Bipolar Disorder Flashcards
symptoms of mania
- Euphoria- elation heightened sense of well being
- Decreased inhibition
- impulsivity
- distractibility, inattention
- Unceasing & indiscriminate enthusiasm for interpersonal
- sexual or occupational interactions
- Irritable mood – provoked easily to anger
- Lability of mood
- Disinhibition and impulsive
- High energy, decreased need to sleep
- increased sex drive
- Pressured speech
what is bipolar I
¨– periods of major depressive, manic or mixed episodes
what is bipolar II
-periods of major depression and hypomania, often hypomania is euphoria, and then major depression puts them at risk of suicede, no psychosis
what is cyclothymic
periods of hypomania and depressive episodes (doesn’t meet full criteria)
must have four of the following to be diagnosed with mania
¨inflated self esteem
¨Decreased need for sleep
¨Being more talkative/pressured
¨Flight of ideas / racing thoughts
¨Distractibility
¨Increase n goal-directed activity / psychomotor agitation
¨Excessive involvement in pleasurable activities w/ negative consequences
characteristics of mixed episodes
¨by anxiety, agitation, irritability, labile mood
what are some safety issues in mania?
¨Danger to self/others
¨Impulsivity / consequences
¨Exhaustion
Grandiosity / consquences (spending, disruptive behaviour
phases of caring for a manic patient
- Acute phase
- Medical stabilization
- Maintaining safety
- Self-care needs - Continuation phase
- Maintain medication adherence
- Psychoeducational teaching
- Referrals - Maintenance phase
- Prevent relapse
three main drugs for bipolar disorder
- Lithium
- divalproex (Epival, Depakote)
- carbamazepine (Tegretol)
signs of mild to moderate lithium toxicity
¨Mild shakiness, especially in the hands
¨Thirst
¨Increased or frequent urination
¨Vomiting & Diarrhea
¨Drowsiness
¨Muscle weakness & Ataxia
signs of severe lithium toxicity
¨Blurred vision
¨Shakiness increased
¨Tinnitus
¨seizures
what type of communication should we use with bipolar disorder?
¨Respectful, calm, non-confrontational
¨Avoid power struggles – set limits
¨In acute phase – firm, calm, short, concise
¨Neutral, non-judgemental
¨Don’t join in on joking & joviality
¨Consistency, reliability & limit setting
¨Redirect as needed re: behaviours, energy
milieu management for bipolar disorder
- Maintain low level of stimuli
- Structured solitary activities with staff
- Redirect violent behavior
- Minimize physical harm: medication/seclusion
- Observe for medication side effects/toxicity
- Protect from consequences of behavior, such as giving away money or possessions
what are comorbid disorders with bipolar disorder?
- panic attacks
- alcohol abuse
- social phobia
- oppositional defiant disorder
- specific phobia
- SAD
** boredlerline PD is common with it
genetics of bipolar disorder
highly heritable.
