Session 12 - treatments of mood disorders and maintenance of bipolar disorder

Question 1

biological treatment of depression?

Answer 1

antidepressants:

• Selective serotonin uptake inhibitors (SSRIs) = first line eg. fluoxetine
• SNRIs, TCA - tricyclic antidepressants (not as popular because SE’s and it’s very toxic is OD therefore don’t want give to a depressed patient), lithium
• in life threatening situations/if pt treatment resistant - ECT

Question 2

psychological treatment of depression?

Answer 2

first line - CBT - problem focused, challenge thoughts and behaviours → low chance to get CBT in a timely way therefore often end up getting medication first

Question 3

social treatment of depression?

Answer 3

help with isolation and social stressors (incl housing, finances)

Question 4

biological treatment of mania?

Answer 4

• first line = antipsychotics (dopamine antagonist) - act quickly
• mood stabilisers (lithium or sodium valporate) - take longer to work

Question 5

psychological treatment of mania?

Answer 5

• unlikely to be unhelpful
• longer term - psychoeducation about triggers and signs of relapse

Question 6

social treatment of mania?

Answer 6

• treat in a place of safety where risk to self and others is minimal
• consideration of the implications of mania eg. debts (excessive spending), STIs, pregnancy

Question 7

why is the treatment of bipolar depression difficult?

Answer 7

can easily tip them into the other extreme by treating one - want to balance getting the patient into the euthymic state without tipping them into mania

Question 8

biological treatment of bipolar depression?

Answer 8

• antidepressant but with mood stabiliser to prevent being sent into mania
• can also give ECT or lithium

Question 9

psychological treatment of bipolar depression?

Answer 9

CBT

Question 10

social treatment of bipolar depression?

Answer 10

(same as unipolar depression).

Question 11

how can you maintain stability of bipolar depression biologically?

Answer 11

• mood stabilisers eg. lithium, sodium valporate
• antipsychotics - used as mood stabiliser eg. Quetiapine

Question 12

how can you maintain stability of bipolar disorder
psychologically?

Answer 12

• psychoeducation abt BPAD
• CBT - prevent relapse

Question 13

how can you maintain stability of bipolar disorder socially?

Answer 13

consideration of effects BPAD on employment eg. shift work, involvement of family, education of family etc

Question 14

why shouldn’t sodium valproate be used with pregnancy women/women of child bearing age

Answer 14

it’s teratogenic