Zusammenfassung
Obwohl im Verlauf bipolarer Störungen oft depressive Episoden in der Häufigkeit dominieren, ist diagnostisch nur das Auftreten manischer oder hypomanischer Episoden entscheidend. Kennzeichnend für diese sind die Kernsymptome einer deutlich gehobenen oder reizbaren Stimmung sowie eines gesteigerten Antriebs. Hinzu treten Symptome wie z. B. reduziertes Schlafbedürfnis oder Rededrang. Das primäre Differenzierungsmerkmal zwischen Manie und Hypomanie ist der Schweregrad der Symptome, wobei die Hypomanie nicht mit schweren Beeinträchtigungen einhergeht. Deswegen ist die Unterscheidung zwischen einer guten Stimmung und einer klinisch relevanten gehobenen Stimmung oft eine Herausforderung. Lange Zeit wurden bipolare Störungen primär medikamentös behandelt, aber inzwischen werden biopsychosoziale Modelle anerkannt, die das Zusammenspiel verschiedener Faktoren betonen. Dies spiegelt sich auch in den aktuellen Leitlinien wider, die eine Kombination von Medikation mit Psychoedukation, familienfokussierter Therapie, interpersoneller und sozialer Rhythmustherapie oder kognitiver Verhaltenstherapie empfehlen.
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Meyer, T.D., Bauer, M. (2020). Bipolare Störungen. In: Hoyer, J., Knappe, S. (eds) Klinische Psychologie & Psychotherapie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-61814-1_45
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