Understanding Bipolar Disorder

An accessible and informative guide to understanding bipolar disorder, written specifically for clients.

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Guide (PDF)

A psychoeducational guide. Typically containing elements of skills development.

Overview

Our ‘Understanding…’ series is a collection of psychoeducation guides for common mental health conditions. Friendly and explanatory, they are comprehensive sources of information for your clients. Concepts are explained in an easily digestible way, with plenty of case examples and accessible diagrams. Understanding Bipolar Disorder is designed to help clients with bipolar understand more about their condition.

Why Use This Resource?

This guide aims to help clients learn more about bipolar disorder. It explains what bipolar is, what the common symptoms are, and effective ways to address it, including medications and cognitive behavioral therapy (CBT).

  • Identify symptoms of bipolar disorder and the factors that contribute to it.
  • Understand what can trigger and exacerbate bipolar.
  • Explore effective treatments for bipolar disorder.
  • Gain insights into how people experience bipolar and how they manage it.

Key Benefits

Comprehensive

Explores what bipolar disorder is and what triggers and exacerbates it.

Relatable

Contains detailed examples and relatable case studies.

Supportive

Written in a friendly and accessible way.

Hopeful

Outlines effective treatment options.

Who is this for?

Bipolar Type I

In bipolar I, people have manic episodes and can be very unwell. Those with bipolar type I usually – but not always – experience episodes of depression as well.

Bipolar Type II

In bipolar II, people have hypomanic episodes which can be like full mania but do not go on for as long. Those with bipolar type II tend to have more severe and longer episodes of depression than those with bipolar disorder type I.

Integrating it into your practice

01

Assess

Identify clients who may be experiencing bipolar disorder.

02

Share

Provide the guide to clients who could benefit from it.

03

Educate

Use the content to inform clients about bipolar disorder and help normalize their experiences.

04

Reflect

Discuss the client’s personal experience with bipolar disorder.

05

Intervene

Plan treatment with the client or direct them to other sources of help and support.

Theoretical Background & Therapist Guidance

This guide draws upon cognitive behavioral theory to explain and contextualize bipolar disorder. It focuses not only on defining symptoms, but also on identifying what can trigger and exacerbate mood episodes. 

Key psychological mechanisms are outlined, including:

  • Positive bias. People with bipolar may overestimate the likelihood of good outcomes or their capabilities, which can fuel (hypo)manic escalation.  
  • Sleep disruption. Irregular sleep is both a trigger and consequence of mood episodes.  
  • Unhelpful beliefs. Perfectionism, self-criticism, and high standards can drive both depression and (hypo)mania.  
  • Behavioral rebound. Attempts to induce or maintain positive mood can backfire and destabilize emotional regulation.

What's inside

  • Clear explanations of bipolar disorder, its types, and important diagnostic criteria.
  • Case studies illustrating diverse client experiences.  
  • Infographics depicting psychological mechanisms like positive bias and unhelpful beliefs.  
  • Lists of common triggers and relapse risk factors.  
  • Overview of medication options and evidence-based psychological treatments.
Get access to this resource

FAQs

Bipolar disorder is a condition involving recurring episodes of depression and (hypo)mania, often lasting weeks. It goes beyond typical mood fluctuations and requires attention.
Yes, many individuals with bipolar go months or even years without major episodes, though vulnerability often remains.
No, factors such as genetics, trauma, substance use, and other life experiences all contribute to risk. It is best understood using a biopsychosocial model.
Psychological therapies are effective, especially when combined with medication. Research indicates that therapy alone is not sufficient for most people with bipolar.
Effective treatments include mood stabilizers and antipsychotic medication. Psychological therapies with research support include CBT, family therapy, and interpersonal and social rhythm therapy.

How This Resource Improves Clinical Outcomes

  • Enhances understanding of bipolar disorder, supporting accurate formulation and diagnosis.
  • Empowers clients by normalizing their experiences and improving self-awareness.
  • Informs individualized relapse prevention planning.
  • Provides a springboard for discussing lifestyle changes, relevant beliefs, and other coping strategies.

