Abnormal Psychology

Mood Disorders and Suicide 231

Figure 6.7

6.7 • Feedback Loops in Treating Bipolar Disorders

Key Concepts and Facts About Bipolar Disorders

• The four building blocks for diagnosing bipolar disorders are ma-
  jor depressive episode (MDE), manic episode, mixed episode,
  and hypomanic episode. Symptoms of a manic episode include
  grandiosity, pressured speech, fl ight of ideas, distractibility, poor
  judgment, decreased need for sleep, and psychomotor agitation.
  A mixed episode is characterized by symptoms of both an MDE
  and a manic episode and may include psychotic features and sui-
  cidal thinking. A hypomanic episode involves mood that is persis-
  tently elated, irritable, or euphoric; unlike other mood episodes,
  hypomanic episodes do not impair functioning.


• There are two types of bipolar disorder. Bipolar I disorder—usually
  more severe—requires only a manic or mixed episode; an MDE
  may occur but is not necessary for this diagnosis. Bipolar II

disorder requires alternating hypomanic episodes and MDEs

and no history of manic or mixed episodes. Both disorders may

involve rapid cycling. Cyclothmic disorder is a more chronic but

less intense version of bipolar II disorder.

• Neurological factors that are associated with bipolar disorders
  include an enlarged and more active amygdala. Norepinephrine,
  serotonin, and glutamate are also involved. Bipolar disorders
  are influenced by genetic factors, which may influence mood
  disorders in general.


• Psychological factors that are associated with bipolar disorders
  include the cognitive distortions and negative thinking associated
  with depression. Moreover, some people with bipolar I disorder
  may have residual cognitive defi cits after a manic episode is over.

Treatments Targeting

Neurological Factors

Treatments Targeting

Psychological Factors

Treatments Targeting

Social Factors

Changes neural

activity

Changes thoughts,

feelings, and

behaviors, including

medication

compliance

Decreases social

stressors and family

conflict

Decreases shame and

isolation

Increases social support

and stability of social

rhythms

CBT: Self-monitoring,

relapse prevention,

problem solving,

cognitive restructuring

Medication: Mood

stabilizers, including

lithium and

anticonvulsants

IPSRT

Family therapy

Group therapy or

self-help group

Note: Treatments for depressive disorders may also be used to treat depressive symptoms in people with bipolar disorders.

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