crest.bd mood & bipolar disorder slides
TRANSCRIPT
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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
Defining mood: mood states in BD
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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
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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Bipolar Wellness Center Webinars Connect. Learn. Engage. CREST.BD
Mania
Hypomania
Normal
Depression
Severe Depression
Defining mood: mood states in BD
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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
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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Bipolar Wellness Center Webinars Connect. Learn. Engage. CREST.BD
Mania
Hypomania
Normal
Depression
Severe Depression
Defining mood: mood states in BD
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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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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.
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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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.
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
from http://www.cci.health.wa.gov.au/docs/KYB-3-Self%20Monitoring.pdf
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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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from http://www.cci.health.wa.gov.au/docs/KYB-3-Self%20Monitoring.pdf
ResourcesIdentify early warning signs of mania
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Bipolar Wellness Center Webinars Connect. Learn. Engage. CREST.BD
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