bipolar and related disorders

bipolar I

• one or more manic episodes

• may be combined with hypomanic or major depressive episodes

bipolar II

• one or more major depressive episodes

• at least one hypomanic episode

• no history of a manic episode

manic episode

• mood is uncharacteristically and consistently elevated or irritable

• increased in targeted, goal directed behavior or restless, purposeless behavior

• inflated self-esteems or thoughts of grandeur

manic episode impact on function

• lack of inhibition

• euphoric in early phases

• high, often undirected, energy levels

• poor judgement which leads to dangerous situations

side effects of mood stabilizing behaviors

• excessive thirst, tremors, excessive urination, weight gain, nausea, diarrhea, cognitive impairments

manic episode considerations for OT

• activities that provide structure and opportunity to release excess energy

• periods between episodes used to education on symptom management

side effects of SSRIs

nausea, headache, sexual dysfunction, insomnia

side effects of tricyclics

dry mouth, blurred vision, sedation, anticholinergic affects

side effects of SNRIs

hypertension, anxiety, dizziness, sedation, nervousness, weight gain, nausea, sweating

side effects of monoamine oxidase inhibitors (MAOIs); nardil & parnate

• weight gain, hypotension, insomnia liver damage

• dietary restrictions

  • ingesting tyramine can increase blood pressure and lead to stroke

    • aged cheese, pickled foods, cured or smoked meats, liver, yogurt, sour cream, fruits, fava beans, peapods, chocolate, beer and red wine

symptom management for depression

• medication

• CBT

• electroconvulsive therapy

  • person can engage in activity 6 hours after treatment