bipolar disorder Flashcards
criteria for Atypicaloty
1.stasticical atypicality
2.violation of socially accepted standers
a-maladaptivity
3-sunjectivite atypicality and or disconfort
a-to the atypical individual
b-to other
4-biological injury or atypicality
foucault’s madness and civilization
-he argues that as leprosy(skin condition) disappeared,the concept of madness developed as its replacement
-the great confinement:the mad/undersible were now locked up in institutions
-in the 19th century that madness was considered as a mental illness
-focault argues that this medicalization of madness introduced treatmnet practice that were just crual
DSM-5
provides an exhaustive classification system for every possible mental dissorder
its porpuses
1-to guide treatment chance
2-to allow clinicins to communicate
3-to please insurance companies who require concrete diagnoses
4-to permit reserch via categorization
mental health and matal illness
are very different from each other
opitimal mental health vs poor mental health
serious mental illnes vs no mental illness symptoms
stigma
-the negative effects of stigma can outweight the negative effects of mental disorder itself*
-stigma by health care professionals results in poorer treatment and worst treatment outcomes
-stigma is considered to be the foremost barrier to ment health care
-they may not want to seek help due to stigma very dengerous
- structural stigma
the policies and practices of institution is positions of power, that systemattically restric the rights and opportunities for people living with mental health
2-social stigma
describes the phenomenon of social groups endorsing sterortyypes about and acting against a stigmatized group
3.self stigma
most dentremental
can be ‘caused’ by social stigma
negatives feelings about one self resulting from an individual’s experiences,perceptions or anticipation of negative social reactions on the baisis of their mental health
dsm-5 criteria-Major depressive disorder
5+ of the following symptoms present during the same 2 week period at least one of the symptoms is either
1-depressed mood
2-loss of interest (anadonia)
maniac episodes
distinct period of abnormally and persistently increse energy and goal-oriented lasting at least 1 week
3 of the following or more:
-inflated self-esteem or grandiosity
-decrese need for sleep
-more talking then usual
-throuhts racing
difference between hypomania and mania
presence of delusion and hallucination(hypomania)
Bipolar I disorder
bassically the same as a bipollar II but includes manic episodes (less sevier kinda) where ii includes hypomania
depression and mania can occur besides each other they are not oposits
‘mixed’
who gets diagnosed
bipolar I:0.6%
bipollar II:0.4%
strong tendency to run in families
females have an incresed likehood of bipolar ll diagnosis,hypomania,rapid cycling (4 episodes a year)and mixed episodes
common midconceptions
that people with bipolar disorder exhibits rapid shifts in affect
vast majority do not
major risks
-high rate of recurrence - life long condition
-high risk for sucide attempts(1/3-1/2)
-highest risk for completed sucide among any phyatric disorder :20%
6th leading cause of disability
comorbidity
each case of bipolar disorder almost alway has comorbid psychiatric and or nonpsychiatric illness:
psychiatic:
-anxiety disorder
2.substance use disorder
3.attetion-deficit
-personality disorder
nonpsychiatric(may be symptoms of medication)
-migraine
-cadiovascular disorder
-edocrine disorder
structural brain changes
-consistent reports overall reduction in gray matter
-reports of several structural being smaller in patients with bipolar disorder:
-hippocampus
-medial prefrontal cortext
-left anterior
-left superior temporal gyrus
-incresed striatal volume
cognitive changes
-impairments in executive function
-more pronounced on tasks that use emotional stimuli
-executive function deficits can be used to predict the onset
creativity and bipolar disorder
summary of Kyaga
-there is no evidence that depression or schizophrenia is associated with creative professions
-there is evidence for bipolar and creative professions
-close relatives of individuals with schizophrenia and bipolar disorder are more likey to hold a creative profession
non-pharmacological treatment
not very helpful with mania or hypomania , works with depressive phase
CBT: cognitive behavioural therapy
psychosocial intervation
pharmological treatments
mood stabilizers
antidepresive and antimanic properties
ex:lihium
Lihium - mood stebilizer
-john cade reported that a group of 10 manic patients displayed markd improvment following the adminsistration of the metallic ion lithium
fast antisuisidel
can cause tremor
-
euthymia
normal phase
anticonvulsants
certain anticonvulsant drugs are considered to be effective mood stabilizer(not as affective as lithium)
1.valproate semisodium (drousines)
2.lamotringine-fewer side effects
atypical antipsychotic
certain antiphychotic drugs are considered to be effective mood stabilizer
1.quetiapine
2.olanzapine
3-aripriprazole
reward hypersensitivity model
vulnerability to bipolar disorder is the result of a hypersensitive reward system: overreactive to goal and reward cues
goal/reward attainment is hypothaiszed to lead to excessive goal/reward activation which leads to cluster of hypomania/manic symptoms
goals/reward nonattainmentis hypothesized to lead to excessive goals/rewards deavtivation which then leads to a cluster of depressive symptoms
reward hypersensitive model
-extensive goal setting and incresed sucess expectancis
-euthymic individuals with BDmake riskier choices then controls (non BD)
-BD exhibit more ambitious goals striving and higher achivment motivation
-abnormalies in the prefrontal cortex volume,and incresed striatal volume(judgment of risk area)
-incresed metabolism in the striatum on both manic and depressed individuals with BD
-excessive increase frontal strital reward-related activation in response to rewars releted cues
