Bipolar Disorders Flashcards
Affective Disorders
- Major depressive disorder
- Dysthymic disorder
- Bipolar disorder: types I and II
- Cyclothymic disorder
- Seasonal affective disorder (SAD)
- post partum disorder
Bipolar Disorder
Characterized by the occurrence of one or more manic episodes or mixed episodes (mania and major depression), that cause marked impairment in social activities, occupational functioning, and interpersonal relationships and many individuals require hospitalization to prevent self-harm. The full range of behaviours may occur across the mood range
Manic episodes
- periods in which the individual experiences abnormally and persistently elevated, expansive, or irritable mood characterized by inflated self-esteem, decreased need to sleep, excessive energy of hyperactivity, racing thoughts, easy distractibility, and inability to stay focused
- other symptoms can include hyper sexuality and impulsivity
Bipolar I Disorder
- Characterized by the occurrence of one or more manic episodes or mixed episodes (mania and major depression), and often one or more major depressive episodes
Bipolar II Disorder
Characterized by a re-occurring major depressive episode either currently or in the past, and at least one hypomanic episode
Characterized as less severe
Cyclothymic Disorder
- Defined by chronic fluctuations of mood from numerous periods of both depressive symptoms and hypomania
- Diagnosis is not made unless the patient has been free of major depression, manic, or mixed episodes for at least two years
- There is usually no sign of a normal range of mood
Strategies for Optimal Assessment
- changes in sleep and eating pattern
- elated mood, irritated, agitation, grandiose thinking
- low concentration, disjointed, distorted thinking
- hallucinations, delusions
- low self-care
- high possibility of injury to self and others
- low interpersonal relations
- low occupational functioning
- hyper sexuality, risky sexual practices
Diagnosing and Planning Appropriate Interventions
- rule out any medical problems
- meeting the patient’s focused needs
- nurse and patient collaboratively determine the outcomes to be achieved
Treatment Options
- pharmacological therapy: mood stabilizers alone or in combination with antipsychotics or benzodiazepines if psychosis, agitation, or insomnia is present and antidepressants for unremitted depression
- family therapy or couples therapy
- cognitive behavioural therapy
- individual therpay
- patient and family education
- electroconvulsive therapy
Implementing Effective Interventions
- nurse and patient collaboratively determine the outcomes to be achieved
- re-establish sleep and nutrition
- offer snacks, high energy foods, finger foods
- short 1-1 interventions
- limit setting, offer protection (physical, psychological , emotional, social)
- environment: calm, safe, soft colour, low noise
- offer routine and structure
Evaluating
- objective re-assessment of interventions and self reflection
- this phase is also part of the termination of the patient-patient relationship
- many times a patient will have a setback due to their feeling of loss of this relationship
Interventions: Depression
- Medication
- Hospital, outpatients, home
- protection: self-harm
- Possible suicide
- short 1-1 interaction
- offer structure
- approach: calm, warm, accept, slow pace
- patience, presence, listen, respect
- no sympathy/over identification
- groups: structured & non-structured
- environment: low stimuli
- help with physical care
- Nutrition: weight, finger foods
- Sleep: no naps, day program
- Directions; simple
- Activities: achievable, what they can do
- Goals: reachable
Interventions: Mania
- Medication
- Hospital, outpatients, home
- protection: self-harm and harm to others
- Limited risk for suicide
- approach: calim, warm, accepting
- patience, presence, listen, respect
- no sympathy but empathy
- no groups
- environment: low stimuli
- help with physical care
- nutrition: weight, finger foods
- Sleep: naps
- Directions: simple
- Activities: limited
- Goals: reachable