Bipolar Disorder involves episodes of mania (hyperactivity) and depression. There are unusual changes in mood, energy level, and the ability to function in everyday life. 

The symptoms of a manic episode include:

• A long period of feeling very happy and outgoing or extremely irritable, jumpy, or agitated
• Talk very fast, jump from one topic to another, racing thoughts
•  Easily distracted
•  Increased goal directed activities that may be irrational
• They need very little sleep
• Impulsive
• Take part in high risk behaviors such as spending sprees, unsafe sex, and drugs/alcohol use

Some symptoms of depression include:

• A long period of feeling sad and empty
• A loss of interest in things that they once enjoyed
•  Feeling tired and slow
• Very irritable
•  Difficulty concentrating
• Think about death/suicide and possible attempt suicide

Almost all cases of bipolar disorder start before the age of 25, and can be seen in childhood. There are several types of bipolar, bipolar I disorder, bipolar II disorder, bipolar disorder not otherwise specified, and cyclothymic disorder.

• Bipolar I Disorder- The individual has manic episodes that interfere with their daily life functioning. They have 1 or more manic episodes that can be paired with depressive episodes. They may also have psychotic episodes (they don’t remember things).
• Bipolar II Disorder-The individual has 1 or more depressive episodes and at least one hypomanic episode which is an elevated mood but not a full blown mania.
• Cyclothymia- At least 2 years of hypomanic and depressive episodes but they do not meet the criteria for the full disorder

The role of the occupational therapist is to evaluate, identify, adapt, monitor, and educate. The OT will evaluate the client’s ability to function in their daily lives and take care of him/herself. They will identify treatment goals for the client that are important and meaningful, adapt the activities or the environment to help the person engage in their occupations, help monitor the client’s reactions to their medications, and finally educate the client and their family members or caregiver on mood disorders and the treatment plan/goals. An OT will also help the client with many of the symptoms of mania and depression. To help with the depression the OT can provide the individual with social skills training, expressive activities such as exercise or art, time management skills, cognitive retraining, and skills for managing their medications. To help with the symptoms of mania the occupational therapist can help the individual organize their thoughts and behaviors and provide skills to deal with their rapid thoughts/emotions, provide concrete goal directed activities, and self expression activities. The OT will do assessments to determine what activities the individual is having difficulty with, and what problems they are having during daily activities. 

References:

Mayo Clinic Staff. (2011).Bipolar disorder. Retrieved from http://www.mayoclinic.com/health/bipolar-disorder/DS00356

American Occupational Therapy Association, (2002).Understanding mood disordersRetrieved from http://www.aota.org/Consumers/consumers/MentalHealth/Mood/35136.aspx

Logsdon, D. (2009). Persons with serious mental illness.American Occupational Therapy Association, Retrieved from http://www.aota.org/CCL/Mental-Illness-CAT.aspx