bipolar related disorders

Question 1

mania diagnosed?

Answer 1

distinct, abnormal, elevated, expansive, or irritable mood for at least 7 days. at least 3 of the following must be included: increased self-esteem/grandiosity, decreased sleep, increased speech, racing thoughts, distractibility, increased activity, increased dangerous impulsitivity. and this must cause distress or dysfunction.

Question 2

What does DTRHIGH stand for and pertain to?

Answer 2

this is how we diagnose mania. distractive, talkative, racing thoughts, hyperactive, impulsive, grandiose, hyposomnic

Question 3

what is hypomania?

Answer 3

milder form of mania. must occur for at least 4 days or more. same symptoms as mania, the symptoms provide unequivocal change in function that is noticed by others. not severe enough to cause marked impairment. must distress function.

Question 4

major depressive episode

Answer 4

pervasive, sad, or irritable mood for at least 2 weeks. must cause distress.

Question 5

bipolar 1

Answer 5

must have manic event. typically is followed by depressive event, but not necessarily. mania + MDE

Question 6

bipolar 2

Answer 6

must have hypomanic event. typically followed by depressive event, but not necessarily. hypomania + MDE

Question 7

cyclothymia

Answer 7

minor depression or dysthymia with 2 years of hypomania.

Question 8

other characteristics of mania/BP?

Answer 8

increased sexual activity, increased seductive flashy dress with accessorizing, increased anger and escalation, increased energy (able to work more, be more creative, think outside of the box and take chances), can become psychotic and have thought disorder, hallucinations, delusions.

Question 9

what other impairments are caused?

Answer 9

increased risk of job loss, divorce, legal action. can spend more time depressed than manic; depressed becomes more disabling, but the manic episodes become more catastrophic.

Question 10

how many months does the average person spend euthymic?

Answer 10

6 months. this could possibly make it harder for the diagnosis.

Question 11

can stress increase mania?

Answer 11

yes. it can lower compliance, disrupt sleep and rhythm and cause substance abuse.

Question 12

do we use antidepressants for bp depression?

Answer 12

try not to use them. they can increase manic symptoms. if we do we use mood stabilizers

Question 13

antipscyhotics?

Answer 13

we can use them. they can block the D2 and resolve some manic symptoms. they all block serotonin 5HT2a receptors and thus are reasonable for treating depression. they do have the unique ability to treat both sides of bp

Question 14

how to treat mania?

Answer 14

psychotherapy does not work! need to use lithium, divalproex, carbamezine, atypical antipsychotics (all block D2 receptors and improve neuronal health and connectivity).

Question 15

in a patient with mania what treatment do you want to use?

Answer 15

you want to use something that will decrease neuronal firing. we typically do this through sodium channels inhibitors like carbamezine.