3. Assessment

what areas are assessed in bipolar disorder?

• history

• general appearance

• mood and affect

• thought process and content

• sensorium and intellectual process

• judgment and insight

• self-concept•roles and relationships

• physiologic and self-care

what general appearance and motor findings can be seen in mania?

• psychomotor agitation

• flamboyant clothing or makeup

• thinking, moving, talking fast

• pressured speech

what is pressured speech?

rapid speech that is hard to interrupt

what is manic mood and affect like?

unstable

euphoric•exuberant•grandiose•false sense of well-being•sometimes angry, aggressive, sarcastic, or irritable

what does labile mood look like in mania?

mood shifts quickly, like laughing then crying, or euphoria that changes fast when the client does not get their way

what behaviors can reflect manic mood and affect?

• nonstop laughing, joking, and talking•uninhibited or overly friendly behavior

• boundless energy and enthusiasm

• unrealistic plans to get rich, famous, or powerful

• excessive calls or emails

• staying busy day and night

• no boundaries*

• excessive spending, giving things away, or partying

what is flight of ideas?

a continuous flow of fast thoughts or words linked by understandable associations

what is clang association?

words linked together because they rhyme

what is circumstantiality?

a long, overly detailed response with lots of extra information

what is tangentiality?

wandering off topic and never answering the question that was asked

what delusion is common in mania?

grandiose delusions

what are judgment and insight like in mania?

judgment is poor and insight is limited

what is self-concept like in mania?

exaggerated self-esteem

how can mania affect roles and relationships?

the client may…

• not fulfill responsibilities

• invade other people’s space or personal business

• become hostile

• not be able to delay gratification

what physiologic and self-care problems can happen in mania?

• poor attention to hygiene and grooming

• not noticing hunger or fatigue