Lived experience of elevated mood and cognitive differences across the bipolar spectrum

Bipolar spectrum disorder affects many people worldwide, yet there is much to learn about how it develops, who might be at risk, and how people experience periods of unusually elevated mood.

Literature review: Elevated mood can impact individuals in different ways. Much of what we know comes from clinical descriptions rather than people’s own accounts. This review brought together findings from 19 studies, wherein people described their experiences of unusually elevated mood in interviews and focus groups. Four patterns were identified: that people often had difficulties recognising they were in a state of elevated mood, that they felt energised but unable to steer that energy, there was frequently sadness intertwined with the highs, and finally, that they struggled with their identity in the aftermath of an episode. What linked all these patterns together was whether the person felt the experience belonged to them, which ultimately shaped how they made sense of it. This highlights the value of supporting people beyond symptom management, helping them spot the signs early and understand how these states fit in with who they are.

Empirical study: It is challenging to identify who might be at risk of developing bipolar disorder. Therefore, it is valuable to understand what distinguishes those at risk. This study compared people thought to be at risk of developing bipolar disorder with those who were not. It focused on how people interpreted their internal states such as changes in mood, energy, and thinking. The at-risk group differed most clearly on the way that they made sense of these inner experiences and were more likely to read strong personal meaning into shifts in mood and energy. This suggests that how people interpret their inner state could be a useful focus when supporting those at high risk of developing bipolar disorder.