Bipolar Disorder is a group of mood disorders characterized by periods of fluctuation between elevated moods (e.g. mania) and low moods (e.g. depression).
Symptoms
Physical
- Decreased need for sleep
- Increased distractibility
- Psychomotor agitation
- More talkative
Cognitive
- Flight of ideas
- Grandiosity
- Impulsivity
Affective
- Periods of mood fluctuation from mania/hypomania to depression
Assessments
Physical
Cognitive
- Montreal Cognitive Assessment (MoCA)
Affective
- Beck’s Depression Scale
- Patient Health Questionnaire 9 (PHQ-9)
Function
- Canadian Occupational Performance Measure (COPM)
Common Occupational Performance Issues (OPIs)
Self-Care
- Decreased motivation to perform grooming, bathing, dressing
- Decreased attention paid to proper nutrition
- Difficulty sleeping
- Engaging in more risky behaviour
- Inconsistent compliance with medication
- Social isolation
Productivity
- Absenteeism or presenteeism; decreased work performance
- Difficulty caring for others
- Difficulty with financial management; erratic spending
- Decreased attention paid to home maintenance and meal preparation
Leisure
- Engaging in more risky leisure activities
- Social isolation
- Decreased occupational engagement
Frames of Reference
- Cognitive Behavioural
- Behavioural
- Psychodynamic
- Recovery
Interventions
Self-Care
Safety: risk assessment, create safety plan if necessary, harm-reduction strategies, decisional balance, Wellness Recovery Action Plan (WRAP), COPE card
ADLs: establish routines, Motivational Interviewing, task simplification and grading
Mood: components of Cognitive-Behavioural Therapy (e.g. cognitive re-structuring, behavioural activation, problem solving), Dialectical-Behaviour Therapy, reminiscence therapy, meaningful occupation
Productivity
Work: job demands analysis (JDA), functional abilities evaluation (FAE), advocate for client to employer, recommendations for workplace accommodations / modifications, advocate for flexible work schedule, advocate for clearly structured work tasks / demands, work with client on assertive communication training
Home: establish routines, task simplification and modification, referrals for community support services (e.g. meal , laundry and cleaning services)
Leisure
Leisure Exploration: explore meaningful occupations and group programs
Leisure Participation: behavioural activation, establish routines