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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Connect. Learn. Engage.CREST.BDCREST.BD
Featuring: Dr. Steven Barnes
CREST.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 QoL
Defining mood
How you can take action
Mood and BD
Tools 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.
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Michalak, 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 mood
Mood - a diffuse feeling state that lasts for a few hours
or days
Emotions - 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
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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 changes
2. watch for triggers
3. watch for early warning signs (and respond if you are
sliding into an episode)
How you can take action
Three steps to minimising downwards and
upwards mood swings:

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paper-and-pencil
pc-based
mobile app
Mood Monitoring
There are many ways to do this, including:

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Changes of season Changes in sleep
Triggers
There 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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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

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Card Sorting Exercise
Early
Middle Late

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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 BD
Questioning your thinking before you act can help with
manic moods
Give 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 BD
Have 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-pencil
Mood 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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Resources
Identify 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/

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Acknowledgments

CREST.BD Mood & Bipolar Disorder Slides

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CREST.BD Mood & Bipolar Disorder Slides