CREST.BD Mood & Bipolar Disorder Slides

CREST.BDBipolar Wellness Center Webinars Connect. Learn. Engage.

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Bipolar Wellness Center Webinars Connect. Learn. Engage. CREST.BD

Mood

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Bipolar Wellness Center Webinars Connect. Learn. Engage. CREST.BD CREST.BD

Featuring: Dr. Steven BarnesCREST.BD Network Deputy and Instructor, Department of Psychology, University of British Columbia

Mood

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Webinar focus

Why mood is important to your QoLDefining moodHow you can take actionMood and BDTools and resources

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1 Zhang, H., Wisniewski, S.R., Bauer, M.S., et al. (2006). Comparisons of perceived QoL across clinical states in BD: data from the first 2000 STEP-BD participants. Compr Psychiatry, 47:161-8.2Michalak, E.E., Torres, I., Bond, D., et al. (2013). The relationship between clinical outcomes and QoL in first-episode mania: a longitudinal analysis. Bipolar Disorders, 15: 188-98.

Mood is fundamental to QoL (for people with or without BD)Mood symptoms – particularly symptoms of depression – are a strong determinant of QoL in people with BD1, 2

Learning to manage mood states is one of the most powerful things you can do to optimise your health and QoL

Why is mood important to QoL?

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Defining moodMood - a diffuse feeling state that lasts for a few hours or daysEmotions - more immediate experiences, they normally have a particular target (“I feel excited about…”) and are typically brief (seconds or minutes) and more intense than moods3

3 Ekman, P., Davidson, R.J. (1994). The nature of emotion: Fundamental questions. Series in affective science. Oxford University Press.

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Depression: • low mood and/or feeling flat• changes in sleep, energy, concentration and/or body weight• feelings of worthlessness or guilt • suicidal ideation• sometimes accompanied by unrealistic beliefs and perceptions in severe cases • symptoms last at least 2 weeks

American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Defining mood: mood states in BD

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Mania

Hypomania

Normal

Depression

Severe Depression


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Mania: • elevated or irritable mood and hyperactivity• increased self-esteem, racing thoughts, distractibility, decreased need for sleep and engaging in risky activities (such as those involving money or sex)• unrealistic beliefs and perceptions can arise in extreme cases • lasts at least one week and is so severe that it affects normal functioning



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Mania

Hypomania

Normal

Depression

Severe Depression


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Hypomania: • imagine this as “mania-lite” • includes all of the symptoms of mania, but doesn’t cause significant lifestyle problems• lasts at least 4 days



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Mania

Hypomania

Normal

Depression

Severe Depression


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1. monitor your mood and well-being daily for changes2. watch for triggers 3. watch for early warning signs (and respond if you are sliding into an episode)

How you can take actionThree steps to minimising downwards and upwards mood swings:

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paper-and-pencilpc-basedmobile app

Mood MonitoringThere are many ways to do this, including:

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Changes of season Changes in sleep

TriggersThere are also certain triggers that seem to be important for many people with BD, including:

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Changes at work Relationship stress

Triggers

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Pregnancy/childbirth Grief and loss

Triggers

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Drugs and alcohol Holidays

Triggers

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Life Charting

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Zeschel, E., Correll, C.U., Haussleiter, I.S., Kruger-Ozgurdal, S., Leopold, K., Pfennig, A., Bechdolf, A., Bauer, M., Juckel, G. (2013). The BD prodrome revisited: Is there a symptomatic pattern? Journal of Affective Disorders, 151: 551-60.Lam, D.H., Jones, S.H., Hayward, P. (2010). Cognitive therapy for BD: A therapist’s guide to concepts, methods and practice (2nd ed.). Wiley-Blackwell, West Sussex, UK.

Early warning signs Growing evidence that early warning signs (‘prodromes’) often occur in the early stages of extreme mood shifts.

Watch for early warning signs

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Watch for early warning signs Common early warning signs for depression: • low energy, feeling tired, difficulty concentrating• intrusive negative thoughts (unwanted thoughts that keep coming back)• wanting to be alone• feeling irritable• sleeping too much or too little• feeling sad or wanting to cry• feeling flat• feeling anxious• feeling guilty

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Common early warning signs for hypomania or mania: • feeling emotionally high• ideas flowing too fast• senses seeming sharper• colours seeming brighter• feeling especially creative• feeling irritable• increased interest in sex• difficulties falling asleep, feeling self-important and making lots of plans

Watch for early warning signs

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Card Sorting Exercise

Early

Middle Late

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Lam, D.H., Jones, S.H., Hayward, P. (2010). Cognitive therapy for BD: A therapist’s guide to concepts, methods and practice (2nd ed.). Wiley-Blackwell, West Sussex, UK.

Recognising how we think and behave can have a big impact on our moods

Thinking

MoodBehaviours

Managing mood in BD

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from http://www.cci.health.wa.gov.au/docs/KYB-4%20Behavioural%20Strategies%20for%20Depression.pdf

Dealing with depression Try activity scheduling - pre-planning your week’s activities: hour-by-hour, for each waking hour of the day

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Dealing with depression Watch out for depressive thinking patterns: • All or nothing thinking• Catastrophizing or fortune-telling• Mind reading• Overgeneralising

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Managing mood in BDQuestioning your thinking before you act can help with manic moodsGive yourself some time before making a decision

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Cook, J.A., Copeland, M.E., Hamilton, M.M., Jonikas, J.A., Razzano, L.A., Floyd, C.B., Hudson, W.B., Macfarlane, R.T., Grey, D.D. (2009). Initial outcomes of a mental illness self-management program based on wellness recovery action planning. Psychiatric services, 60: 246-249.Fukui, S., Starnino, V.R., Susana, M., Davidson, L.J., Cook, K., Rapp, C.A., Gowdy, E.A. (2011). Effect of Wellness Recovery Action Plan (WRAP) participation on psychiatric symptoms, sense of hope, and recovery. Psychiatric Rehabilitation Journal, 34: 214-222.

Managing mood in BDHave a plan for if the mood episode gets serious

from http://www.cci.health.wa.gov.au/docs/KYB-3-Self%20Monitoring.pdf

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Tools and Resources

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paper-and-pencilMood Monitoring


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pc-based Mood Monitoring

from https://www.facingus.org/tour/tracker

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mobile apps

imoodjournal emoods T2Tracker

Mood Monitoring

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ResourcesIdentify early warning signs of mania

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For more information and resources, visit our Bipolar Wellness Center at:

http://www.bdwellness.com/

To assess your quality of life, visit our QoL tool at:

http://www.bdqol.com/

http://www.bdwellness.com/

http://www.bdqol.com/

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Acknowledgments

CREST.BD Mood & Bipolar Disorder Slides

Education

Transcript of CREST.BD Mood & Bipolar Disorder Slides