LESSON 5 BIPOLAR Flashcards by Adel Camante

Group of mental disorders which involves alterations of extreme mood – From the peak of euphoria to the depths of despair

Bipolar disorder

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The hallmark is the unusual shifting of mood of an individual

Bipolar disorder

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Manifestation of bipolar disorder (there are periods na nag manifest ang symptoms and meron wala)

Episodic

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Bipolar disorder is under the category of

Mood disorder

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___ and ___ are in one continuum (symptoms can be hand in hand)

Bipolar disorder
Depressive disorder

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___ is in between schizophrenia and depressive disorder

bipolar disorder

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__ and __ have the same genetic predisposition (if one has __then you are predisposed to have __)

bipolar
schizophrenia
schizophrenia
bipolar

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Normal mood swings differ from bipolar disorder as causes can be identified (low score on exam, shift your mood, from happy to sad) while bipolar reason cannot be known

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AT LEAST 1 WEEEK
(may experience irritably mood or energetic, sense of superiority)
- symptoms persist within the day

manic episode

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Associated with AT LEAST 3 of the following if the prominent mood is Irritable the minimum should be 4

Inflated SELF-ESTEEM or GRANDIOSITY (ex: sasali ng Quiz bee kahit dinaman magaling sa math, unrealistic ang confidense)
DECREASED NEED FOR SLEEP (hindi inaantok)
MORE TALKATIVE than usual or pressure to keep talking (wala ng concerned sa ibang tao or nakaka bothered na, wala ng pakialam)
FLIGHT OF IDEAS or RACING THOUGHTS (Thoughts are faster inside mind, hindi ma verbalize ang mga thoughts and lead to incomprehensible)
DISTRACTABILITY (mabilis ma divert ang attention)
Increase in GOAL DIRECTED activity or psychomotor agitation (di mapakali, gagawin kahit hindi trabaho, lulutuin lahat ng pagkain na makita, maglilinis kahit malinis)
Execessive involvement in RISKY ACTIVITIES (Ex: mag open ng business kahit wala namang knowledge or engage unprotected sexual activities, shopping spree)

Manic episode

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ang mood disturbance affect everyday living and may cause HOSPITALIZATION

Manic episode

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kapag ang isang tao ay na hospitalize ang isang taong may manic episode kahit hindi na meet ang 1 week threshold or di nameet ang tatlong symptoms automatic na meet ang manic episode basta na hospitalize

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• Manic episode can have ____ that may lead to hospitalization
• _____episode walang psychotic feature

• manic episode should not be explain by subtance or any other medical condition

Psychotic feature
Hypomanic

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AT LEAST 2 WEEKS

• Affect everyday living and cannot be explain by any other medical condition

Major depressive episode

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5 of the following ang dapat ma meet kung saan ang isa ay dapat (1) DEPRESSED MOOD or (2) ANHENDONIA

Depressed mood (sadness )
Anhendonia (walang nararamdaman na pleasure or fulfillment sa mga activity or hobbies)
Significant weight loss/gain or loss of apetite (kahit hindi naman nag d-diet)
Insomia/ hypersomia nearly everyday
Psychomotor agitation (di mapakali) or retardation (mabagal ang kilos)
Fatigue (kahit walang ginagawa, pakiramdam mo pagod ka)
Feelings of worthlessness or excessive guilt (parang lahat is kasalanan mo)
Diminished to think or concentrate
Suicidal ideation/attempt

Major depressive disoder

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Same in manic episode but the minimum duration is 4 CONSECUTIVE DAYS

• symptoms are NOT SEVERE ENOUGH to cause an impairement and not SEVERE ENOUGHT TO GET HOSPITALIZED

Hypomanic episode

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If there is symptoms in four consecutive days but has psychotic feature it is?

Manic episode

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Presence of atleast 1 MANIC EPISODE (even history) pero pwede din magkaroon ng hypomanic or depressive

• Hindi dapat overlapping with schizoaffective

Bipolar 1

“ Kapag SCHIZOAFFECTIVE kapag nawala yung mood episode mananatili yung psychotic symptoms however kapag BIPOLAR DISORDER kapag nawala ang mood episode mawawala narin ang psychotic feature “

• Kapag nagkaroon ka ng feeling na ok lang na hindi matulog doon nagsisimula ang manic episode

• During manic episode hindi mapapansin ng tao na there is a problem (because they are energetic)

Bipolar 1

may need for HOSPITALIZATION and psychotic feature among other bipolar stage

Bipolar 1

In manic episode nagiging risk taker ang mga tao and later turn into negative emotional state and end with major depressive episode (ex: gambling , extreme gambling leads to loss of family or friends and later turn into sadness (negative) which became a major depressive episode)

• Average onset is 20-30 years old

• Suicide risk is 20-30 times higher compared to general population

• Suicide attempt is much common in women (di completely namatay) kapag completed suicide common in men
• Women much experience depressive symptoms

