Final: Bipolar

bipolar disorder

• characterized by mood swings ranging from profound depression to extreme euphoria (mania) w/ intervening period of normalcy

mania criteria

• persistent elevated, expansive, irritable mood

• last at least one week, most of the day, every day

• 3 or more of the following:

  • inflated self-esteem or grandiosity

  • decreased need for sleep

  • more talkative than usual

  • flight of ideas or perception that thoughts are racing

  • distractibility

  • increased goal directed activity or psychomotor activation

  • excessive involvement in activities w/ high potential for painful consequences

hypomania

• excessive energy and activity lasting at least 4 days

• same criteria as mania, less severe (no psychosis)

cycothymic disorder

• hypomania and mild depression

• at least 2 years

sx of mania

• change in baseline for a week

• talking fast, jumping from one idea to another, having racing thoughts, easily distracted

• long periods of feeling “high”, overly happy or outgoing, unrealistic beliefs in ones abilities

• extreme irritability, agitations, feeling jumpy or weird, restlessness, little sleep, labile

• increased goal directed activities (w/ no reason), taking on new projects, behaving impulsively, engaging in high risk pleasurable activities

mania cognitive, physiological and behavioral

cognitive:

• denial of real dangers

• flight of ideas

• distractibility

• grandiosity

• delusions

physiological:

• dehydration

• inadequate nutrition

• sleep deprivation

• weight loss

behavioral:

• aggressive

• grandiose acts

• hyperactivity

• irritability

• irresponsibility

• poor grooming

• sexually provocative

• verbose

etiology

• increased NE in brain

• neuronal excitation (glutamate)

• excess dopamine

• age of onset

risk factors

• genetics***

• hereditary and environmental

treatment

• medication (lifetime)

• therapy: individual, group, and family

  • family involvement, education, support, and help to know when manic

• milieu

• treatable

• everyone’s different

• less effective going on and off meds

• chronic: relapse prevention

  • symptom recognition and management, relapse plan

assessment

• safety

• delusions

• food, fluids

• mood

• behavior

• cognition

• speech