Engage Aotearoa

Tag Archives: Bipolar Disorder

Engage Facebook Highlights

Here are a half a dozen recent highlights from our Facebook page. Please LIKE US!

Kiwi tastes a golden nugget. It’s delicious. Superb animated film about addiction.

Writing from the Toi Ora Creative Writers in the ArtWeek zine
Toi Ora writers make a splash: writing from Matthew Savage, Liz Higgins, Andrew Holdaway and more.

Nine Things Every Parent with an Anxious Child Should Try
Your child turns to you and says, “I don’t want to take the bus. My stomach hurts. Please don’t make me go.” A discussion

Public lecture by Professor Rosalind Gill: Sexting, sexualisation and sexism
Modern youth sexuality, sexting and the sexy selfie. 27 November 2014, 6pm.

Finding the Treatment Options that Suck Less
The Crazymeds Manifesto: to help you find treatment options that suck less.

Worst Things to Say to a Person With Bipolar Disorder
When your friend or loved one has bipolar disorder, here are the worst things you can tell them.

Real Life Story on TV One this Sunday 14 July at 8:30 am

Chris McMurray is a poet and a rapper. Words are his thing.

At nine he lost his father to a fatal heart attack… and he went down a disruptive path of drug use, after which he was diagnosed with Schizophrenia and Bipolar disorder.

Now at the age of twenty-two Chris uses his art to express what it’s like living with mental health problems and is looking to the future.

Share his story in the documentary this Sunday the 14th of July at 8:30 am on TV One.

Check out the promo clip here on Youtube.

May 2013 Issue of The Like Minds Newsletter

The latest issue of the Like Minds Newsletter is available now.

The feature article explores Richard Anderson’s experience of schizophrenia, the benefits of work and his strategies for keeping well.

They cover aspects of the Like Minds National Providers Hui and hear about the resilience focus of the Noho Wananga.

This month marks the launch of the DSM-5. Like Minds talks to a psychiatrist, an international mental health consultant and a mental health advocate to get their thoughts on the revised manual. Changing Minds Manager Tina Helm offers her full perspective as a separate document, Anticipating the DSM-5.

Journalist Robyn Yousef tells us why she waited so long to ‘seize the day’ and share her story about living with bipolar disorder.

Hikoi champion Annie Chapman is walking her way around the North Island to raise awareness about choice in mental health care. She explains what is driving her and how you can support her petition.

Mental health radio show Take It From Us recently celebrated its 20th anniversary. Sheldon Brown discusses his role as host and how the show came to be.

Finally, remember to sign up for Stigma Watch and check out poetry book Smells Like Sugar and SamRB’s second album Queen Street Acoustics.

You are welcome to email your feedback and story ideas to likeminds@mentalhealth.org.nz and, if you think others would enjoy receiving this e-newsletter, please forward this email so they can subscribe.

New Research out from BMC Psychiatry in Feb 2013

Research article
Childhood clumsiness and peer victimization: a case–control study of psychiatric patients
Bejerot S, Humble MB

BMC Psychiatry 2013, 13:68 (25 February 2013)
[Provisional PDF]

Research article
A case-linkage study of crime victimisation in schizophrenia-spectrum disorders over a period of deinstitutionalisation
Short TB, Thomas S, Luebbers S, Mullen P, Ogloff JR

BMC Psychiatry 2013, 13:66 (20 February 2013)
[Provisional PDF]

* This study reports an increase in crime victimisation by people with schizophrenia spectrum disorders since services were moved to the community. It is the opinion of Engage Aotearoa that violence by people who are unwell is often due to a lack of responsive services and appropriate supports, rather than the mental-health condition itself. Stressed out family members and friends are not always the most appropriate supporters when things have reached crisis point. Voluntary respite services are highly restricted in accessibility. The current NZ system requires that someone has become a risk to themselves or others before acute services are provided. Crisis Team response times are renowned for being too long. This all creates space for escalation and victimisation before treatment and support can be accessed. This is a complex issue that extends well beyond mental-health problems themselves and reaches into the core of how we as a society support those who are experiencing a mental-health crisis.   

Research article
Antipsychotic medications and cognitive functioning in bipolar disorder: moderating effects of COMT Val108/158 Met genotype
Arts B, Simons CJ, Drukker M, van Os J

BMC Psychiatry 2013, 13:63 (19 February 2013)
[Provisional PDF]

*Note: The results of this gene-environment study, if replicated, may partly explain why people with the same diagnosis can respond very differently to the same antipsychotic medication.

Research article
A 6-month randomized controlled trial to test the efficacy of a lifestyle intervention for weight gain management in schizophrenia
Attux C, Martini LC, Elkis H, Tamai S, Freirias A, Camargo Md, Mateus MD, Mari Jd, Reis AF, Bressan RA

BMC Psychiatry 2013, 13:60 (18 February 2013)
[Provisional PDF]

*Note: Weight management strategies are important interventions for addressing a common side-effect of many anti-psychotic and some antidepressant medications. However, in the opinion of Engage Aotearoa, this article de-emphasises the role of medications in the weight-gain of people with schizophrenia diagnoses and incorrectly implies it is a direct consequence of the mental-health problem itself, when it is not. 