Bipolar 1

• Genetically 5% -10% is the risk of having __ if there is a history in your family

• Highly correlated to Cannabis or Marijuana that can worsen the symptoms

• Negative experience can trigger relapse

Bipolar 1

• MANIC EPISODE relapse is linked to goal attainment life events (ex: promotion, nagpakasal)

• Common in BIPOLAR DISORDER is single or not married

• Creativity and leadership are associated with manic episode (malaki chance na maka develop)

Under bipolar 1

presence of atleast 1 HYPOMANIC EPISODE and atleast 1 MAJOR DEPRESSIVE EPISODE • Kapag isa lang ang na-meet (Ex: 1 hypomanic hindi pwedeng tawaging ___ • Never dapat ma-meet ang MANIC EPISODE

Bipolar 2

Kapag na meet ang dalawa (1 hypomanic and 1 major depressive) but na meet ang manic episode hindi na pwedeng i-diagnose na may Bipolar 2 ka, bipolar 1 lang )

• Maaring mag cause ng impairement • BIPOLAR 2 is mas matagal ang suffering sa depressive episodes, that is why it is not a milder form of Bipolar 1 - mas common sa bipolar 2 ang seasonal variation in mood (Ex: Kapag tag ulan- depressive episode, kapag tag init- Hypomanic episode)

Bipolar 2

• Average onset is MID-20s (kapag mas tumatanda mas bumababa ang mood episodes) - More common in women • Common risk factor is IMPULSIVITY contributed to suicide attempts

Bipolar 2

Heightened levels of creativity is caused why bipolar disorder doesn’t realize that they need to seek treatment (nakikita nila itong positive rather than negative) • MAS NAKAMAMATAY ang modalities - Genetically - MOTHERs - kapag bagong panganak highly vulnerable sa Hypomanic episode

Bipolar 2

presence of HYPOMANIC and DEPRESSIVE SYMTOPMS for atleast 2 YEARS (1 year for children and adolescence) • Presence lang either 1 never ma meet ang tatlo

Cylclothymic disorder

DO NOT meet the criteria for manic, hypomanic, and major depressive symtomps • Symtomps ay dapat present for atleast HALF THE TIME sa total duration dapat wala sa 2 months na walang symptoms, kung magkakaroon ng pahinga dapat less than 2 months

Cyclothymic disorder

It is a MILDER but MORE CHRONIC (pang matagalan) version of bipolar disorder - Kapag may relative with BIPOLAR 1 Malaking chance na magkaroon nito - Equally in men and women - Onset is BEFORE 10 years old - 15%-50% kapag may__ disorder you will develop Bipolar 1 or Bipolar 2 disorder

Cyclothymic disorder

Atleast 1 MANIC EPISODE (followed by hypomanic and depressive episode) mas maraming na experience na hypomanic episode/mood episode sa bipolar 1 (kahit sobrang tagal na ng experience ng manic episode) (Psychotice feature can be seen) (HOSPITALIZATION)

Bipolar 1

HYPOMANIC and DEPRESSIVE EPISODE (no manic episode) (ang PSYCHOTIC FEATURE ay dapat cause by depressive disorder

Bipolar 2

Presence of HYPOMANIC and DEPRESSIVE SYMTOPMS not fulfill criteria for MDE, MANIC, and HYPOMANIC (mas matagal, CHRONIC

Cyclothymic disorder

___ gold standard for treatment of BIPOLAR DISODER (kayang mag prevent ng suicidal ideations) — MAS LAMANG • VALPORATE is second option (less ang risk)

Lithium carbonate

mas effective kapag yung isang tao is diagnosed with bipolar disorder and have specifier of RAPID CYCLING

Cognitive behavioral therapy

naiibang specifier sa bipolar disorder at major depressive disoder

Rapid cycling

within a YEAR may 4 na MOOD EPISODES (ex: 2024, 4 mood episodes) • Mas common sa female • Mas mahirap i-treat (sever variation ng bipolar disorder) • May ibat ibang pattern

Rapid cycling

• direct ang transition, from having manic episode to depressive symptoms) - Walang pahinga, tuloy tuloy

Rapid switching

ang interval between moods ay DAYS to WEEKS (Ex: may mood episode ngayon after 4 days meron uli)

Ultra rapid cycling

ang interval lang ay 1 araw/ 24 hours in between episodes • Kapag gabi doon nag switch papuntang depresive episode, kapag MANIC or HYPOMANIC nangyayari naman during day time

Ultra ultra rapid cycling

• low level of serotonin, dopamine, norepinephrine are linked to bipolar disorder • Poor sleep quality is linked to negative Mood

Rapid cycling

- “POSITIVE” Stress is linked to manic and hypomanic episodes (life experiences, ex: nag asawa or na promote )