Bipolar Disorders

An abnormally and persistently elevated, expansive, or irritable mood, accompanied by increased energy and goal-directed behavior.

A distinct period of abnormally elevated, expansive, or irritable mood that lasts at least one week or less if hospitalized.

Rapid shifts in mood with little change in external events.

A severe bipolar disorder characterized by manic episodes and potentially depressive episodes.

A less severe form of bipolar disorder with hypomania (milder mania) alternating with depressive episodes and not experiencing a full manic episode.

A less severe form of mania, characterized by elevated mood and energy but not as disruptive as full mania.

Disturbances in thinking, such as hallucinations and delusions, that can occur in some bipolar disorders.

A mood disorder characterized by manic episodes and, sometimes, depressive episodes.

Diagnostic criteria for Bipolar I Disorder, divided into categories.

A less severe form of mania, may increase functioning.

A mood disorder featuring hypomanic episodes and major depressive episodes.

A period of serious depression lasting for at least two weeks, impacting daily life.

Chronic mood swings with hypomanic and depressive episodes that don't meet full criteria for Bipolar Disorder.

Depression often appears first in children, marked by intense emotions and may differ by developmental level.

Older adults may have increased neurologic and cognitive problems, with a possible decrease in mania incidence.

A bipolar episode where symptoms of both depression and mania are present nearly every day for at least a week, causing significant impairment in daily life. May require hospitalization or include psychotic features. Must not be caused by a medical condition or substance.

The fluctuations between depressive and manic (or hypomanic) periods in bipolar disorder.

Characterized by irritable hypomanic episodes that do not pose a risk to the individual's well-being.

Characterized by irritability and sleep disturbances.

Symptoms include extreme energy, inflated self-importance, reduced sleep, pressured speech, racing thoughts, distractibility, goal-focused obsession, excessive arousal, and potentially dangerous behaviors like risky spending.

The lifetime prevalence of bipolar disorder is 1% to 4%. The typical symptom onset is adolescence (14-21). No gender differences in frequency.

Women are at higher risk for rapid cycling and depression, while men are more prone to manic episodes during the illness course. Postpartum psychosis increases subsequent bipolar conversion risk significantly.

Bipolar disorder often co-occurs with other conditions, primarily anxiety disorders like panic disorder and social phobia, and substance use.

Giving birth can initiate the first signs of bipolar disorder, possibly due to hormonal shifts and sleep loss.

Bipolar disorder frequently co-occurs with anxiety disorders, attention deficit/hyperactivity disorder, impulse control disorders, and substance use disorders.

Biological theories, chronobiologic theories, and genetic factors contribute to the development of bipolar disorder.

Sleep disruptions can induce mania in some individuals with bipolar disorder, potentially due to changes in neurotransmitters and hormones.

Twin, family, and adoption studies support a strong genetic link to bipolar disorder (e.g., relatives of bipolar patients have a 25% increased risk of bipolar disorder or major depressive disorder).

Imbalances in neurotransmitters like norepinephrine, dopamine, and serotonin are factors in bipolar disorder, with potential excess in mania.

Reducing environmental stress and trauma in vulnerable individuals is a focus of psychological theories in understanding bipolar disorder.

A medication for bipolar disorder considered as effective as lithium.

Side effects can include sedation, tremor, weight gain, and pancreatitis.

Liver function tests (LFTs) and complete blood counts (CBC) are needed before starting Depakote.

Can be an effective treatment for bipolar disorder, especially for those with limited response to lithium.

Requires baseline LFTs and CBCs due to potential bone marrow suppression and liver inflammation.

Rare, but serious side effects like agranulocytosis (low blood cell count) or Stevens-Johnson syndrome (serious skin reaction).

A newer anticonvulsant effective for treating rapid cycling bipolar disorder.

Does not require routine blood monitoring, which is an advantage to patients.

Can cause Stevens-Johnson syndrome, a potentially life-threatening skin reaction.

A serious skin condition characterized by a rash, blisters, and potential shedding of skin.

Describes the range of moods and their corresponding affects in people with bipolar disorder, varying from anxious to euthymic to expansive.

Potential negative outcomes if a manic patient doesn't receive proper treatment, including suicide attempts, substance abuse, relationship issues, and medical complications.

Describes common traits seen in patients who are experiencing mania, such as manipulation, demanding behavior, and a tendency towards splitting (extreme opinions).

Strategies nursing staff should use to handle patients experiencing mania, such as frequent meetings to discuss patient behavior and staff responses, and setting clear limits.

Important factors to consider in assessing a patient with bipolar disorder, including potential danger to self or others, need for protection, potential need for hospitalization, and overall medical assessment.

Potential problems linked to bipolar disorder, like risks of injury and violence (self-harm or harm to others), ineffective coping, nutritional deficiencies, sleep difficulties, mood alterations, and thought process disturbances.

Describes the challenges and importance of maintaining a therapeutic relationship with a bipolar patient, involving calmness, focusing on patient needs, respect, and providing support to prevent relapse.

Focuses on maintaining stable mental health periods to support the patient with stress reduction, illness management, and relapse prevention strategies.

Maintaining physical health is important in recovery from bipolar episodes, including adequate rest, hydration, and nutrition; aiding with physical well-being.

Treatment aims for quick symptom control and preventing further episodes, or reduce severity/frequency of episodes.

Medications used to stabilize mood swings, including lithium, and anticonvulsants like divalproex (Depakote), carbamazepine (Tegretol, others).

Medications used for short-term relief if agitation (anxiety or restlessness) is present, like clonazepam (Klonopin), and lorazepam (Ativan).

Medications used for psychosis and mania, examples include olanzapine (Zyprexa), and risperidone (Risperdal).

Specific blood levels of lithium are important for effective treatment; acute treatment range is 0.8 to 1.5 mEq/L, while maintenance levels are typically 0.6 to 1.2 mEq/L. Toxic levels are 1.5 mEq/L or higher.