mh 4

Question 3

affect changes in mania

Answer 3

intense elated mood. agitated and irritable

Question 4

physiological changes in mania

Answer 4

Decreases need for sleep,
increase sense of energy,
psychomotor agitation (not being able to stay still)

Question 5

behavioural changes in mania

Answer 5

• Excessive involvement in pleasurable risk-taking activities,
• pressure of speech (talk fast)
• Increased goal-directed activity

Question 6

cognitive changes in mania

Answer 6

• inflated self-esteem/grandiosity,
• Flight of ideas/racing thoughts,
• distractibility

Question 7

How common is hypomania?

N = 148 Lancaster University students completed Mood Disorders Questionnaire (MDQ; Hirschfeld et al., 2000)

Found what percentage of people had experiences indicating hypomania

Answer 7

35.1%

Question 8

Episodes of mania and hypomania often (but not always) co-occur with

Answer 8

depression/low mood.

Question 9

Bipolar 1

Answer 9

at least one manic episode. major depressive episodes are typical but not necessary for diagnosisb

Question 10

Bipolar 2

Answer 10

At least one hypomanic episode and one major depressive episode

Question 11

is hypomania or mania more severe

Answer 11

mania

Question 12

cyclothymia

Answer 12

At least 2 years (1 in young ppl), numerous periods with hypomanic symptoms that don’t meet criteria for hypomanic episode and numerous symptoms of depressive episode that don’t meet criteria for a depressive episode

Question 13

what counts as primary care for service users

Answer 13

when they first come in to service. e.g. when they see their GP.

Question 14

what are the NICE guidelines for people with bipolar depression at primary care

Answer 14

• a psychological intervention that has been developed specifically for bipolar disorder and has a published evidence-based manual describing how it should be delivered OR

a choice of psychological intervention in line with NICE guidelines for severe depression
(CBT, interpersonal therapy, behavioural couples therapy)

Question 15

Secondary care NICE guidelines

Answer 15

(when referred to community mh team (after referred from GP)

same as primary but recommend medication.

Question 16

Longer term care NICE guidelines

Answer 16

Offer a family intervention to people with bipolar disorder whoa re living with or are in close contact with family.

Offer a structured psychological intervention.
Designed for bipolar, has published evidence based manual describing how it should be delivered.

Aim to prevent relapse, for people who have persisting symptoms between episodes of mania or bipolar depression

Question 17

5 psychological interventions for Bipolar

Answer 17

1. Enhanced relapse prevention/individual psychoeducation
2. CBT
3. Individual and social rhythm therapy
4. Group psychoeducation
5. Family therapy

Question 18

Enhanced relapse prevention/indiv psychoeducation

Answer 18

relatively brief intervention designed to train the individual in coping strategies and to identify early warning signs of mania and depression

Question 19

CBT

Answer 19

a form of therapy thinking ab the role of our thinking and behaviour n our emotion’s, how the reciprocally influence one another

Question 20

Interpersonal and social rhythm therapy

Answer 20

Focus on interpersonal factors.
Sleep wake cycle, work life balance, daily routines.

Question 21

Group psychoeducation

Answer 21

structured intervention. High frequency (up to 21 sesh, 2hrs duration)

To help people become experts in their condition. Improve medical adherence, mood stability, self management

Question 22

Family focused therapy

Answer 22

psychoeducational. Strong behavioural component. focus on understanding disorder specific risks, communication and problem solving in the family. Each approach is primarily focused on reduction of relapse and reoccurrence of mania or depression.

Question 23

Common features of psychological
interventions

Answer 23

providing essential information about bipolar.
▪ identifying early warning signs and signs of relapse.
▪ helping to develop coping strategies to deal with early
warning signs, mood instability, or
situations which might trigger changes in mood and activity
levels.
▪ developing a crisis plan and a
post-treatment ‘staying well’ plan.

Question 24

integrative cognitive model for Bipolar disorder (Mansell et al., 2007)

Answer 24

• mood swings consequence of conflicting appraisals (of changes in internal states such as moods, thoughts, images physical sensations)
• Appraisal then leads to struggle to try and control internal states and attempt to stay within a range considered acceptable by the individual.
• Feelings of high energy = imminent success
  VS
  feelings of high energy = mental breakdown

Question 25

integrative cognitive model for Bipolar disorder (Mansell et al., 2007) what is in the flow model where do ascent and descent behaviours come from

Answer 25

when chage in internal state is appraised as having extreme personal meaning, they will either perform a behaviour to try and keep that high move (ascent) or think "what is wrong with me" and keep it down (descent) also top down processes impacting appraisals: Beliefs about self, world and others (including procedural beliefs about affect and control) Life Experiences (including current environment & reactions of others)

Question 26

TEAMS therapy

Answer 26

can be used for anyone with mood swings. But developed for bipolar. Active ingredients - exposure to previously avoided internal states - Disconfirmation of extreme appraisals of internal states - reorganising and reprioritising life goals and values. Example techniques - behavioural experiments - imagery restricting using metaphors

Question 27

Recovery in Bipolar.

Answer 27

some ppl would rather keep bipolar. open up a discussion, discuss which areas they find difficult. What they are struggling with. Recovery to some may be about achieving life goals rather than reducing key symptoms. e.g. education, work...

Question 28

POETIC guidelines for recovery in bipolar

Answer 28

Purpose / meaning (having or finding meaningful activities in the present and making sense of extreme mood experiences from the past. ) Optimism / hope (Hope-inspiring relationships often helped to foster a Belief in the possibility of recovery. e.g. those who have recovered) Empowerment (p.p had control over life. understand and manage moods accessing professional support if need.) Tensions (personal recovery of bipolar is complex. conflicts within recovery domains). Identity Rebuild positive sense of self Connectedness (connect with diff groups of people. family, friends, peers, with lived experience of bipolar disorder. and professionals (psychotherapists).