6.1 Bipolar and Related Disorders Flashcards
Mood
- Pervasive and sustained emotion that may have major influence of someone’s perception of the world (depression, joy, elation, anger, anxiety)
Affect
- Emotional reaction associated with an experience
Mania
- Alteration of mood expressed by elation (great happiness), inflated self-esteem, grandiosity (superiority), hyperactivity, agitation, and accelerated thinking/speaking
- Can be biologic (organic) or physiologic. Can also be a response to substance abuse or due to a medical condition.
- Madness characterized by rapid onset and remission with agitation and irritability
Bi-Polar Disorder Facts
- Gender incidence is equal
- IT IS A DISEASE OF THE BRAIN
- Average age onset is 25
- Occurs more often in high socioeconomic classes
Bi-Polar Disorder Facts
- Disorder tends to be recurrent
- Associated with increased mortality mainly due to suicide
- Bi-polar disorder can be completely treated with lithium for about 1/3 of the population.
- Characterized by mood swings from depression to extreme euphoria (mania) with intervening periods of normalcy.
- Causes marked impairment of functioning.
- Depression must have a history of 1+ manic episodes
- May or may not have delusions
- Onset of symptoms may reflect seasonal pattern
HYPOMANIA - milder form of mania
Bi-Polar 1 Disorder
- Currently experiencing or has experienced an full manic episode
- Depression may or may not be present
Bi-Polar 2 Disorder
- Major depression with signs of hypomania
- Never experienced a full manic episode
Cyclothymic Disorder
- Chronic mood disturbances for at least 2 years
- Periods of elevated mood that do not meet criteria for hypomania and has depression that does not meet major depressive disorders.
Substance Induced Bipolar Disorder
- Alcohol
- Amphetamines
- Cocaine
- Hallucinogens
- Inhalants
- Opioids
- Hypnotics
Can also be caused by withdrawal of drugs
- Anesthesia, analgesia, anticholinergics, anticonvulsants.
- Elevated, irritable, inflated self-esteem, decreased need for sleep
Bipolar Disorder Secondary to Medical Condition
- Bipolar disorder due to a medical condition that becomes clinically significant when it impacts area of functioning
Predisposing Factors to Bi-Polar Disorder
- Possibly due to chemical imbalance in the brain
Biological - Genetic
Biochemical - Excess norepinephrine and dopamine. Low serotonin
Physiological - Anatomical changes to the brain or brain lesions/enlarged ventricles.
Most common Medications
- Steroids, amphetamines, antidepressants, high dose anti-convulsant, narcotics may cause manic episodes.
Developmental Implications
- Research does not support correlation between ADHD and Bi-Polar Disorder
- ADHD IS HOWEVER The MOST COMMON CO-MORBIDITY OF BI-POLAR DISORDER
Psychopharmacology
- Monotherapy - Traditional mood stabilizers or atypical antipsychotics. Secondary medications used if monotherapy fails
- Maintenance Therapy - Same medications used to deal with acute exacerbations
Medications
- Lithium
- Anticonvulsants
- Atypical Antipsychotics
ADHD
- It is the most common co-morbidity of bi-polar disorders
- ADHD medications can exacerbate mania and should only be administered after bi-polar symptoms are controlled.
- Non-stimulant ADHD medications can induce switches between mania or hypomania
- Symptoms of ADHD and Bi-Polar disorder overlap (distractibility in attention, impulsivity)
Family Interventions
- Education of negative behaviors and how to manage them
- FAMILY FOCUSED PSYCHOEDUCATIONAL TREATMENT (FTT) focuses on reducing relapse and increasing medication adherence.
