Topic 6 Bipolar and Impulse-Control Disorders

• Bipolar disorders are chronic, recurring that involve unusual, unpredictable fluctuations of low and elevated moods.
• Bipolar 1 disorder is the most severe.
• Bipolar 1 disorder has the highest mortality rate.
• Periods of severe depression and mania alternate within Bipolar 1 disorder.
• Patients with Bipolar 1 disorder have experienced at least 1 manic episode.
• Bipolar 2 disorder is less acute and can be treated outpatient.
• Bipolar 2 is shown by cycles of hypomania, or less severe mania, that lasts at least 4 days, and major depression.
• People with bipolar 2 may seem more talkative or distractible than usual but will not experience serious impairment in social or occupational functioning.
• People with bipolar 1 disorder can have problems with ADLs like eating or sleeping, interpersonal and occupational functioning.
• Manic episodes are intense mood disturbances that have persistent euphoria, elevation, and or expansiveness that lasts for at least 1 week, nearly every day.
• Manic patients are extremely goal oriented in specific activities that may lead them to sleeping, eating, and drinking.
• Manic patients are in perpetual motion, may talk non stop or engage in agitated and aggressive behavior.
• Manic patients frequently engage in high risk behaviors because they feel so elevated and are a risk for injury to themselves or others.
• Mania is a psychiatric emergency and requires hospitalization.
• Bipolar 2 on the mood map does not show full manic episodes but instead shows hypomania.
• Cyclothymic disorder is an alternation of hypomania with mild to moderate depression for at least 2 years in adults.
• Rapid cycling is possible with cyclothymic disorder.
• Hypomania is a low level, less dramatic mania.
• Hypomania patients do experience euphoria that increases their functioning that is accompanied by excess activity and energy.
• Cyclothymic disorder on a mood map shows sinus rhythm between hypomania and dysthymia.
• Mixed episodes meet criteria for both manic episodes and major depressive episodes.
• Cyclothymic disorder must last for at least 1 year for children.
• People with cyclothymic disorders have irritable hypomanic episodes.
• Children with cyclothymic disorder experience irritability and sleep disturbances.
• For people with bipolar to experience rapid cycling, they may have at least 4 mood episodes within 12 months.
• Cycling can occur within a month or a 24 hour period.
• Rapid cycling is more associated with severe symptoms such as poorer global functioning, high recurrence risk, and resistance to conventional somatic treatments.
• Substance or medications can induce mania in clients who do not have prior manic episodes.
• Levodopa, corticosteroids and anabolic androgenic steroids can induce mania.
• Some antidepressants can induce manic episodes like TCAs and MAOIs.
• Substance or medication induced bipolar is directly related to a specific substance.
• Withdrawal and intoxication can be a part of substance or medication induced bipolar disorder.
• Bipolar and related disorders due to medical conditions are directly attributed to specific conditions.
• The condition of bipolar due to medical conditions are verified through examinations or medical records.
• Men and women have an equal rate of getting bipolar but they respond differently to the condition.
• Men with bipolar are more likely to have legal problems and commit violent acts.
• Women with bipolar are more likely to misuse alcohol, commit suicide, and develop thyroid disease.
• Women who experience severe postpartum within 2 weeks of giving birth have a 4 times greater chance of getting bipolar disorder.
• The average age for onset of bipolar is 18 - 20 years of age.
• ADHD as a comorbidity with bipolar I disorder can pose special challenges since bipolar in youth can initially be thought of as ADHD. If that person is given a stimulant then it can trigger a manic episode.