Bipolar Disease

Question 1

What is bipolar disorder?

Answer 1

disorder that causes unusual shifts in energy and activity levels characterized by episodes of depression and mania

Question 2

What are the three main types of bipolar?

Answer 2

Bipolar I, Bipolar II and Cyclothymic disorder

Question 3

What is cyclothymic disorder?

Answer 3

adults who experience at least 2 years (for children, a full year) of both hypomanic and depressive periods without ever fulfilling the criteria for an episode of mania, hypomania, or major depression

Question 4

How many American adults are affected by BPD?

Answer 4

5.7 million

Question 5

What is the typical age of onset?

Answer 5

25

Question 6

What are the depressive symptoms

Answer 6

prolonged sadness insomnia or hypersomnia, weight loss or gain, changes in appetite, feelings of guilt and worthlessness, fatigue or loss of energy, inability to concentrate, inability to take pleasure in former interests, social withdrawal and suicidal ideation

Question 7

What are the symptoms relating to mania?

Answer 7

– increased physical and mental activity and energy, exaggerated optimism and self-confidence, decreased need for sleep, grandiose thoughts, impulsive behaviour and poor judgement, and delusions or hallucinations

Question 8

What is BPD I?

Answer 8

extremely high (mania) to extremely low (depression)

Question 9

What is a manic episode?

Answer 9

A manic episode is a highly elevated or irritable mood lasting 1 week with or without psychotic symptoms such as delusions and hallucinations

Question 10

What is a mixed episode?

Answer 10

Mixed episode is characterised by both depression and manic symptoms almost daily for at least one week resulting in rapid mood cycling with or without psychotic symptoms

Question 11

What is BPD II?

Answer 11

presence or history of a major depressive disorder and at least one hypomanic episode. Predominantly a depressed mood

Question 12

What is hypomania?

Answer 12

Hypomania involves similar but less intense mood and energy elevation as opposed to mania

Question 13

What is the aetiology of BPD?

Answer 13

Research indicates bipolar is genetic in nature as it tends to run in families; 80-90% of individuals with bipolar have a family history of some mood disorder. Environmental and biochemical factors may influence the expression of the gene

Question 14

What are the risk factors of BPD?

Answer 14

Genetics – twins have concordance rates of 57% and 14% for fraternal twins. Biology – functional abnormalities of the limbic system which is consistent with studies where MDD and BPD patients demonstrated blunted or decreased behavioural and physiologic reactivity to sad or negative stimuli. Co-occurring medical and psychiatric conditions. Cognitive abilities . Personality. Support systems. Personal history – sexual abuse, physical abuse, emotional abuse, war, disaster, displacement, domestic violence, parental mental illness, serious accidents, death of a loved one, chronic work stress and caregiver stress. Exposure to stress – neurochemical changes such as the excess release of cortisol which can interfere with limbic-cortisol systems. Coping strategies. Childbirth. Seasonal changes and substance abuse

Question 15

What is the prodromal period and how long does it last?

Answer 15

Prodromal period lasting 1.8 – 7.3 years before full onset of BPD has been noted. Dysregulated mood and fluctuations in energy increase in intensity during this period

Question 16

What is the risk of relapse?

Answer 16

High risk of relapse, recurring episodes and mood cycling during the first 2 years of the illness. 60% will experience a recurrence during first two years

Question 17

What is the risk of suicide?

Answer 17

Suicide rate in those with BPD higher than in any other mental health condition. 50% of BPD suffers attempt suicide at least once – 11% succeed

Question 18

What medications are used for BPD?

Answer 18

Anti-depressants, mood stabilizers and antipsychotic medications such as lithium, Risperdal and Seroquel

Question 19

What is the most widely used medication for BPD?

Answer 19

Lithium is the most approved medication for BPD as extensive research has supported its efficacy

Question 20

What is cognitive behavioural therapy?

Answer 20

Cognitive behavioural therapy (CBT) helps people to learn how to obtain more satisfaction and rewards through their own actions – helps change negative thinking behaviours. Teach about the illness, how it is triggered, how to recognise symptoms and identify triggers (1)

Question 21

What is electroconvulsive therapy?

Answer 21

Electric currents are sent throughout the brain to induce seizures often showing an immediate improvement in symptoms. Used to treat severe depression or acute mania. Usually administered in a series over a course of several days or weeks depending on the individual and severity of symptoms