Bipolar Pathophysiology Flashcards
Mood is known as a pervasive + sustained emotion/feeling that influences…
A person’s behaviour, and influences their perception of the world
Fluctuations in mood are normal. What is not normal are…
Persistent episodes in extreme ends of the spectrum, or rapid fluctuations in mood that impair functioning
Bipolar 1 Disorder is classified as…
Distinct period of…
A distinct period of at least 1 week of a full manic episode
Bipolar 2 Disorder is classified as…
Both ends of the spectrum~
A current or past hypomanic episode and a current or past major depressive episode
Bipolar disorder is a lifelong illness, with variable course, meaning that…
Outcomes?
Full recovery/maintenance is possible, but a cure is not possible yet
Some risk factors for developing Bipolar include…
First-degree relative with BD (genetics)
Drug/alcohol abuse
Medical conditions involving CNS, hormones, endocrine dysfunction
Period of high stress/major life changes
Multifactorial
Exact cause is unknown: several theories involving neurotransmitters + signal transduction have been proposed
A class of drugs that is known to cause secondary mania is…
And why?
Antidepressants
Prescribed in unipolar depression with no history of mania - then mania begins
Would have to abruptly stop - withdrawal side fx
Other drugs besides antidepressants that are notable for causing mania include…
Anything that increases NE or dopamine (stimulants)
Corticosteroids
Thyroid medications
Recreational drugs (alcohol, weed)
2/3 of people with bipolar have some symptoms before the age of 19, but these symptoms…
This is bad, because…
Are usually part of the depressive pool
…Hence treated like unipolar depression
Often leads to longer delays in treatment, greater depressive symptoms severity, higher levels of substance use
Mixed state refers to…
Having both manic and depressive symptoms at the same time
The kindling theory states that…
Relates to prognosis of BD
“Abnormalities lead to more abnormalities” - syndromal episodes increase vulnerability to more episodes
Harder to stay in euthymic states
Which can then lead to neurodegeneration + deficits in function
Often occurs without treatment
The best predictor of level of functionining in someone with BD is…
Medication adherence
Yet ~50% of patients d/c medication due to adverse events
Comorbid conditions that may worsen BD include…
Anxiety disorders
Substance use disorder
ADHD, PTSD
Other medical comorbidities
Medications that are often used 1st line may worsen BD
Something that should be done for all patient interactions with BD is…
Comprehensive assessment for suicide risk
C-SSRS
Mania is diagnosed via…
What symptoms and how do they affect the individual?
Persistent + abnormally elevated mood (irritable/expansive) and energy with at least 3+ specific changes from usual behaviour
Need to occur nearly everyday for at least a week, and significantly impair functioning/psychotic features/hospitalization
CANNOT be due to physiological effects of substance/other medication
