Bipolar (Pathways)

Overview

• Peak onset adolescence to late 20s

• 1% of people

• Genetic basis

Assessment

• Consider if depression with symptoms mania or hypomania

Mania / Hypomania

• High energy levels (feeling "wired" and "hyper")

• Excessively seeking stimulation

• Increased distractibility

• Overly driven in pursuit of goals

• Needing less sleep

• Positive mood (feeling unusually confident and capable)

• Irritability (tendency to be impatient and angry)

• Pressured speech

• Behavioural changes (impulsive, disinhibited, increased sexual drive, risk-taking, outrageous behaviours, reckless spending)

• Excessive creativity and grandiose plans

• Mystical experiences (in mania, these can become delusions)

• Reporting enhanced sensory experiences e.g., colours richer than usual

• Poor self-regulation

Mood changes tend to be endogenous, rather than as a result of outside triggers.

In mania, symptoms have minimum duration of 7 days and lead to a marked impairment of functioning.

In hypomania, symptoms have a minimum duration of 4 days and while mood is distinctly different, there is no substantial impairment.