Behavioral Science: Bipolar Related Disorders

Question 1

Mania

Answer 1

Distinct, abnormal, elevated, expansive (or irritable mood) x 7 days minimum

• at least 3 of the following must be present for at least 1 week:
  1. increased self-esteem/grandiosity
  2. decreased sleep
  3. increased speech
  4. racing thoughts
  5. distractibility
  6. increased activity
  7. increased dangerous impulsivity
• must cause distress/dysfunction, cannot be due to another disorder, medical condition, substance misuse

Question 2

Hypomania

Answer 2

• milder mania
• at least 4 days or more
• same symptoms
• not severe enough to cause marked impairment, but symptoms are noticed by others

Question 3

Bipolar 1

Answer 3

Mania + MDE

- MUST HAVE MANIA, don’t need depression

Question 4

Bipolar 2

Answer 4

Hypomania + MDE

- MUST HAVE HYPOMANIA, don’t need depression

Question 5

Cyclothymia

Answer 5

> 2 years hypomania with minor depressions

Question 6

Other characteristics of bipolar:

Answer 6

increased sexual activity, seductive/flashy dress, increased anger, lots of energy, able to be creative/think outside the box/take chances, can become psychotic
- most spend more time depressed than manic

Question 7

Biological factors a/w bipolar

Answer 7

• Altered NT activity
• Monoamine receptor deficiency
• genetics
• Kindling Hypothesis: too much neuronal limbic firing, seizure and anti-epilepsy drug model via Na2+ channel blockade

Question 8

Gender prevalence

Answer 8

More common in women

Question 9

Psychosocial factors a/w bipolar

Answer 9

Low self-esteem, negative outlook, learned helplessness, catastrophic loss, demeaning parents, peers can yield denial and fantasy defenses to occur = mania
- stress can increase mania!

Question 10

Bipolar treatment

Answer 10

• don’t use antidepressants, if you must, use a mood stabilizer first to prevent antidepressant from causing mania
• atypical antipsychotics (block D2 receptor which treats mania, blocks 5HT2a receptor which treats depression)
• mood stabilizers
• therapy doesn’t work. meds are a must.

Question 11

Mood stabilizers

Answer 11

Lithium, Divalproex, Carbamazepine, Atypical antipsychotics (risperidone, aripiprazole)

Question 12

Lithium

Answer 12

provides Ca2+ membrane stability and promotes neuronal health and protective factors

Question 13

Divalproex

Answer 13

Increases GABA activity

Question 14

Cabamazepine

Answer 14

Blocks Na+ channels and promotes neuronal health

Question 15

Psychotherapy for bipolar

Answer 15

Works for depressed phase, def not for manic phase