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References And Further Reading

  • Chen, C. H., Suckling, J., Lennox, B. R., Ooi, C., & Bullmore, E. T. (2011). A quantitative meta‐analysis of fMRI studies in bipolar disorder. Bipolar disorders, 13(1), 1–15. https://doi.org/10.1111/j.1399-5618.2011.00893.x  
  • Chu, C.-S., Stubbs, B., Chen, T.-Y., Tang, C.-H., Li, D.-J., Yang, W.-C., et al. (2018). The effectiveness of adjunct mindfulness-based intervention in treatment of bipolar disorder: a systematic review and meta-analysis. Journal of affective disorders, 225, 234–245. https://doi.org/10.1016/j.jad.2017.08.025  
  • Craddock, N., & Sklar, P. (2013). Genetics of bipolar disorder. The Lancet, 381(9878), 1654–1662. https://doi.org/10.1016/S0140-6736(13)60855-7  
  • De Prisco, M., Oliva, V., Fico, G., Fornaro, M., de Bartolomeis, A., Serretti, A., et al. (2022). Defining clinical characteristics of emotion dysregulation in bipolar disorder: A systematic review and meta-analysis. Neurosci Biobehav Rev, 142, 104914.  
  • Ferrari, A. J., Stockings, E., Khoo, J. P., Erskine, H. E., Degenhardt, L., Vos, T., & Whiteford, H. A. (2016). The prevalence and burden of bipolar disorder: findings from the Global Burden of Disease Study 2013. Bipolar disorders, 18(5), 440–450.  
  • Goodwin, G., Dolman, C., Young, A., Jones, I., Richardson, T., & Kitchen, S. (2021, October 21). Bipolar Diagnosis Matters: An look at the early findings of the Bipolar Commission. Bipolar UK.
  • Jefsen, O. H., Erlangsen, A., Nordentoft, M., & Hjorthøj, C. (2023). Cannabis Use Disorder and Subsequent Risk of Psychotic and Nonpsychotic Unipolar Depression and Bipolar Disorder. JAMA Psychiatry, 80(8), 803–810. https://doi.org/10.1001/jamapsychiatry.2023.1256  
  • Johnson, S. L. (2005). Life events in bipolar disorder: Towards more specific models. Clinical Psychology Review, 25(8), 1008–1027. https://doi.org/10.1016/j.cpr.2005.06.004  
  • Kessler, R. C., Chiu, W. T., Demler, O., & Walters, E. E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of general psychiatry, 62(6), 617–627.  
  • Marangoni, C., Hernandez, M., & Faedda, G. L. (2016). The role of environmental exposures as risk factors for bipolar disorder: a systematic review of longitudinal studies. Journal of affective disorders, 193, 165–174. https://doi.org/10.1016/j.jad.2015.12.055  
  • Miklowitz, D. J., Efthimiou, O., Furukawa, T. A., Scott, J., McLaren, R., Geddes, J. R., & Cipriani, A. (2021). Adjunctive psychotherapy for bipolar disorder: a systematic review and component network meta-analysis. JAMA psychiatry, 78(2), 141–150. https://doi.org/10.1001/jamapsychiatry.2020.2993  
  • Schönfelder, S., Langer, J., Schneider, E. E., & Wessa, M. (2017). Mania risk is characterized by an aberrant optimistic update bias for positive life events. Journal of affective disorders, 218, 313–321. https://doi.org/10.1016/j.jad.2017.04.073  
  • Steinan, M. K., Scott, J., Lagerberg, T. V., Melle, I., Andreassen, O. A., Vaaler, A. E., & Morken, G. (2016). Sleep problems in bipolar disorders: more than just insomnia. Acta Psychiatrica Scandinavica, 133(5), 368–377. https://doi.org/10.1111/acps.12523  
  • Woods, C., Richardson, T., & Palmer‐Cooper, E. (2023). Are dysfunctional attitudes elevated and linked to mood in bipolar disorder? A systematic review and meta‐analysis. British Journal of Clinical Psychology, 63(1), 16–53. https://doi.org/10.1111/bjc.12442  
  • Xuan, R., Li, X., Qiao, Y., Guo, Q., Liu, X., Deng, W., et al. (2020). Mindfulness-based cognitive therapy for bipolar disorder: A systematic review and meta-analysis. Psychiatry Research, 290, 113116. https://doi.org/10.1016/j.psychres.2020.113116

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