When Dr. Sarah Sperry talks to her patients with bipolar disorder, she often asks them what part of their condition affects their lives the most.
Many of them say it’s the lack of control over their emotions and how they react to things around them. They find it hard to manage their feelings, and this can be very disruptive.
Traditionally, the main goal of treating bipolar disorder has been to prevent severe episodes, like deep depression or intense mania. However, the subtle mood changes and emotional swings that happen between these major episodes have not been given the same attention.
These smaller shifts are just as important because they impact daily life, but they’re much harder to measure and track.
Standard questionnaires used in treatment don’t always capture these fluctuations accurately, making it difficult to know if a treatment is working on this aspect of the disorder.
Dr. Sperry and her team at the University of Michigan Medical School have spent more than ten years studying data from nearly 400 people with bipolar disorder.
They also looked at information from over 200 others who either had different mental health conditions or no psychiatric issues at all. Their research is part of the Prechter Longitudinal Study of Bipolar Disorder, and their findings were recently published in Nature Mental Health.
The researchers discovered that instead of just looking at a person’s symptoms at one specific time, it’s more useful to observe how these symptoms change over time.
They suggest that paying attention to the “spikes” in a person’s mood—how much and how often their emotions deviate from their usual state—can provide a better understanding of their condition.
By focusing on reducing the size and frequency of these emotional spikes, treatments could become more effective in improving the overall quality of life for people with bipolar disorder.
Dr. Sperry believes that the current way of measuring success in treating bipolar disorder may not be the most effective. She argues that instead of just looking at whether a person has fewer severe episodes, we should also be considering how much their mood and emotions fluctuate.
According to her, this instability is a key factor in how people with bipolar disorder experience their daily lives.
To test their ideas, Dr. Sperry and her team analyzed data from several commonly used mental health questionnaires. These include the PHQ-9 for depression, the ASRM for mania, and the GAD-7 for anxiety.
They found that people with bipolar disorder showed much more variation in their responses over time compared to people with other mental health conditions or those without any psychiatric issues. This variation was closely linked to lower quality of life, both mentally and physically.
The team developed a new scoring system that predicts a person’s quality of life based on how much their mood fluctuates over time. They used rolling averages to track these changes, and the system can be applied even with just a year’s worth of data.
What’s more, the questionnaires are simple and quick to complete, meaning that they can be done regularly through a smartphone app or website. This could allow doctors and researchers to monitor patients more frequently and adjust treatments more effectively.
Dr. Sperry and her colleagues hope that their new approach to measuring mood instability in bipolar disorder can be tested further in other studies.
If their findings hold up, this could lead to better ways of evaluating treatment effectiveness and improving the lives of people with bipolar disorder.
They have made the code for calculating this variability score available, so that others can use it in future research and clinical work.
Dr. Sperry emphasizes that mood variability is a central part of life for people with bipolar disorder. She believes that by focusing on reducing these emotional shifts, we can make a real difference in how treatment impacts their daily functioning and overall well-being.
Together with Dr. Melvin McInnis, the director of the Prechter Bipolar Research Program, and Dr. Anastasia Yocum, the program’s data manager, they are pushing for a shift in how we understand and treat this complex condition.
If you care about health, please read studies that scientists find a core feature of depression and this metal in the brain strongly linked to depression.
For more information about health, please see recent studies about drug for mental health that may harm the brain, and results showing this therapy more effective than ketamine in treating severe depression.
The research findings can be found in Natural Mental Health.
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