Bipolar disorder Flashcards
1
Q
bipolar disorder definition
A
disorder characterized by dramatic shifts in emotions, moods and energy levels from extreme highs to extreme lows
2
Q
depressive episode + symptoms ( 6 )
A
- shows symptoms and presents the same as unipolar depression
- diagnosed when it lasts > 2 weeks minimum
- Features include
- persistent low mood + suicidal thoughts
- low energy and focus
- loss of pleasure and interest (anhedonia )
- lack of appetite
3
Q
manic episodes
A
- a distinct period of abnormally elevated and persistently heightened emotions
Episode is only diagnosed when; - lasts >7 days or more
- minimum of 3 symptoms
- severe enough to cause severe social/occupational functioning
4
Q
manic episode symptoms ( 6 )
A
- increased energy + restlessness
- decreased need for sleep + insomnia
- racing thoughts + poor conc
- increased libido + sexual inhibitions + STI
- Extravagant spending ( shopping sprees + gambling)
- incomprehensible + pressured speech
- psychotic symptoms of delusions + hallucinations
5
Q
hypomania
A
- symptoms of mania are not severe enough to cause marked impairment in social or occupational functioning
- no psychotic features
- epsiodes of less severe high
6
Q
diagnosing hypomania
A
- symptoms last for only 4 days
- not severe enough for impairment socially or otherwise
- no psychosis
7
Q
cyclothymia
A
- milder lows and milder highs
2. patients cycle between hypomania and milder lows for atleast 2 years or more
8
Q
bipolar 1
A
- major lows (depressive episodes) lasting a minimum of two weeks
- major highs (manic episodes) lasting more than 1 weeks thus requiring hospitalisation during this time
9
Q
bipolar 2
A
- Major lows (depressive episodes) lasting minimum of 2 weeks
- less extreme high episodes (hypomanic episodes) lasting for 4 days minimum
10
Q
mixed episodes
A
- experience symptoms of depression and mania at the same time
- rapidly alternate from mania to depression in the matter of a few hours
11
Q
rapid cycling
A
- 4 or more episodes of depression or mania in a given year
2. minimum of 4 depressive, manic, hypomanic or mixed episodes within a 12 month period
12
Q
etiology of bipolar disorder (4)
A
exact underlying cause of bipolar disorder is unknown
- patients with family members with bipolar disorder are 10 x more likely to have it
- drugs + medication can trigger manic episodes e.g. SSRI used in depression can induce manic episodes in suscep patients
- dysfunction of hypothalamic-pituitary-adrenal axis - abnormal secretions of cortisol found in unipolar depression
- psychosocial - traumatic experiences/in childhood can predispose patients
13
Q
what kind of questions to ask?
A
- do you experience moods that are higher than normal?
- do you feel more irritable than usual?
- do you ever have increased energy than usual?
- how much do you sleep?
PATIENTS TEND TO PRESENT TO THE DOCTOR MORE WITH DEPRESSIVE EPISODES
14
Q
management of bipolar disorder?
A
- refer all patients to specialist mental health assesment unit where diagnosis can be made (<14 = CAMHS)
- Evaluate risk of harm to self and to others
- suicidal idealation -> suicidal intent ->
- alcohol + drug misuse
- financial ruin/sti/pregnancy
- adult safeguarding -> risk of exploitation
- risk to others -> dependants?
15
Q
treatment of bipolar disorder
A
- Lithium salts - lithium acts as a mood stabiliser. More effective at treating mania than depressive symptoms
- Antidepressants - SSRI are contraindicated as they can trigger mania
- CBT - not very effective but can help handle stressful situations
- Antipsychotics/Benzodiazapine/ Anticonvulsant
