A warm welcome to CREST.BD’s Bipolar Wellness Centre webinar series! These webinar slides provide a summary of current research evidence on the relationship between mood, bipolar disorder (BD) and quality of life (QoL), as well as pointing you to some tools and resources to help you optimally manage your mood.
3. 3
Bipolar Wellness Center Webinars
Connect. Learn. Engage.CREST.BDCREST.BD
Featuring: Dr. Steven Barnes
CREST.BD Network Deputy and
Instructor,
Department of Psychology,
University of British Columbia
Mood
4. 4
Bipolar Wellness Center Webinars
Connect. Learn. Engage.CREST.BD
Webinar focus
Why mood is important to your QoL
Defining mood
How you can take action
Mood and BD
Tools and resources
5. 5
Bipolar Wellness Center Webinars
Connect. Learn. Engage.CREST.BD
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.
2
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?
6. 6
Bipolar Wellness Center Webinars
Connect. Learn. Engage.CREST.BD
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
3
Ekman, P., Davidson, R.J. (1994). The nature of emotion: Fundamental questions. Series in affective science. Oxford
University Press.
7. 7
Bipolar Wellness Center Webinars
Connect. Learn. Engage.CREST.BD
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
8. 8
Bipolar Wellness Center Webinars
Connect. Learn. Engage.CREST.BD
Mania
Hypomania
Normal
Depression
Severe Depression
Defining mood: mood states in BD
9. 9
Bipolar Wellness Center Webinars
Connect. Learn. Engage.CREST.BD
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
10. 10
Bipolar Wellness Center Webinars
Connect. Learn. Engage.CREST.BD
Mania
Hypomania
Normal
Depression
Severe Depression
Defining mood: mood states in BD
11. 11
Bipolar Wellness Center Webinars
Connect. Learn. Engage.CREST.BD
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
12. 12
Bipolar Wellness Center Webinars
Connect. Learn. Engage.CREST.BD
Mania
Hypomania
Normal
Depression
Severe Depression
Defining mood: mood states in BD
13. 13
Bipolar Wellness Center Webinars
Connect. Learn. Engage.CREST.BD
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:
14. 14
Bipolar Wellness Center Webinars
Connect. Learn. Engage.CREST.BD
paper-and-pencil
pc-based
mobile app
Mood Monitoring
There are many ways to do this, including:
15. 15
Bipolar Wellness Center Webinars
Connect. Learn. Engage.CREST.BD
Changes of season Changes in sleep
Triggers
There are also certain triggers that seem to be
important for many people with BD, including:
16. 16
Bipolar Wellness Center Webinars
Connect. Learn. Engage.CREST.BD
Changes at work Relationship stress
Triggers
17. 17
Bipolar Wellness Center Webinars
Connect. Learn. Engage.CREST.BD
Pregnancy/childbirth Grief and loss
Triggers
20. 20
Bipolar Wellness Center Webinars
Connect. Learn. Engage.CREST.BD
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
21. 21
Bipolar Wellness Center Webinars
Connect. Learn. Engage.CREST.BD
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
22. 22
Bipolar Wellness Center Webinars
Connect. Learn. Engage.CREST.BD
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
23. 23
Bipolar Wellness Center Webinars
Connect. Learn. Engage.CREST.BD
Card Sorting Exercise
Early
Middle Late
24. 24
Bipolar Wellness Center Webinars
Connect. Learn. Engage.CREST.BD
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
25. 25
Bipolar Wellness Center Webinars
Connect. Learn. Engage.CREST.BD
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
26. 26
Bipolar Wellness Center Webinars
Connect. Learn. Engage.CREST.BD
Dealing with depression
Watch out for depressive thinking patterns:
• All or nothing thinking
• Catastrophizing or fortune-telling
• Mind reading
• Overgeneralising
27. 27
Bipolar Wellness Center Webinars
Connect. Learn. Engage.CREST.BD
Managing mood in BD
Questioning your thinking before you act can help with
manic moods
Give yourself some time before making a decision
28. 28
Bipolar Wellness Center Webinars
Connect. Learn. Engage.CREST.BD
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
30. 30
Bipolar Wellness Center Webinars
Connect. Learn. Engage.CREST.BD
paper-and-pencil
Mood Monitoring
from http://www.cci.health.wa.gov.au/docs/KYB-3-Self%20Monitoring.pdf
31. 31
Bipolar Wellness Center Webinars
Connect. Learn. Engage.CREST.BD
pc-based
Mood Monitoring
from https://www.facingus.org/tour/tracker
32. 32
Bipolar Wellness Center Webinars
Connect. Learn. Engage.CREST.BD
mobile apps
imoodjournal emoods T2Tracker
Mood Monitoring
33. 33
Bipolar Wellness Center Webinars
Connect. Learn. Engage.CREST.BD
from http://www.cci.health.wa.gov.au/docs/KYB-3-Self%20Monitoring.pdf
Resources
Identify early warning
signs of mania
34. 34
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/