Bipolar/Mania Flashcards
what was the old name for bipolar/mania?
manic depression
what is criteria for manic episode?
intense alteration in mood- expressed by feelings of elevated, expansive, irritable, persistently increased goal-directed activity or energy, boundless self-confidence, can change quickly to irritation and anger, creates many plans/goals, but are unable to fulfill them
how long does a manic episode need to last for it to fit the criteria?
lasting at least 1 week, most of the day, and nearly every day
what needs to be ruled out for a manic episode to fit criteria?
not due to medications, such as corticosteroids, stimulants, and methamphatamines, substances, and other diseases
what are the side effects of mania?
needs to have at least 3 of the following symptoms to meet the criteria
inflated self-esteem on grandiosity (no filter)- grandiose delusion and persecutory delusions
decreased need for sleep can be some sleep or no sleep)- usually won’t take time to eat well, so it can lead to unintentional weight loss/malnourished
more talkative-usually pressured speech; often circumstantial and tangential
flight of ideas, racing thoughts- loose associations/clang association
distractibility
increase in goal-directed activity (work, school, sexual)/psychomotor agitation- unable to stop moving
excessive involvement in activities that have high potential for painful consequences- can cause financial difficulties (maxing out credit cards), unprotected sex, drugs, and risky behavior
what is hypomania?
euphoric- increased functioning; excessive activity- energy for at least 4 days/at least 3 of criteria of mania met
episode is change for person and is observable by others
episode is not severe enough to impair functioning or require hospitalization
no psychosis with manic portion
not attributable to substance use
criteria for bipolar disorder 2
what are bipolar disorders?
mood swings from profound depression to extreme euphoria (mania), with intervening periods of normalcy
impair occupational functioning or usual social activities or relationships- may require hospitalization to prevent harm to self/others
what are three types of bipolar disorders specturm?
- bipolar 1
- bipolar 2
- cyclothymic
what is bipolar 1 disorder?
full syndrome of manic symptoms- risk for exhaustion
usually alternate with episodes of depression/anxiety and agitation
psychosis is possible- auditory hallucinations are most common
high risk for suicide d/t impulsivity; do not think about their actions and have poor insight
what are some comorbidities of bipolar 1 disorder?
anxiety disorder
ADHD
impulse control
conduct disorder
substance abuse disorder >50%
higher medical issues
what is bipolar 2 disorder?
major depression with episodic occurrence of hypomania (less severe/dramatic than mania episode)
has never met criteria for full manic episode
does not have psychosis unless they develop depression
what are comorbidities with bipolar 2 disorder?
anxiety disorders
eating disorders (binge eating)
substance use disorders
what is cyclothymic disorder?
symptoms of hypomania alternating with mild to moderate depression for at least 2 years (adults)
do not meet criteria for other types- yet disturbing enough to affect functioning
what are the comorbidities of cyclothymic disorder?
substance use disorder
sleep disorder
ADHD
what is bipolar disorder with rapid cycling?
at least 4 episodes in 12 month period
more severe symptoms- resistant to treatment
what changed to disruptive mood dysregulation disorder?
childhood bipolar
if a child/teen has true bipolar, then what are they at risk for?
high risk for suicide
what are the developmental implications for childhood bipolar?
frequency- symptoms occur most days in a week
intensity- symptoms are sever enough to cause extreme disturbances
number- symptoms occur 3 to 4 times a day
duration- symptoms occur 4 or more hours a day
what are the risk factors for bipolar disorder (mania)?
genetic- strong hereditary implications (if parents have it, then a person has a 20% chance of developing it), ANK3 and CACNA1C
biochemical influences- excess of norepinephrine and dopamine; low serotonin; acetylcholine (too much in depression, not enough in mania)
electrolyte imbalance
brain structure and function- grey matter loss causing dysfunction in the prefrontal cortex region, hippocampus, and amygdala; neuroendocrine causing a dysfunction in hypothalamic, pituitary-thyroid adrenal axis, and inflammation activation
psychosocial theories- credibility of psychosocial theories has declined in recent years; disease of brain; psychosocial issues play a role in triggering episodes, but not causative factor
what are some potential bipolar triggers?
stressful experiences
physical illnesses
seasonal changes in weather
some medicines
recreational drugs
what are treatments for bipolar disorder (mania)?
psychopharmacology medications first
what are examples of mood stabilizing medication/antimanic medications?
lithium carbonate (Lithium, Lithobid, Eskalith CR)