Research article
Perception of depressive symptoms by the Sardinian public: results of a population study
BMC Psychiatry 2013, 13:57 (16 February 2013)
Provisional PDF]

*Note: These results show that the public sees a difference between depression as a response to loss (‘a normal response’) and clinical depression requiring professional attention.  In the opinion of Engage Aotearoa, the public (and the authors) appear to assume that diagnosable mental-health problems are not normal responses’. This is an attitude that likely contributes to stigma about depression. Unfortunately this article does not acknowledge that clinical depression is indeed a normal response that can usually also be traced to previous difficult experiences. 

Research article
Substance use among inmates at the Eldoret prison in Western Kenya
Kinyanjui DW, Atwoli L

BMC Psychiatry 2013, 13:53 (13 February 2013)
[Provisional PDF]

Research article
Is virtual reality always an effective stressors for exposure treatments? Some insights from a controlled trial
Pallavicini F, Cipresso P, Raspelli S, Grassi A, Serino S, Vigna C, Triberti S, Villamira M, Gaggioli A, Riva G

BMC Psychiatry 2013, 13:52 (11 February 2013)
[Provisional PDF]

Research article
Residual symptoms and functioning in depression: does the type of residual symptom matter? a post-hoc analysis
Romera I, Pérez V, Ciudad A, Caballero L, Roca M, Polavieja P, Gilaberte I

BMC Psychiatry 2013, 13:51 (11 February 2013)
[Provisional PDF]

Research article
CBT for depression: a pilot RCT comparing mobile phone vs. computer
Watts S, Mackenzie A, Thomas C, Griskaitis A, Mewton L, Williams A, Andrews G

BMC Psychiatry 2013, 13:49 (7 February 2013)
[Provisional PDF]

Research article
Influence of personal and environmental factors on mental health in a sample of Austrian survivors of World War II with regard to PTSD: is it resilience?
Tran US, Glück TM, Lueger-Schuster B

BMC Psychiatry 2013, 13:47 (4 February 2013)
[Provisional PDF]

*Note: This research suggests a humorous and challenge-focused attitude to stress and trauma is associated with resilience to PTSD. Environmental elements showed associations with resilience to PTSD symptoms. The authors conclude the socio-environmental factors are simply consequences of PTSD symptoms. However, it is also possible that these factors are directly contributing to the symptoms and that resolving them would improve resilience to PTSD. 

APA Interview with International Expert on Bipolar Disorder

Myths and Realities About Bipolar Disorder

Five questions for bipolar disorder expert Eric Youngstrom, PhD

The following feature interview was produced by the American Psychological Association.  

Media coverage of people who have been diagnosed with bipolar disorder usually does not fully explain this serious mental-health problem, how best to treat it and how it can affect those who have it, as well as their families, friends and coworkers. To explain what bipolar disorder is and psychology’s role in identifying and treating it, APA asked Eric A. Youngstrom, PhD, to share his knowledge about this mental illness.

Dr. Youngstrom is professor of psychology and psychiatry at the University of North Carolina at Chapel Hill and acting director of the Center of Excellence for Research and Treatment of Bipolar Disorder. He earned his doctorate in clinical psychology at the University of Delaware and specializes in the relationship of emotions and psychopathology and the clinical assessment of children and families. Dr. Youngstrom has published more than 150 peer-reviewed articles on clinical assessment and emotion, he has served as an ad hoc reviewer on more than 60 psychology and psychiatry journals.

APA: What is bipolar disorder and how is it different from the general mood swings that many people experience?

Dr. Youngstrom: Bipolar disorder is a condition that leads to extreme changes in mood, energy and sleep. With all of these things, people will experience ups and downs in everyday life. What sets bipolar disorder apart is that the swings happen with more frequency and intensity than developmentally appropriate and they last much longer. The extremes also start to cause problems at school, home, with friends or other important areas in the person’s life. There is no sharp dividing line that separates bipolar disorder from ordinary changes in energy and mood. It is the combination of extremity and impairment that signals when it has become a problem. Interestingly, although we have long thought of bipolar disorder as a “mood disorder,” we’re learning that focusing on shifts in energy may be a more accurate way of detecting episodes of the illness. The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) defines four different types of bipolar disorder: bipolar I, where the person has had a manic episode at least once in their lives; bipolar II, where the person becomes seriously depressed, but also has a history of hypomania (a milder mania); cyclothymic disorder, where the person has years of depressive and hypomanic symptoms without developing a full mania or depression; and bipolar “not otherwise specified,” for situations that do not fit into any of the other three definitions.

