Malady Wise

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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.