Bipolar and Related Disorders

What is mood?

A sustained emotion that influences a person’s perception of the world

What is affect?

The external, observable emotional response to an experience

What is mania?

An elevated mood with elation, grandiosity, hyperactivity, agitation, and rapid thinking/speech

What is bipolar disorder?

Mood swings from depression to mania with periods of normal mood

What defines Bipolar 1 disorder?

Presence of a full manic episode (may also have depression)

How is Bipolar I disorder further specified?

By the current or most recent episode (manic, hypomanic, mixed, or depressed)

What severe features can occur in Bipolar I disorder?

Psychotic or catatonic features

Key idea of Bipolar 1?

MUST have mania (depression may or may not occur)

Hypomania

Mild form of manic where judgement remains intact, no psychotic features

What defines Bipolar 2 disorder?

Major depressive episodes with hypomania

Does Bipolar II include full manic episodes?

No — never has a full manic episode

Key idea of Bipolar 2?

Major depression episodes + hypomania, NO full mania

What is cyclothymic disorder?

Chronic mood disturbance with periods of hypomania and mild depression

How do symptoms in cyclothymic disorder compare to Bipolar I and II?

Symptoms are less severe and do not meet criteria for Bipolar I or II

Key idea of cyclothymic disorder?

Chronic mild ups and downs for 2+ years

What is substance- or medication-induced bipolar disorder?

Mood disturbance (mania or depression) caused by substance use or withdrawal

What is bipolar disorder due to another medical condition?

Mood disturbance caused by a medical condition

What neurotransmitter is associated with psychotic features?

Dopamine

What is a key first-line medication for bipolar disorder?

Lithium

What are the characteristics of Stage 1: Hypomania?

Mild symptoms, no major impairment or hospitalization; cheerful mood, rapid ideas, increased activity

What are the characteristics of Stage 2: Acute Mania?

Severe impairment, euphoria, pressured speech, hallucinations/delusions, excessive activity, ↓ need for sleep, poor inhibition

What are the characteristics of Stage 3: Delirious Mania?

Severe, life-threatening; labile mood, panic anxiety, disorientation, clouded consciousness, frenzied activity, exhaustion, psychotic symptoms

What is a key nursing intervention for imbalanced nutrition in mania?

High-calorie, nutrient-dense finger foods; no utensils needed

What type of activities are appropriate for manic patients?

Noncompetitive, simple (e.g., walking)

Should manic patients in acute episodes attend group therapy?

No

Where should a manic patient’s room be located?

Away from the nurses’ station (low stimulation area); not to be paired with another manic pt.

What are key outcome goals for a manic patient?

No injury, no harm to self/others, eats well (high-calorie snacks), falls asleep within 30 min, sleeps 6–8 hrs/night

What are key patient teaching points for lithium?

Take regularly; maintain consistent sodium & fluid intake (no major changes); drink 6–8 glasses water/day; report N/V; monitor lithium levels regularly

Lithium level (acute mania)?

0.8 - 1.4

Lithium level (Maintenance)?

0.4 - 1.0