L11: Mood Instability Flashcards
Define mood instability
rapid oscillations of intense affect, with a difficulty in regulating these oscilattions or their behavioural consequences
What are the characteristics of a depressive episode?
- low mood
- loss of enjoyment (anhedonia)
- loss of interest & motivation for everyday activities
- sleep problems
- appetite problems
- loss of concentration
- poor energy
- psychomotor agitation/retardation
- feelings of emptiness or worthlessness
- self doubt/blame
- suicidal thoughts
What are the characteristics of (hypo)mania?
- constant elation or euphoria
- irritable mood, getting into arguments easily
- observable hyperactivity
- increased energies
- inappropriate optimism
- overestimating personal ability
- poor judgment, grandiose plans
- speeding up of thought and speech, flights of ideas
- need for little sleep
What is the time course of bipolar disorder?
- switching episodes of mania vs depression in varying severity
- can also have mixed states
- and in between “euthymic” states
- looks very different for every person
- around 50-60% relapsing within a year of recovery from a mood episode
What are other common symptoms in bipolar disorder?
comorbidity & differential diagnosis
- 30-70% report anxiety
- 93% anxiety disorder lifetime comorbidity
- 75% psychotic symptoms (at either episode)
important differential diagnosis - MDD
- schizoaffective disorder & psychotic disorder
- anxiety disorder
- substance use disorder
- personality disorder
- ADHD (in children)
What do you know about the epidemiology of bipolar disorder?
- around 2-4% of pop
- bipolar I affects men & women equally
- bipolar II more women (hypomania)
- strong genetic component
- high risk of suicide (30-50% attempts, of which 15-20% complete)
What is the developmental trajectory of BD?
for most
- starts before age of 21
- starts w single depressive episode
- family history of BD
into young adulthood:
- becomes recurrent depression and prodomal hypomania symptoms present throughout young adulthood
- then mania or hypomania episode comes
this is also referred to as the bipolar spectrum (how it develops over time)
What is typically the treatment for bipolar disorder?
- in acute phase: medication but need to be careful here
- psychosocial interventions
- challenge of treating anxiety
Is there a link between bipolar disorder & creativity?
- correlational evidence between creativity & bipolar
- first degree relatives of BD more likely to have creative/high achieving professions
In what other disorders does mood instability present?
part of diagnostic symptoms in BPD & partly ADHD and PTSD
recent studies
- over half ppl w depression & ADs
- generally ppl w mental disorder have higher chance of mood instabiltiy
-> TRANSDIAGNOSTIC PHENOMENON
In the general pop, is there a developmental specificity to mood instablity?
adolescents more mood instability
Why is mood instability so clinically relevant?
its associated w
- general poor clinical outcomes
-suicidal thinking
- healthcare service use
- self harm
- addiction
- trauma
-> GENERAL POOR PROGNOSIS
Are there any abnormalities in cognitive functioning that are associated w mood instability?
- biases in processing emotional info (negative memory biases) in BD
- attentional dysfunction in ADHD w hypomanic symptoms
- dysfunctional mental imagery
-> both a bit confusing research
How do we usually measure mood instability?
- self report scales of trait constructs
- weekly (or longer) retrospective ratings of symptoms (but memory biases)
How could we improve how we capture mood instability?
combination of maths & digital tools
like mood tracking applications
