7 Bipolar Flashcards
What are the 5 different stages of moods?
Mania, hypomania, euthymia, dysthymia, depression
What is the mild form of bipolar and what two moods is it made up of?
Cyclothymic - hypomania and dysthymia
What is disruptive mood dysregulation?
A new diagnosis for children as BD was being over diagnosed
What 4 symptoms might you have if you have mania?
Irritable mood, abnormal goal directed behaviour / increased self-esteem, decreased need for sleep, excessive talking, flight of idea’s
What is hypomania?
It is less severe than mania / no marked impairment
What 4 symptoms might you have if you have major depression?
Low mood, anhedonia / weight change, sleep disturbances, psychomotor agitation, fatigue, guilt, suicidal, dysfunction
What are the two types of depression?
Bipolar and monopolar
What happens during episode free periods?
Social functioning and cognition decreases
What is bipolar 1?
Having episodes of major depression and mania
What is bipolar 2?
Having major depression and hypomania / being impulsive
What are the gender differences in bipolar?
Women: more depressed, thyroid dysfunction, atypical or reverse vegetative, postpartum, comorbidity
What are the gender differences in bipolar comorbidity?
Women: more comorbid with anxiety / Men: more comorbid with substance abuse
What is the Switch?
The transition from one mood, to one of opposite polarity / usually depression to mania
What triggers cause the Switch?
Stress, sleep deprivation, antidepressants, ECT, substances
List three environmental factors which might cause bipolar?
Childhood adversity, chronic stress, trauma, mood instability, sleep disturbances (irregular, reduction, time zones)
What REM patterns may trigger bipolar?
Low REM latency and high REM density
What % heritability is bipolar?
85%
What two genes may cause bipolar?
CLOCK and PER3
What does and doesn’t neuroimaging of bipolar patients brains show?
Does show hypoactive OFC / risk / impulsivity
Doesn’t show if somehow has bipolar
How do bipolar patients react in the pre-pulse inhibition tasks?
They are just as startled the second time / do not block important information
What differences do bipolar patients have at the HPA axis?
Decreased hippocampal and amygdala volume
What does stress increase and what effect does this have?
Increases glucocorticoids, leading o neuronal loss
What are the three main therapeutic goals in BD?
Treat symptoms, prevent relapse, reinstate
What are the two types of drugs used in treating BD?
Adjuncts and mood stabilizers
Give an example of an adjunct drug?
Modafinil, thyroid
Give an example of a mood stabiliser drug?
Lithium, anti epileptics, atypical antipsychotics
What % effectiveness is lithium?
60-80%
How does lithium work to treat BD?
Alters neuronal excitability in the hippocampus - EPSP’s
What two parts of BD is lithium most effective in treating?
Manic episodes and suicide
What percentage of BD patients relapse on lithium?
< 30%
A downside of lithium is that is has a N_ T_ W_?
Narrow therapeutic window
Name three drugs that we learnt about, which treat BD?
Lithium, valporic acid, carbamazepine, lamotrigine, ketamine, atypical anti-psychotics
How does valporic acid work in treating BD?
Increases GABA or inhibits sodium
How does carbamazepine work in treating BD?
Block voltage sensitive sodium channels
How does lamotrigine work in treating BD?
Acts on sodium channels / an anticonvulsant
Which drug used in treating BD has the least side effects / has some positive side effects? What are they?
Lamotrigine: increases cognitive functioning / safe for fetus’
What two drugs that are used for treating BD, do we not know how they work?
Ketamine and atypical antipsychotics
What % of BD patients stop drug treatment?
50%
What happens when BD patients stop drug treatment?
Symptoms worsen / increase in suicide rates
What is an alternative to drug therapy is BD treatment?
Psychotherapy
How does psychotherapy work for BD patients?
Psychoeducation: what it is, what happens, how to deal with, how to prevent triggers?
