MH: Chapter 13: Bipolar and Related Disorders

Play an AI-generated podcast conversation about this lesson

What is Bipolar I Disorder characterized by?

It only involves major depressive episodes

It never includes hypomanic episodes

It is not a mental health condition

One or more manic episodes (correct)

What is a manic episode in Bipolar I Disorder? (Select all that apply)

Characterized by depressive moods

Lasting less than one day

Lasting at least one week (correct)

A period of abnormally elevated or irritable mood and increased energy or activity (correct)

During a manic episode, individuals may experience which of the following symptoms? (Select all that apply)

Inflated self-esteem or grandiosity (correct)

Decreased need for sleep (correct)

Increased talkativeness or pressure to keep talking (correct)

Feeling lethargic and unmotivated

While not required for a diagnosis, many individuals with Bipolar Disorder I will also experience depressive episodes.

True (A) Signup and view all the answers

While not required for a diagnosis, many individuals with Bipolar Disorder I will also experience depressive episodes. Which of the following symptoms can these episodes include? (Select all that apply)

Persistent sadness or low mood (A), Loss of interest or pleasure in activities (C), Sleep disturbances (insomnia or hypersomnia) (@) Signup and view all the answers

Bipolar II Disorder does not include full-blown manic episodes.

True (A) Signup and view all the answers

What is true about hypomanic episodes?

They last for at least four consecutive days. (A) Signup and view all the answers

Hypomanic episodes are more severe than manic episodes and lead to significant impairment in social or occupational functioning.

False (B) Signup and view all the answers

Hypomanic episodes involve a noticeable change in mood and increased energy or activity lasting at least four consecutive days.

True (A) Signup and view all the answers

Symptoms of hypomanic episodes can include which of the following? (Select all that apply)

Decreased need for sleep (B), Elevated or irritable mood (A), Increased self-esteem or grandiosity (C) Signup and view all the answers

Individuals with Bipolar II typically don't experience major depressive episodes.

False (B) Signup and view all the answers

Which of the following symptoms are associated with major depressive episodes in individuals with Bipolar II? (Select all that apply)

Significant changes in appetite or weight (D), Persistent sadness or low mood (A), Loss of interest or pleasure in almost all activities (C) Signup and view all the answers

Mania is an abnormally elated mental state, typically characterized by feelings of euphoria, lack of inhibitions, racing thoughts, diminished need for sleep, talkativeness, risk taking, and irritability.

True (A) Signup and view all the answers

Mania interferes with lifestyle in a negative manner, requiring hospitalization to control severe symptoms and psychotic features.

True (A) Signup and view all the answers

Manic patients will do many risky things as a result of the raced thoughts they experience, which will endanger their lives as well as other people's lives.

True (A) Signup and view all the answers

Hypomania is an abnormal psychological state that is similar to but milder than mania, characterized by an elevated or agitated mood and commonly occurring in people with bipolar disorder.

True (A) Signup and view all the answers

People in a hypomanic state have more severe symptoms which are serious enough to need hospitalization.

False (B) Signup and view all the answers

A state of hypomania may also bring happiness and joy to one's life since the elevated moods do not do any harm or put the lives of affected individuals in danger.

True (A) Signup and view all the answers

Which of the following statements about appearance in a Mental Status Exam for a Bipolar patient experiencing Mania or Hypomania is true? (Select all that apply)

Patients may appear disheveled or overly dressed. (A), Flamboyant clothing may be observed in some patients. (C), o Increased energy can result in a more animated posture or expressive gestures. (D) Signup and view all the answers

Which of the following statements about Behavior in a Mental Status Exam for a Bipolar patient experiencing Mania or Hypomania is true? (Select all that apply)

Often engages in excessive talking (pressured speech) and may interrupt others. (A), May exhibit hyperactivity, restlessness, or increased motor activity. (B) Signup and view all the answers

Which of the following statements about Mood and Affect in a Mental Status Exam for a Bipolar patient experiencing Mania or Hypomania is true? (Select all that apply)

Affect may be exaggerated; fluctuating between elation and irritability. (A), Mood is often euphoric, excessively cheerful, or irritable. (B) Signup and view all the answers

Which of the following statements about Speech in a Mental Status Exam for a Bipolar patient experiencing Mania or Hypomania is true? (Select all that apply)

Speech may be pressured, rapid, and difficult to interrupt. (A), Flights of ideas are common, where the person jumps from one topic to another without logical connection. (B) Signup and view all the answers

Which of the following statements about Thought Process in a Mental Status Exam for a Bipolar patient experiencing Mania or Hypomania is true? (Select all that apply)

Thought processes may be tangential, with ideas rapidly shifting. (A), Possible presence of grandiosity or inflated self-esteem; the patient may have an unrealistic perception of their abilities. (B) Signup and view all the answers

Which of the following statements about Thought Content in a Mental Status Exam for a Bipolar patient experiencing Mania or Hypomania is true? (Select all that apply)

May have delusions of grandeur or inflated self-significance (e.g., believing they possess special powers or knowledge). (A), Can exhibit racing thoughts, making it difficult for the examiner to keep up with their narrative. (B) Signup and view all the answers

When examining perception in a Mental Status Exam for a bipolar patient experiencing mania or hypomania, the patient may report hallucinations (auditory or visual), though these are less common in pure mania than in mixed episodes or psychotic states.

True (A) Signup and view all the answers

Which of the following statements about Cognition in a Mental Status Exam for a Bipolar patient experiencing Mania or Hypomania is true? (Select all that apply)

Attention and concentration may be compromised due to distractibility. (A), Orientation is generally intact unless the manic episode is severe. (B) Signup and view all the answers

Which of the following statements about Insight and Judgement in a Mental Status Exam for a Bipolar patient experiencing Mania or Hypomania is true? (Select all that apply)

Judgment can be impaired, leading to risky behaviors (e.g., spending sprees, reckless driving). (A), Insight may be poor; the individual may not recognize their condition as a problem or may underestimate the consequences of their actions. (B) Signup and view all the answers

What is a common mood stabilizer used in the treatment of bipolar disorder?

