Random Feelings of Nervousness in Bipolar Disorder
Yes, random feelings of nervousness without an apparent reason are common in bipolar disorder and should be recognized as a potential symptom rather than dismissed as abnormal. 1
Why This Occurs in Bipolar Disorder
Anxiety symptoms are frequently part of the bipolar disorder presentation itself, not just a separate comorbid condition:
- Premorbid anxiety and dysphoria are common features in individuals with bipolar disorder, often appearing before or between mood episodes 1
- Anxiety can act as both a precipitating and perpetuating factor for mood episodes 2
- Some individuals experience the physiological manifestations of anxiety (racing heart, tight chest, nervousness) without consciously recognizing the emotional experience—described as "panic without panic" or alexithymia 2
Clinical Context and Patterns
The nervousness you're experiencing fits within several recognized patterns:
- Mood lability with rapid and extreme mood shifts is a hallmark characteristic of bipolar disorder, particularly in younger individuals 1
- These feelings may represent subsyndromal symptoms occurring between major mood episodes 3, 4
- Approximately 75% of symptomatic time in bipolar disorder consists of depressive episodes or symptoms, which commonly include anxiety features 3
What to Monitor
While these feelings are "normal" for bipolar disorder, you should track certain patterns:
- Document whether the nervousness occurs in distinct episodes versus being chronic and persistent 1, 5
- Note any associated changes in sleep patterns, energy levels, or goal-directed activity that might signal an emerging mood episode 1, 5
- Watch for triggers such as antidepressant medications, which have the strongest evidence for precipitating mood episodes 1
When to Seek Immediate Attention
Contact your treatment provider if the nervousness is accompanied by:
- Decreased need for sleep (not just insomnia, but feeling rested on less sleep) 1
- Marked increase in goal-directed activity or psychomotor agitation 5
- Suicidal thoughts, as bipolar disorder carries high suicide risk (annual rate of 0.9% versus 0.014% in general population) 3
Management Approach
The anxiety component should be addressed as part of your overall bipolar treatment:
- Anxiety management strategies including breathing techniques, progressive muscle relaxation, grounding strategies, and mindfulness can be helpful 2
- Regular cardiovascular exercise and activities of enjoyment should be integrated 2
- Ensure you're maintaining treatment with mood stabilizers (lithium, valproate, lamotrigine) or atypical antipsychotics, as these are first-line treatments that help stabilize overall mood patterns 3, 6
The key distinction is that while these feelings are common in bipolar disorder, they still warrant monitoring and management as part of your comprehensive treatment plan rather than being ignored or minimized.