Bipolar Disorders, Mania, and Meds

Bipolar disorders involve episodes of:

• mania

• hypomania

• depression

• mixed features

mania:

severe mood elevation or irritability that involves:

• grandiosity

• decreased need for sleep

• pressured speech

• racing thoughts

• poor judgement

hypomania:

milder elevation that:

• lasts at least 4 days

• produces observable change

• doesn’t require hospitalization

• doesn’t include psychosis

“if psychosis is present, think mania”

Bipolar 1:

this requires at least 1 manic episode

lasts generally a week

causes marked impairment, safety problems, severe judgment, poss psychosis and need for hospitalization

Bipolar 2:

“this requires 1 manic episode and 1 major depressive episode with no history of a full manic episode”

requires hypomania and major depressive episode

these patients are at an increased risk for SI

Cyclthymic disorder

• chronic mood fluctuation

• hypomanic symptoms that don’t meet the hypomanic criteria

• depressive symptoms that never meet full MDD

• duration for at least 2 years

“no full manic or MDD symptoms during the time”

substance/medication induced behavior disorder

this is caused by

• intoxication

• withdrawal

• medication

• toxin exposure

“corticosteroids are an important medication trigger for mania”

MANIA STAGES AND NURSING PRIORITIES

hypomania:

mild increased energy, talking, confidence, less sleep, no psychosis

acute mania:

severe hyperactivity, grandiosity, pressured speech, poor judgement, little sleep/food

delirious mania:

EMERGENCY

extreme agitation, confusion, disorganization, inability to meet basic needs

some nursing priorities include:

• safety

• fluids and food

• sleep

• hygiene

nursing interventions:

• low stimulating room

• short, calm directions

• firm belief

• no arguing

• high cal, high protein

• nighttime routine

• avoid crowds and large groups