Lithium (A) Signup and view all the answers

Which of the following anticonvulsants are used to treat mania? (Select all that apply)

Depakote (A), Oxcarbazepine (B), Carbamazepine (D) Signup and view all the answers

Which of the following anticonvulsants is used to treat depression in bipolar disorder?

Lamotrigine (A) Signup and view all the answers

Which of the following antipsychotics are commonly used in the treatment of bipolar disorder? (Select all that apply)

Aripiprazole (A), Lurasidone (B), Quetiapine (C) Signup and view all the answers

Which of the following components is typically included in a Mental Status Exam? (Select all that apply)

Behavior (A), Mood and Affect (B), Thought Process (D) Signup and view all the answers

Which of the following statements accurately describe the mechanism of action of lithium? (Select all that apply)

It modulates levels of serotonin and norepinephrine. (B), It promotes neuroprotection and neuroplasticity. (C) Signup and view all the answers

Lithium is primarily indicated for which of the following conditions? (Select all that apply)

Bipolar Disorder: To manage acute manic and mixed episodes, as well as to prevent future episodes of mania and depression. (A), Major Depressive Disorder: Often used as an adjunct to antidepressants for treatment-resistant depression. (B), Suicidal Ideation: Because it reduces the risk for suicidal completion. (C) Signup and view all the answers

Lithium is typically administered in which form?

Oral form (tablet or liquid). (A) Signup and view all the answers

Dosage of lithium varies based on individual factors, including the specific condition being treated, individual response, and serum lithium levels.

True (A) Signup and view all the answers

What is the optimal therapeutic range for serum lithium levels to ensure therapeutic effectiveness and avoid toxicity?

0.6 - 1.2 mEq/L (B) Signup and view all the answers

Which systems should be monitored during lithium treatment due to its potential effects?

Renal and thyroid function (B) Signup and view all the answers

Which of the following are common side effects of lithium? (Select all that apply)

Gastrointestinal upset (nausea, diarrhea) (A), Weight gain (B), Fatigue (C), Tremors (especially in the hands) (D), Increased thirst and urination (polyuria and polydipsia) (@) Signup and view all the answers

Which of the following are serious side effects of lithium? (Select all that apply)

Lithium toxicity, including symptoms such as confusion and tremors (A), Renal impairment or changes in kidney function (B), Hypothyroidism affecting thyroid hormone levels (C) Signup and view all the answers

What symptoms are indicative of lithium toxicity when blood levels exceed the therapeutic range? (Select all that apply)

Confusion (A), Severe tremors (B), Ataxia (C) Signup and view all the answers

What are the indications for Divalproex Sodium (Depakote)?

Mania (B), Mood instability (irritability) (D) Signup and view all the answers

What is the proposed mechanism of action for Divalproex Sodium (Depakote)?

Increasing levels of gamma-aminobutyric acid (GABA) (B), Modulating various neurotransmitter systems involved in mood regulation. (D) Signup and view all the answers

What factors influence the dosage of Depakote for managing mania?

All of the above (D) Signup and view all the answers

What is the therapeutic range for Depakote levels in the blood?

50 to 125 mcg/mL (B) Signup and view all the answers

Which of the following statements regarding Depakote is true?

Liver function tests should be conducted when using Depakote. (B) Signup and view all the answers

Which of the following are known side effects of Depakote? (Select all that apply)

Tremors (@), Mood changes or behavioral disturbances (@), Sedation (A) Signup and view all the answers

Which of the following are serious side effects of Depakote? (Select all that apply)

Liver toxicity (A), Pancreatitis (B), Thrombocytopenia (C) Signup and view all the answers

Depakote should be used with caution in individuals with liver disease, pancreatitis, bleeding disorders, or a history of urea cycle disorders.

True (A) Signup and view all the answers

When giving a patient Depakote, it is not essential to monitor for potential drug interactions if the patient is on other medications.

False (B) Signup and view all the answers

What are common safety risks associated with bipolar disorder? (Select all that apply)

Risk to self (A), Risk to others (B), Sleep disturbance (C), Hallucinations and/or delusions (D), Non-adherence (@) Signup and view all the answers

What is the duration requirement for symptoms to be considered cyclothymia in adults?

At least two years (B) Signup and view all the answers

Which of the following symptoms are characteristic of hypomanic episodes in cyclothymia? (Select all that apply)

Elevated mood (B), Decreased need for sleep (D), Increased energy (A) Signup and view all the answers

Which statement about depressive symptoms in cyclothymia is true?

Individuals may experience low energy, feelings of sadness, hopelessness, or irritability. (B) Signup and view all the answers

Cognitive Behavioral Therapy (CBT) for Bipolar Disorders or cyclothymia focuses on recognizing and changing negative thought patterns and behaviors. Is this statement true or false?

True (A) Signup and view all the answers

What is the primary focus of Interpersonal Therapy for Bipolar Disorder or cyclothymia?

Addressing interpersonal issues and improving communication skills (B) Signup and view all the answers

Why is psychoeducation important for patients with Bipolar or cyclothymia?

It helps patients and their families understand the disorder. (A) Signup and view all the answers

Which lifestyle modification is essential for managing symptoms of bipolar disorder?

Establishing regular routines for sleep, diet, and exercise (C) Signup and view all the answers

Bipolar I Disorder

Characterized by one or more manic episodes.

Manic Episode

A period lasting at least one week with elevated mood.