Bipolar Flashcards
Bipolar I - labs?
CBC and lytes RPR/VDRL - syphillis check UA - drug screen CT - head is normal EVERYTHING IS NORMAL
Bipolar I sx?
pressured speech
speech is rapid
thought process is quickly skipped from one idea to another - “flight of ideas” (and pt is aware)
inability to answer simple and direct
What is bipolar dz?
common and recurrent
oscillating mood, energy, and ability to fxn - cannot hold a job
Bipolar mood episodes?
manic
hypomanic
depressive (MDD)
Manic vs hypomanic episodes?
4 days (hypomanic) to 7 days (manic) hypomanic is less severe but same sx
Manic and hypomanic sx?
at least 3 mood elevation sx
- inflated self esteem*
- decreased need for sleep
- over talkativeness*
- flight of ideas*
- distractibility
- excessive goal-directed/psychomotor agitation
- impulsivity (shopping)
Bipolar I?
Bipolar I: -ONE manic episode -MDD (most people have it but not dx) specifiers -anxious distress --> bipolar I w/ anxiety -mixed features -rapid cycling (4 sx/12 mo) -melancholic features (looks sad)
Bipolar II?
-ONE HYPOmanic AND one MDD
-NO MANIC EPISODE
specifiers
-hypomanic/depressed
-anxious, distressed, mixed, rapid cycling
-partial remission, full remission
MDD and does not get better?
MDD AND PDD
MDD that does not get better + hypomanic?
Bipolar II w/ PDD
- hx of MDD
- talking superiority *
- staying up all night *
- hypomanic
- chatting familiarly w/ strangers (very talkative)
bipolar II
Bipolar disorder I tx?
- mood stabilizers (lithium, valproate)
- neuroleptics (olanzapine)
- benzos (agitation/psychosis)
- antidepressants: titrate
- ECT
Bipolar disorder II tx?
first line: mood stabilizers (lithium, valproate)
antidepressants
Cyclothymic disorder?
hypomania + depressive sx for 2 yrs
does NOT meet bipolar criteria for episodes
Mixed feature episodes?
using specifier for hypomanic or manic episodes