Mood Congruence and Incongruence in Bipolar Disorder

Mood Congruence and Incongruence in Bipolar Disorder Bipolar Disorder Symptoms Print Mood Congruence and Incongruence in Bipolar Disorder Classification helps differentiate psychotic episodes By Marcia Purse Marcia Purse is a mental health writer and bipolar disorder advocate who brings strong research skills and personal experiences to her writing. Learn about our editorial policy Marcia Purse Medically reviewed by Medically reviewed by Steven Gans, MD on May 16, 2017 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Steven Gans, MD Updated on January 23, 2020 Bipolar Disorder Overview Symptoms & Diagnosis Causes Treatment Living With In Children Your Rights Mood incongruence is a term used to describe a serious symptom of bipolar disorder. It is a psychotic feature of the disease wherein the persons belief or action, whether by hallucination or delusion, does not match with his or her mood. By contrast, mood congruence also describes a psychotic symptom of bipolar disorder, but, in this case, the belief or action is consistent with that persons mood. While the difference between mood congruence and incongruence may seem of little consequenceâ€"given that they both related to a psychotic episodeâ€"the way in which each impacts a persons ability to function and thrive can be strikingly different. Examples of Mood-Incongruent and Mood-Congruent Symptoms Incongruent means conflicting. As such, mood incongruence implies that the symptoms conflict with the persons current mood. Examples include: Laughing when your dog diesBelieving you have super powers despite going through a major depressive episode In each case, the actions of the person do not match either the situation or emotional state. The delusion of superpowers, for example, in no way coincides with themes of powerlessness that are inherent in depression. By contrast, congruent means in agreement. In this case, any symptoms, however extreme, are considered mood-congruent when they in agreement with the persons current mood. Examples include: Feeling suicidal when your dog diesBelieving you have super powers when you are going through a manic episode No matter how unreasonable the responses may be, they nevertheless match the circumstance or emotional state of that person at that moment. Psychosis Within the context of bipolar disorder, both mood congruence and incongruence are used to describe a psychotic feature of the disease. We dont use mood congruence, for example, to describe a person with bipolar disorder who has a reasonable response to a situation. The terms simply allow us to classify any false beliefs a person may have in order to provide appropriate treatment. We refer to these false beliefs as psychoses. Psychosis is simply a break from reality, a condition which more often happens during a manic episode and even a depressive episode (but never with a hypomanic episode). Psychosis involves hallucinations  (experiencing things that are not real) and/or delusions  (believing things that are not real). Psychosis Symptoms, Causes, and Treatment Hallucinations and Delusions Most people tend to associate hallucinations with schizophrenia, but they can happen in bipolar disorder, as well. Hallucinations involve experiences or perceptions that are not real, whether they be things a person sees, hears, smells, tastes, or physically feels. Examples include: A mood-congruent hallucination in a depressive episode would involve themes such as guilt or sadness. For example, hearing a voice that tells you that youre worthless.A mood-congruent hallucination in a manic episode would involve grandiosity, like seeing the president in your living room.A mood-incongruent hallucination in a depressive episode would have you  experiencing sensations contrary  to your depression without any feelings of guilt, death, disease, inadequacy, or deserved punishment.A mood-incongruent episode in a manic episode would be just the opposite, perhaps voices telling you that youre unworthy or deserve punishment. Delusions, by contrast, are firmly held beliefs that are neither true nor based in reality. They do not involve hallucinations but instead play out in beliefs and actions that are contrary to reality. Delusions in Bipolar Disorder Psychosis Treating People With Bipolar Disorder Treatment typically involves the management of symptoms and the prevention of mood episodes. This includes the use of medication (mood stabilizers, antidepressants, antipsychotics) and psychotherapy.?? It is important that any person with bipolar disorder receive ongoing care and medical oversight. This is especially true for those experiencing mood-incongruent symptoms in whom the risk of hospitalization and suicide is far greater. The 9 Best Online Therapy Programs