The Big Picture
Bipolar and related disorders cause unusual changes in a person’s mood, energy, and ability to function. These changes are different from the normal emotional ups and downs that everyone experiences.
A person may have emotional lows called depression and emotional highs called mania. The condition is long-term, but treatment can help control mood changes and related symptoms.
Support during different phases of the illness can include watching for mood changes, helping track daily patterns, creating a calm environment during manic periods, and encouraging rest and self-care.
Look for Nova Scotia CCA Notes throughout this page for current provincial guidance.
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Start Here If You’re Overwhelmed
Focus on these core ideas:
- Bipolar and related disorders cause unusual shifts in mood, energy, and ability to function.
- A person may move between depression and mania.
- Symptoms usually occur through three phases: acute, continuation, and maintenance.
- Mania can involve increased energy, little need for sleep, racing thoughts, poor judgment, and unusual behaviour.
- Mood changes can occur even during continuous treatment and should be reported immediately to the doctor.
- During manic periods, the support worker should provide a calm environment, encourage rest and self-care, and avoid arguing with the client.
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Course Notes: Key Ideas You Need to Know
What Are Bipolar and Related Disorders?
Bipolar and related disorders are a group of related brain disorders. They cause unusual changes in:
- mood
- energy
- ability to function
These changes are more than the normal ups and downs people experience.
Bipolar and related disorders were formerly called manic-depressive illness. About 1% of Canadians experience the disorder.
The illness is long-term and requires careful management throughout a person’s life.
Depression and Mania
A person with bipolar disorder can experience emotional lows called depression and emotional highs called mania.
Thoughts, moods, and behaviours can move from normal to grandiose and then to depressed. These symptoms can lead to damaged relationships, poor performance at work or school, and even suicide.
Bipolar disorder is treatable. With proper treatment, people with the disorder can lead full and productive lives.
When a Manic Episode Is Diagnosed
A manic episode is diagnosed when an elevated mood occurs with three or more other symptoms of mania:
- most of the day
- nearly every day
- for 1 week or longer
If the person’s mood is irritable, four additional symptoms must be present.
When Bipolar Disorder Usually Begins
Bipolar disorder tends to run in families.
Signs and symptoms can range from mild to severe. They usually begin in late adolescence or early adulthood.
Some people first show symptoms during childhood. Others first show symptoms later in life.
Bipolar disorder is often not recognized as an illness, and some people may go for years before it is properly diagnosed and treated.
Bipolar Disorder in Children and Adolescents
Children and adolescents can develop bipolar disorder. It is more likely in children whose parents have the disorder.
The pattern can look different in younger people.
Children and young adolescents may experience very fast changes between depression and mania many times within one day. Their episodes may be less clearly separated than the episodes seen in many adults.
Children experiencing mania are more likely to be:
- irritable
- prone to destructive tantrums
They may be less likely to appear overly happy or elated.
Mixed symptoms are also common in young people with bipolar disorder.
Older adolescents may develop episodes and symptoms that are more like the classic adult pattern.
Why Accurate Diagnosis Matters
Bipolar disorder in children and adolescents can be difficult to distinguish from other problems with similar symptoms, including drug abuse.
Effective treatment depends on an accurate diagnosis.
Children or adolescents who have emotional and behavioural symptoms should be carefully evaluated by a mental health professional.
Long-Term Treatment
Most people with bipolar disorder, including people with severe forms of the illness, can achieve substantial stabilization of mood swings and related symptoms with proper treatment.
Bipolar disorder is a recurring illness. People with the disorder need long-term preventive treatment.
Treatment usually controls the disorder better when it is continuous rather than periodic.
Even with continuous treatment, mood changes can still occur.
Report: Mood changes should be reported immediately to the doctor. The doctor may be able to prevent a full episode by adjusting the treatment plan promptly.
Working closely with the doctor and communicating openly about treatment concerns and options can help make treatment more effective.
