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									Bipolar Disorder

   Ami Frederick
      Facts About Bipolar Disorder
Affects over 2 million Americans
Also affects family members, spouses, friends, and
Tends to run in families and can be inherited
   No specific genetic defect identified yet
           What Is Bipolar Disorder?
Chronic condition
Unique pattern of mood cycles
    Experience both lows of depression
    and highs of mania                   “Depression is an insidious
    Variable between individuals, but    vacuum that crawls into your
    predictable for that individual      brain and pushes your mind
Presence of >1 manic episode             out of the way.”
On average, 4 episodes in 10 years          ~ Depressed woman (Comer, 258)
without Rx
        What Is a Manic Episode?
Excessive moodiness or irritability
Lasts for at least 1 week
Not related to substance abuse or medical condition
Episodes usually follow stressful life events or mental
Persistence of at least 3 of the characteristics on following
   Characteristics of a Manic Episode
Extreme irritability or         Decreased need for sleep
distractibility                 Unrealistic belief in one’s abilities
Excessive “high” feelings       Substance abuse
                                Poor judgment
                                Provocative or obnoxious behavior
behavior w/ risk taking
                                Increased sexual drive
Increased energy and activity
Rapid talking & thinking
  Characteristics of Depressive Episode
Persistent sadness      Feelings of worthlessness,
Fatigue                 hopelessness, and/or guilt
Sleep disturbances      Difficulty concentrating,
   Excessive sleep      remembering, or making
   Inability to sleep   decisions
Eating disturbances     Withdrawal from friends
   Loss of appetite     Withdrawal from enjoyable
   Overeating           activities
Loss of self-esteem     Persistent thoughts of death
               Bipolar Depression
Bipolar I (BPI)              Bipolar II (BPII)
  Classic manic-depression     Presence of hypomanic or
  Presence of manic,           major depressive episode
  hypomanic, or major          Significant distress or
  depressive episode           impairment
  Significant distress or      No history of a manic episode
  History of manic episode
Obtain PMHx, including          Ask family about mood
medications                     changes
Family Hx                       Physical exam to R/O
Observe behavior & mood         physical causes for Sx
Recent mood swings & how        Lab tests to assess thyroid
long pt has been experiencing   px/drug levels
Most people can be helped with Rx
Psychological Rx
   Focus on px that develop due to manic episode
   Help pt recognize onset of episode and take corrective action
Supportive counseling
Group help
   National Depressive and Manic Depressive Association (NDMDA)
   National Alliance for the Mentally Ill (NAMI)
                    Rx Cont’d
   Severe cases
Psychologist + Psychiatrist
Psychologist                      Psychiatrist
   Provides support                  Monitors medication
   Educates pt and family
   Training about coping skills
Lithium – controls mania & prevents recurrence of depressive
and manic episodes
Carbamazepine & Valproate – mood-stabilizing anticonvulsants
   May be combined with lithium for max. effect
   Valproate FDA approved for Rx of acute mania
Combinations of antidepressants and above 3 for depression
             Other Modes of Rx
Construction of life chart depicting all mood Sx,
medications, and life events
Because manic-depressive illness is recurrent, long-term
prophylactic (preventive) Rx is indicated
What To Do If Someone Is Suspected To
           Be Bipolar?
 Be emotional support
 Be a good listener
   Know when to give advice and when to be silent
 Refer to professional
 Keep person from harmful actions
   Either to themselves or to others
   Risk of suicide
A.D.A.M. (2003). Bipolar Disorder. Available at
     symptoms.html. Accessed March 14, 2005.
Comer, R. (2004). Abnormal Psychology, 5th ed. Pp. 258-260.
     NY: Worth Publishers.
Franklin, D. J., PhD. (2002). Bipolar Depression. Available at
     Accessed March 14, 2005.
Switzerland (1992). ICD-10 Classification of Mental and
     Behavioural Disorders. World Health Organization: CH-
     1211, Geneva 27. Available at
     Accessed March 14, 2005.

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