APA: Is bipolar disorder on the rise or does it just seem that way because of frequent media coverage?

Dr. Youngstrom: Both may be true, but changes in the actual rate are likely to be in the small to medium range, whereas changes in clinical diagnosis and media attention are huge. Several studies have found that the rate of clinical diagnoses of bipolar disorder has increased markedly over the last 20 years, especially in children and teenagers. The media often present these as percentage increases, which exaggerates the appearance of change because the current generation of practitioners was not trained to look systematically for bipolar disorder in youths. When something is rarely or never diagnosed and then starts to be recognized, the change in the rates can be misleading — 40 times more than something very small is still a small rate. A recent meta-analysis found no sign that the rates were increasing over the last 20 years. However, some of the risk factors associated with bipolar disorder, such as obesity, changes in diet, disruption of sleep and earlier onset of puberty, definitely have been increasing over the last few decades, so we cannot rule out the possibility that there is an increase in bipolar disorder. The increase is just much smaller than the changes in attention by the media and clinicians.

APA: How prevalent is bipolar disorder? Is it more common among certain demographic or geographic groups?

Dr. Youngstrom: The meta-analysis mentioned above found that bipolar disorders in children and teens are about half as common in adults, affecting 2 percent of the general population around the world (compared to 4 percent for bipolar in adults, or 6 to 8 percent for depression in teens). This makes bipolar about a third as common as depression and less than half as common as attention-deficit hyperactivity disorder in youths, but about twice as common as autistic spectrum disorders. Many longitudinal studies suggest that roughly a third of all depressions have a bipolar course when followed over time. There is no good evidence that it is more common in some demographic groups than others, although ethnic minorities with bipolar disorder are likely to be misdiagnosed with schizophrenia, conduct disorder or antisocial behavior instead. Women are more likely to be diagnosed with bipolar II, but there is no evidence of a gender linkage. It is more likely that women seek help more often for depression, so clinicians see more women with bipolar II. Internationally, bipolar disorder appears equally common among youths in the USA as in the rest of the world. In adults, rates of bipolar disorder may be lower in Asia than in the USA, but it is hard to tell whether this is due to protective factors — such as lower rates of obesity or higher fish consumption — versus greater social stigma preventing people from acknowledging problems and seeking help.

APA: What causes bipolar disorder? Are there differences in how the disorder affects children, adolescents and adults?

Dr. Youngstrom: Bipolar disorder is caused by a combination of biological and environmental factors. Genes play a major role, but genes are not enough by themselves to cause bipolar disorder. Identical twins share 100 percent of the same genes, but if one twin has bipolar disorder, the other twin does not develop bipolar 20 percent or more of the time. At this point, research has identified lots of genes that each contribute a little bit of risk for bipolar disorder. Diet may play an important role as well. Stress and trauma increase risk, as do intense emotional conflicts in families. Most of the risk factors for bipolar disorder also increase the odds of developing other conditions, such as anxiety or attention problems, which probably is why we see such high rates of co-occurrence among these disorders. Interestingly, the risk factors appear to be the same for children, adolescents and adults, which gives us more confidence that we are dealing with the same condition. The biggest way that the illness seems to change with age is that older individuals are more likely to experience depression and less likely to have mania, whereas in childhood it is more mania or a mixture of high energy with negative mood. Researchers and clinicians have described that pattern for more than a century.

APA: What are the most effective treatments for the disorder?

Dr. Youngstrom: The best treatments for bipolar disorder focus on smoothing out the highs and lows in mood and energy. There are several different psychotherapies that have promising results. These include cognitive behavioral therapy to pay attention to automatic positive thoughts as potential triggers for hypomania or mania; dialectical behavior therapy for improving emotion regulation; psychoeducational therapy to understand triggers and ways of managing the illness; family-focused therapy to improve communication and reduce intense emotional conflict; and interpersonal social rhythm therapy that emphasizes regular sleep and activity patterns. When the mood and energy become extreme, reaching the severity of a full-blown mania or depression, then medication is important in reducing the symptoms to a level where therapy and everyday functioning become possible. Therapy has a lot of promise as a way of preventing progression of bipolar disorder, delaying relapse and improving functioning in between episodes. Many incredibly talented and productive people have successfully dealt with bipolar disorder, so a goal of treatment should not just be symptom reduction, but helping the person to make the most of their gifts and abilities.

For more information, contact Dr. Youngstrom by email.


The American Psychological Association, in Washington, D.C., is the largest scientific and professional organization representing psychology in the United States and is the world’s largest association of psychologists. APA’s membership includes more than 137,000 researchers, educators, clinicians, consultants and students. Through its divisions in 54 subfields of psychology and affiliations with 60 state, territorial and Canadian provincial associations, APA works to advance the creation, communication and application of psychological knowledge to benefit society and improve people’s lives.