Bipolar Disorders Flashcards
What are Bipolar Disorders characterised by?
Manic/hypomanic episodes and depressive episodes.
What does the name Bipolar mean?
Bi = two; Polar = opposite ends of the mood spectrum.
What kind of condition is Bipolar Disorder?
It is a chronic, episodic condition. It requires lifelong management.
What are the main (broad) issues that Bipolar Disorder is associated with?
Functional impairment;
suicide risk;
psychiatric and medical comorbidities.
What are three phases of illness/treatment for Bipolar Disorder?
Acute Stabilisation, ongoing maintenance, relapse prevention.
Treatment will differ throughout the course of the illness, based on what?
Based on the phase, severity and polarity.
What does treating Bipolar Disorder based on the polarity of the episode mean?
Which extreme side of the spectrum someone’s mood is (high vs. low).
In the DSM-5, what is criterion A. for a manic/hypomanic episode?
(two points)
- abnormally & persistently elevated, expansive or irritable mood, and
- increased goal directed activity/energy, present nearly every day.
According to the DSM-5, what is the difference in duration between a manic and hypomanic episode?
Manic - at least one week (or any duration if hospitalisation is needed).
Hypomanic - at least 4 consecutive days.
What are the 7 points for Criterion B. in the DSM-5’s definition of Bipolar? (for both Bipolar 1 & 2).
- inflated self-esteem or grandiosity.
- decreased need for sleep.
- rapid or pressured speech.
- flight of ideas or racing thoughts.
- distractibility.
- increase in goal-directed activity or psychomotor agitation.
- excessive involvement in risky activities (that will likely have negative consequences).
Of the 7 points for Criterion B. of Bipolar Disorder, how many are necessary for diagnosis? And to what extent?
At least 3 or more (4 if person is just irritable).
Significant presence in person that is noticeably different from usual behaviour.
Give an example of what the beginnings of a manic episode might look like?
Start by having a brilliant idea at work - something ground-breaking.
Focus intensely on idea, there is new-found efficiency, work is high quality, easier to complete.
Increased energy, drive toward goals.
What might someone in a manic state be oriented toward?
Pleasure seeking, such as buying things, sex, risky behaviour. Can’t see the negative consequences of behaviour.
What behaviour does the energy of a manic episode often produce?
Excessive exercise.
How might someone describe what they look like when they are in a manic episode?
They look brighter, sharper, more excited; ‘you can see it in their eyes’.
What are some negative experiences/emotions of a manic episode?
Can be traumatic, go into psychosis, feel paranoid, see connections between things, connections everywhere.
Still feels exciting but it is terrifying.
Which ‘episodes’ are necessary for a Bipolar 1 diagnosis?
Manic - necessary.
Hypomanic - NOT necessary (but can be present).
Depressive - NOT necessary (but can be present).
Typically B1 has both depressive and manic episodes.
Which ‘episodes’ are necessary for a Bipolar 2 diagnosis?
Manic - NOT necessary.
Hypomanic - necessary.
Depressive - necessary.
In Bipolar 1, what is the average ratio of manic to depressive episodes?
1:3 - depression occurs 3 times more than mania.
While Bipolar 1 has been present in literature for centuries (‘unexplainable joy and sorrow at the same time’), in which century was it that the illness was first classified?
18th century.
In Bipolar 1, what are the manic and depressive episodes deviations from?
They are deviations from wellness.
In Bipolar 1, what are ‘period’s of wellness’ considered to be?
Period’s of wellness are considered ‘remissions’.
When is the typical onset of Bipolar 1? Does it differ from time of diagnosis?
Early adulthood. Diagnosis isn’t always made at this time because the first manic episode may not be until much later.
Diagnosis of Bipolar 1 is normally made when mania is severe enough to - what?
- disrupt social life and work.
At the severe end (top of the curve) of mania, what can it delve into?
Psychosis - hallucinations, paranoia, catatonia, jumbled thoughts.
Why is it important to quickly medicate severe mania, particularly if there are psychotic symptoms??
Because being in psychosis and severe mania can have an impact on the brain.
How do hypomanic episodes differ from manic episodes? (3)
Hypomanic episodes are less severe than manic episodes, shorter in duration and not severe enough to result in hospitalisation.
Although hypomanic episodes differ from manic episodes, why are they still important?
Because the changes in functioning, and mood disturbances, are uncharacteristic of the individual and noticeable to others.
Hypomanic episodes do not DISRUPT functioning but can still impair functioning.