Nova Scotia CCA Note
Sorrentino’s Canadian Textbook for the Support Worker, 5th Edition says mood changes should be reported immediately to the doctor. In current Nova Scotia CCA practice, the CCA follows the reporting and escalation directions set out for the person’s care. These directions may be identified by a regulated health professional and documented in the care plan . (novascotiacca.ca)
Nova Scotia’s current standards also say that a CCA monitors behaviour while providing care, recognizes when changing needs or symptoms must be reported, and responds to behavioural expressions by using planned interventions and strategies. (novascotiacca.ca)
Why this matters in Nova Scotia: Do not assume that a CCA independently decides who should change treatment or that every change is reported directly to a doctor. Follow the person’s care plan and the documented reporting and escalation directions for the workplace. (novascotiacca.ca)
Official source: Continuing Care Assistant Occupational Standards of Practice Official PDF
Last checked: October 7, 2026
The Three Phases
Symptoms of bipolar and related disorders usually occur in three phases.
1. Acute Phase
The acute phase occurs when symptoms are escalating .
2. Continuation Phase
The continuation phase occurs while symptoms are still visible and the client is usually receiving treatment.
3. Maintenance Phase
The maintenance phase occurs after the client’s acute symptoms have subsided .
Signs and Symptoms of Mania
A manic episode can include several changes in mood, thinking, energy, sleep, judgment, and behaviour.
Possible signs and symptoms include:
- increased energy, activity, and restlessness
- an excessive high or euphoric mood
- extreme irritability
- racing thoughts
- very fast talking and jumping between ideas
- distractibility and difficulty concentrating
- little need for sleep
- unrealistic beliefs about personal abilities and powers
- poor judgment
- spending sprees
- a prolonged period of behaviour that is different from usual
- increased libido, or sex drive
- abuse of drugs, especially cocaine, alcohol, and sleep medications
- provocative , intrusive , or aggressive behaviour
- denial that anything is wrong
Helping Track Daily Patterns
The support worker can assist with keeping a daily chart.
The chart may include:
- mood symptoms
- treatments
- sleep patterns
- life events
Tracking these areas can help the client and family understand and cope with the illness.
Supporting a Client During Depression
During a period of depression, the support worker should follow the guidelines for major depression.
Supporting a Client During Mania
During manic periods, the support worker should:
- provide a calm environment with fewer distractions
- encourage periods of rest
- encourage self-care
- assist with self-care when required
Avoid: Do not argue with the client. Arguing could irritate the client.
Exam Clue Words
- Three or more: An elevated mood must occur with three or more other symptoms of mania for the stated diagnostic pattern.
- Four additional symptoms: When the person’s mood is irritable, four additional symptoms must be present.
- 1 week or longer: The elevated mood and other symptoms must occur most of the day, nearly every day, for at least this length of time.
- Report immediately: Mood changes can occur even during continuous treatment and should be reported to the doctor without delay.
- Do not: During mania, the support worker should not argue with the client because arguing could increase irritation.
Fast Review
Use these points for a quick final review before a quiz or exam.
- Bipolar and related disorders cause unusual changes in mood, energy, and ability to function.
- About 1% of Canadians experience the disorder.
- Bipolar disorder can involve emotional lows called depression and emotional highs called mania.
- A manic episode is diagnosed when elevated mood occurs with three or more other symptoms most of the day, nearly every day, for 1 week or longer. If the mood is irritable, four additional symptoms must be present.
- Symptoms usually occur in three phases: acute, continuation, and maintenance.
- Children and young adolescents may have very fast mood swings between depression and mania many times in one day.
- Mania can involve increased energy, little need for sleep, racing thoughts, fast talking, distractibility, poor judgment, irritability, unusual behaviour, and denial that anything is wrong.
- Continuous treatment usually controls the disorder better than periodic treatment.
- Mood changes can still happen during treatment and should be reported immediately to the doctor.
- The support worker can help track mood symptoms, treatments, sleep patterns, and life events.
- During manic periods, provide a calm setting, encourage rest and self-care, and assist with self-care as required.
- Do not argue with a client during mania because arguing could irritate the client.
Final Pep Talk
There are several details to separate here, especially the three phases and the signs of mania. Focus first on the main pattern, then review the specific signs and support-worker actions a few at a time.