PSYCH: BIPOLAR

• Bipolar disorder


  Mental health condition that causes extreme mood swings that include emotional highs (mania or hypomania) and lows (depression)
• Bipolar disorder


  • When a person becomes depressed, they may feel sad or hopeless and lost interest or pleasure in most activities
  • When their mood shifts to mania or hypomania (less extreme than mania), they may feel euphoric, full of energy or unusually irritable
  • These mood swings can affect sleep, energy, activity, judgment, behavior and the ability to think clearly
  • Episodes of mood swings may occur rarely or in multiple times a year
  • While most people experience some emotional symptoms between episodes, some may not experience any
  • Although bipolar disorder is a lifelong condition, mood swings and other symptoms can be managed by medications and psychological counseling psychotherapy
• Types of bipolar disorder

  • Bipolar I disorder
  • Bipolar II disorder
  • Cyclothymic disorder
  • Bipolar related disorders induced by certain drugs or alcohol or due to a medical condition, such as Cushing's disease, multiple sclerosis or stroke
• Bipolar I disorder


  • The patient may have had at least one manic episode that may be preceded or followed by hypomanic or major depressive episodes
  • In some cases, mania may trigger a break from reality (psychosis)
• Bipolar II disorder


  • The patient had at least one major depressive episode and at least one hypomanic episode, but never had a manic episode
  • An individual with this disorder can be depressed for longer periods, which can cause significant impairment
• Cyclothymic disorder


  • The patient had at least two years for adult or one year in children and teenagers of many periods of hypomania symptoms and periods of depressive symptoms
  • Though less severe than major depression
• Although bipolar disorder can occur at any age, typically it is diagnosed in teenage years or early 20s
• Mania and hypomania

  • Mania is more severe than hypomania and causes more noticeable problems at work, school and social activities, as well as relationship difficulties
  • Mania may also trigger psychosis and require hospitalization
  • Both manic and hypomanic episodes include symptoms like abnormally upbeat, jumpy or wired; increased activity, energy or agitation; exaggerated sense of well-being and self-confidence (euphoria); decreased need for sleep; unusual talkativeness; racing thoughts; distractibility; poor decision making
• Major depressive episode

  • Includes symptoms that are severe enough to cause noticeable difficulty in day to day activities, such as work, school, social activities or relationships
  • An episode includes symptoms like depressed mood, marked loss of interest or feeling no pleasure in all or almost all activities, significant weight loss or gain, insomnia or sleeping too much, restlessness or slowed behavior, fatigue or loss of energy, feelings of worthlessness or excessive or inappropriate guilt, decreased ability to think or concentrate, or indecisiveness, thinking about, planning, or attempting suicide
• Other features of bipolar disorder

  • Symptoms of bipolar II disorders and I may include other features, such as anxious distress, melancholy, psychosis or others
  • The timing of symptoms may include diagnostic labels such as mixed or rapid cycling
  • Bipolar symptoms may occur during pregnancy or change with the seasons
  • Symptoms can be difficult to identify in children and teens, and the pattern can vary from that of adults
  • Children and teens may have distinct major depressive, manic, or hypomanic episodes, but the pattern can vary from that of adults
  • Despite mood extremes, people with bipolar disorder often do not recognize how much their emotional instability disrupts their lives and the lives of their loved ones and often don't get treatment they need
• Behaviors considered appropriate and can mask depression

  • In children: cranky, school phobia, hyperactivity, learning disorders, failing grades, antisocial behaviors
  • In adolescence: substance abuse, joining gangs, engage in risky behavior, underachiever, drop out
  • In adults: substance abuse, eating disorders, compulsive behavior, hypochondriasis
  • In older adults: argumentative, cranky, somatic ailments
• Factors in psychopathology, etiology, and psychodynamics of mood disorders

  • Genetic factors: Higher incidence among family with depressive disorders for depression, higher incidence among family with manic or mood disorders than general population for bipolar (mania)
  • Neurochemical factor: Decreased serotonin and norepinephrine for depression
  • Neurostructural factor: Limbic system hypometabolism for depression, limbic system dysfunction for bipolar (mania)
  • Individual: Imagine or real loss of loved person or object for depression, mask for depression for bipolar (mania)
  • Psychosocial factor: Faulty family and social interaction for both depression and bipolar (mania)
• Treatment and management

  • Biologic therapy: Psychopharmacology, ECT
  • Interpersonal therapy: Help client establish a successful relationship, help client learn to trust others
  • Behavioral therapy: Reinforcing behavioral change through positive feedback and decreasing negative interactions, focus on improving social and coping skills
  • Cognitive therapy: Changing negative thinking into positive thinking
  • Attitude therapy: May also be an option