3802 - Bipolar Disorder

Define BPD

Previously known as manic depression, BPD is characterised by periods of depression and periods of abnormally elevated mood that each last from days to weeks.

Symptoms

• Mania

• Hypomania

• Depression

Mania

Severe elevated mood or associated with psychosis

• euphoria

• irritability

• hyperactivity

• decreased need for sleep

• flight of ideas

• pressured speech

• overconfidence

• impulsivity

Hypomania

Less severe than mania/milder form or mania

No hospital admission needed usually

Depression

Persistent feelings of sadness, hopelessness, and a lack of interest or pleasure in daily activities

Bipolar depression episodes are shorter and use of anti-depressants is limited to shorter times compared to unipolar depression

Reason: can cause pt to switch and become manic

Bipolar 1

• At least one manic episode needed for diagnosis

• Major depressive episodes, but not needed for diagnosis

• Affects both genders equally

Bipolar 2

• One or more major depressive episodes

• At least one hypomanic episode

• No evidence of mania

Differential diagnosis for BPD

• ADHD

• Schizophrenia

• Delirium

• Autism

Physical conditions to consider

• Can be secondary to stroke

• Disabilities

• Multiple sclerosis

• Tumors

Treatment

• Anti-psychotics (aripiprazole, olanzapine, haloperidol, queatiapine, risperidone)

• Mood stabilisers (lithium, sodium valproate, carbamezapine, lamotrigine)

• Benzodiazepines (diazepam, lorazepam)

• Anti-depressants (SSRIs - citalopram)