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Flashcards in Bipolar Disorder Deck (52)
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What are the characteristics of bipolar disorder?

  • Cyclic mood disorder
  • Extremes of euphoria and depression during episodes
  • Mania and depression
  • May include psychosis, paranoia, hallucinations


What is commonly associated with bipolar disorder?

  • Suicide (15%)
  • Alcohol and drug addiction (50%)


What are the stages of mania?

  1. Starts pleasant (Euphoria)
  2. Irritability
  3. Paranoia (Think others are jealous of you)


What are common symptoms of mania?

  • Irritability
  • Flight of ideas (racing thoughts)
  • Distractability (poor concentration)
  • Hyperactivity
  • Increased, rapid, pressured speech
  • Decreased need for sleep - Red flag


Depression in bipolar disorder is (mild/severe).

Very severe


(T/F) To be diagnosed with bipolar disorder, you must have mania AND depression.

False. Diagnosis of bipolar disorder occur if patient ONLY has mania.

  • Depression is not a required symptom.


What is the average age of onset for bipolar disorder?

21 (college years)


Bipolar I is more common in males or females?

Neither. There is equal incidence in both males and females


Bipolar II is more common in males or females?

Females > Males


How do some bipolar patients act between episodes?

  • Many patients do very well between episodes
    • Hypomania may be helpful in work
    • Psychotic mania predicts poor outcome


Depression in bipolar disorder is usually (acute/chronic).

Chronic (can be very severe)

  • Substance abuse (alcohol and drugs) worsens course
  • Suicide in 15% of patients with depression


What is secondary mania?

Mania induced from:

  • Drugs (dopamine agonist - cocaine, antidepressants, amphetamines)
  • Medical conditions (brain trauma, HIV, stroke, MS, epilepsy, brain tumor)
  • Medications (steroids - anabolic or glucocorticoids)


What is the cause of early onset mania?

Idiopathic bipolar disorder


What is the cause of mania onset after 40 years old?

Usually a medical condition or drugs/medications


What are some things that cause mania to precipitate?

  • Post-partum state
  • Sleep deprivation
  • Dopamine agonist (amphetamines/L-dopa)
  • Antidepressants
  • Stroke or brain injury
  • Jet lag (especially West to East)
  • Severe life stress


What is hypomania?

  • State of increased energy without psychotic symptoms or need for hospitalizatoin
  • Less intense form of mania


What type of bipolar diagnosis is made in patients with hypomania?

Bipolar II


What symptoms result in classification of mania, not hypomania?

  • Paranoia
  • Delusions
  • Hallucinations


Patients are often (aware/unaware) of their mania?

Unaware (feel too good to be an illness)

Family, friends, or the legal system bring it to their attention


What is characteristic of Bipolar Course I?

Rapid cycling (4 or more mood episodes per year)


What is characteristic of Bipolar Course II?

  • Mainia/depression may last for 4-8 months and remit spontaneoulsy
    • May go years without episodes
    • Depression may be chronic (last years)


What is characteristic of Bipolar Depression 1?

  • "Atypical depression"
  • Excessive sleeping
  • Increased eating
  • Suicide risk
  • Teen atypical depression may be first sign of bipolar disorder


What is characteristic of Bipolar Depression 2?

  • Often "atypical" features (increased sleeping, eating)
  • May be seasonal (winter depressions, etc.)
  • May have psychosis (hearing voices, delusions)


What is characteristic of Bipolar Depression 3?

  • Suicide happens in this phase
  • Hypothyroidism (may result from Lithium use)
    • Symptoms similar to depression
  • Alcohol use may start during this phase


What are the side effects of using Lithium to treat bipolar disorder?


Lithium side effects:

  • Movement (tremor)
  • Nephogenic diabetes insipidus
  • HypOthyroidism
  • Pregnancy problems


What is characteristic of Bipolar Depression 4?

  • Most patients have more depression than mania
  • Depression more debilitating
  • Treatment more difficult for depression
    • Antidepressant use can push depression into mania


What is Cyclothymic Disorder?

  • Presence of hypomanic symptoms  for at least 2 years that don't meet criteria for full hypomanic episode and numerous periosds of depressive symptoms that don't meet criteria for full major depressive episode
  • Results in distress or functional impairment
  • Chronic, smoldering form of bipolar illness (not as severe as bipolar but can progress to it)


What is the treatment plan for patients with addiction and bipolar disorder?

  • Must treat addiction and mood disorder
    • Often harder to treat than those with only bipolar


What is the Mania Criterion A in DSM5?

A distinct period of abnormally and persistently elevated, expansive, or irritable mood AND abnormally and persistent increased goal directed activity or energy - lasting 1 week and present most of the day, nearly every day (or any duration if hospitalization is necessary)


What is the Mania Criterion B in DSM5?

  • Inflated self esteem or grandiosity
  • Decreased need for sleep
  • Distractability
  • More talkative than usual, with pressured/rapid speech
  • Flight of ideas or racing thought
  • Increased goal directed behavior or agitation
  • Excessive involvement in pleasurable activities (sex, cars, money) that may have painful results