Exam 2 - Bipolar Disorder

Question 1

Bipolar Disorder:

DSM-5 Criteria: Mania/Manic Episode

Answer 1

Must have: both
1. Distinctly elevated or irritable mood
2. Abnormally increased activity or energy

Must have 3 of the following:

• Increased goal-directed activity
• Talkative/ rapid speech
• Racing thoughts
• Decreased need for sleep
• Increased self-esteem
• Distractibility
• Excessive risky behavior

Question 2

Bipolar Disorder: Episode Types:

Manic Episode & Hypomanic Episode

Answer 2

Manic Episode: Mania that…

• 1+ weeks, Most of the day, Nearly every day OR requires hospitalization

Hypomanic Episode:

• 4+ days of clear changes in functioning/behavior BUT impairment isn’t as significant

Question 3

Bipolar Disorder Types

Answer 3

Two Types:
1. Bipolar Disorder I.
2. Bipolar Disorder II.

_Bipolar I. _→ at least one Manic Episode

Bipolar II.→ Includes hypomanic episodes – not full manic episodes

Question 4

Identify the Bipolar Disorder Type:

Answer 4

Bipolar I. Disorder

• Because they had experienced Mania (aka: a Manic Episode)

Question 5

Identify the Bipolar Disorder Type:

Answer 5

Bipolar II. Disorder

• Because they only had hypomania (no Mania/Manic Episode)

Question 6

Bipolar Disorder:

Prevalence, Onset Age, Gender

Answer 6

Prevalence:

• Bipolar I. → affects ~1% of population
• Bipolar Types combined → ~ 4%

Average Onset Age: Between 18 - 22 years old

Gender:

• Prevalence: No gender differences
• Symptoms: Women report more depressive episodes

Question 7

Bipolar Disorder - Suicide Risk

Answer 7

~ 15% of people with a diagnosis die by suicide

25% report suicide attempts

> 50% report suicidal ideation in the past 12 months

Question 8

Bipolar Disorder:

Biological - Gene’s

Answer 8

Heritability = high.
* Ranges from 70-90% heritability

Shares genetic risk factors with schizophrenia and MDD

Question 9

Bipolar Disorder: Etiology (causes)

Biological: Brain + Genetics

Answer 9

Heritability = high.
* Ranges from 70-90% heritability

Genetics → Shares genetic risk factors with Schizophrenia and MDD

Brain:

• Reduced Volume: Prefrontal, & Limbic Structures
• Increased Activation: emotion regions (amygdala + striatum)
  
  • increased response to high rewards
• Mania → Hypersensitivity to dopamine receptors

Question 10

Bipolar Disorder:

Reward Sensitivity

Answer 10

Reward Sensitivity: How motivated/excited a person is to obtain a reward

• increased response to reward cues
• Reward Sensitivity: Predicts BP onset & severity of symptoms

Question 11

Bipolar Disorder:

Goal Striving

Answer 11

Goal Striving: Increased pursuit of extreme goals

• Ie: if you do this thing you will win a million dollars
• Atypical Goal Striving → Predicts future Mania symptoms & onset of BD

Question 12

Bipolar Disorder: Treatments

Answer 12

1. Medication: 1st line of treatment
2. Talk Therapy: very useful when paired with medication

Question 13

Bipolar Disorder Treatments: Medication

Answer 13

Medications:

• Mood stabilizers
• Anticonvulsants
• Antipsychotics

Mood Stabilizer: Lithium

• Very effective Mood Stabilizer
  * 1/3 of patients = dramatic improvement
  * 1/3 = some improvement
  * 1/3 = no improvement
• Protective Against Suicide

Antidepressants = Risky Meds:

• Potential to trigger Mania
  * BUT helpful when paired with Mood Stabilizers to prevent triggering mania

Risky Behaviors: Medication non-compliance is high in BD

Question 14

Bipolar Disorder Treatments: The 4 Types of Talk Therapy

Answer 14

1. Psychoeducation & Family-Focused Education
2. Social Rhythms Therapy
   • Create Routines + Life Charts to help regulate mood (ie: sleep)
   • Life Carting: Identifying personal patterns & triggers
3. Goal Regulation
   • Break down large goals into smaller steps (goal pacing)
4. Behavioral Activation
   • use it carefully start small, build up

Question 15

Bipolar Disorder: Art & Creativity

Answer 15

Bipolar Disorder: x10 more prevalent in artists