Mood management in bipolar disorder : a five stage process

The clinical effectiveness of psychological interventions for bipolar disorder (BD) may be enhanced by having a coherent psychological model of BD, which amalgamates many of the concepts proposed in the existing psychological models of BD and some which are not. This PhD aimed to expand on the Self Regulation Model (SRM; Leventhal et al. , 1984) framework to enhance understanding of mood identification and regulation in BD. The mood management model proposed was tested using three methodologies (namely experience sampling, mood induction and a cross-sectional survey design) to provide insight into mood management processes in daily life, following controlled mood manipulation and in response to self-report questionnaires in a large sample of people with BD from across the North West of England and Nottingham. Demonstrating differences between euthymic bipolar participants and healthy controls regarding the psychological processes that underlie the self-regulation of mood may inform psychological interventions. Compared to healthy controls, people with BD reported more variability in mood, perceived more positive consequences, less personal control, less understanding, a shorter duration of mood and made more internal attributions for hypomanic and depressive experiences. Furthermore, while people with BD reported implementing helpful coping strategies (CS) to manage low mood, the most commonly used CS for mania were related to stimulating behaviours that would likely escalate mood and were rated as unhelpful by participants themselves. The current results support the application of the SRM to BD and the importance of expanding this model to explain mood management in BD. The clinical implications, limitations and avenues for future research are discussed.