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Bipolar Disorder Ami Frederick Facts About Bipolar Disorder Affects over 2 million Americans Also affects family members, spouses, friends, and employers 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 trauma Persistence of at least 3 of the characteristics on following slide 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 Unusual/destructive Provocative or obnoxious behavior behavior w/ risk taking Increased sexual drive Increased energy and activity Denial Rapid talking & thinking Agitation 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 impairment History of manic episode Diagnosis 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 them Treatment 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 Hospitalization?? Severe cases Medications Psychologist + Psychiatrist Difference? Psychologist Psychiatrist Provides support Monitors medication Educates pt and family Training about coping skills Medications Lithium – controls mania & prevents recurrence of depressive and manic episodes Carbamazepine & Valproate – mood-stabilizing anticonvulsants Kindling 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 References A.D.A.M. (2003). Bipolar Disorder. Available at http://health.allrefer.com/health/bipolar-disorder- 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 http://www.psychologyinfo.com/depression/bipolar.htm. Accessed March 14, 2005. Switzerland (1992). ICD-10 Classification of Mental and Behavioural Disorders. World Health Organization: CH- 1211, Geneva 27. Available at http://www.psycom.net/depression.central.bipolar.html. Accessed March 14, 2005.
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