patients to hit a very small trigger, let's bad traffic (small trigger), that then leads into them being late for work (medium trigger). Where people without bipolar could usually shake this off and carry on through our day without a second thought. Someone with bipolar disorder might get so stressed about the traffic that caused them to be late, that they feel like they are having a panic attack (large trigger). These triggers very often have snowball effects and can happen almost daily without consciously used to realize triggers and use techniques to help level them out again, along with their medications and therapy.
Information about your wife's triggers
We have already discussed how Triggers can generally snowball from small to larger triggers, but here are some other facts about your wife's triggers that are common with all triggers in relations to bipolar. There are always going to be large triggers and small triggers. Some of the triggers are going to be a recipe for disaster time and time again; sometimes you will be able to predict it before you even see it. This can be extremely challenging especially if your wife has not yet recognized the trigger. (I can think of a family member that creates a disastrous trigger for my wife every time we all get together, fortunately my wife has realized this person as a trigger and has coping mechanisms that she now uses to help get through the situation. gotten so in touch with her triggers that we have even politely excused ourselves from the family function before, knowing that she was pushing her trigger too much and that if she were not to leave more likely than not symptoms of bipolar disorder would appear). My wife has had to work at this very hard, do not be discouraged if your wife still does not even consciously catch herself before the triggers appear. This does take time and discipline, but I guarantee this will get easier the more aware you and your wife can become.
If your wife is too ill to work on her triggers, keep working the symptoms until she has become stable, but you can observe and create your own lists of things, but I would recommend not sharing the list or trying to do any deep examination while your wife is unstable.
Triggers can and will change. I mentioned above in my wife's trigger list, that over six months triggers have been both added and dropped from the list. This is very normal, there will always be triggers that are very common and hold solid themes, but some might disappear as different times in life are coming and going. It is good to have an understanding that sometimes we will have to re-evaluate our list for our wives, and help them discover new triggers to add to the list, if you have seen a change in your wife's behavior that has become more frequent, due to something that is new or different in her life. Make sure to let your wife know that creating these trigger lists are not to point out things that make her do something wrong, these are simply lists that can help us get clear and focused on what specific situation is specifically provoking bipolar disorder in your wife.
Triggers vs. Triggers
I wish that I could sit here and explain to you that trigger A is a larger trigger than trigger B. It simply is not the case. Bipolar disorder triggers are common in all bipolar patients, but different triggers create stronger or weaker bipolar symptoms to occur. Being stuck in traffic might be your wife's biggest trigger for stress, where we would think something like losing a job, would be much more stressful. Simply when dealing with bipolar disorder you will discover what kinds of triggers are the worst, and which are easier to bypass for your wife.
Food Drinks and drugs are three of the strongest triggers associated with bipolar disorder. Alcohol is a drink trigger that is usually associated with more consumption when your wife is depressed or consuming a lot of caffeine when nervous and anxious usually will lead to more anxiety. It is very often hard for our wives to realize what we sometimes would consider common sense. One of my wife's big triggers is lack of energy, then she will tell me that she's had very little to eat all day, and not consumed any water, then she wonders why she feels tired sluggish and 'out of it'. I use to get very upset, now I have learned to realize that she does not think with that kind of logic all the time, that is something that she has to work on daily are common things that we must do to not let little triggers take over.
It is impossible for your wife and yourself to find all triggers, and all solutions to them, it is important to make a list of the 'BIG' triggers. The big triggers are what or will has set your wife into episodes in the past. Episodes that are big enough to where they could not sleep, work, turned to drugs, alcohol, and so on. These are the triggers that we want to come up with first, once we have a list of these triggers we then must sit down as a couple and come up with action plans. I know this sounds a little bit tedious and over redundant but this exercise could have the difference between a struggling wife for a few days that might need an extra therapy session that week, and checking your wife into a mental health treatment facility.