Quick review of the essential points— DSM5 diagnosis criteria, assessments, treatments—of these disorders to better prepare for the National Clinical Mental Health Counseling Exam. This can be used like flashcards or as a presentation.
2. 1. Bipolar I Disorders
2. Bipolar II Disorder
3. Cyclothymic Disorder
4. Substance/ Medication Induced Biolar and Related
Disorder
3. Diagnosis I
Typically repetitive cycle
of depression and mania,
possibly between
depressive episodes
Either phase can lead to
delusions and
hallucinations
Chronic but can have
years between episodes
Often begins in early 20s
1. Manic periods
Abnormal high or irritable mood
Increased energy and goal-
directed activity
Lasts 1 week or more (less if
hospitalized)
Includes 3-4 of:
Grandiosity
Racing thoughts
Little sleep
Distractibility
High risk activities
Pressured speech and activity
2. Sufficient intensity of episode
4. Diagnosis II
Specifiers include kinds and how current the episodes:
Major depression
Hypomania
Mania
Mixed
Rapid cycling (four mood episodes without break during
the last 12 month period)
Mood is most of the time, nearly every day
Impairs function
5. Diagnosis III
Co-occurring:
Anxiety
Substance abuse
Eating Disorders
ADHD
Impulse Control Disorders
Conduct Disorders
Autism
Tourette’s Disorder
Diabetes
Migraines
Rule Out:
Schizophrenia & Psychotic
Disorders: No psychosis
except when depressed
Depressive Disorders: Anti-
depressants will not trigger
anxiety or mania
6. Find Out
Family history
Clearest connection of all mental
disorders
Symptomology development
Affective functioning
Cognitive functioning
Substance history
Trauma and loss history
Chart moods
7. Treatments
1. Medication
Mood-stabilizing like Lithium
(useless against mania, and toxic
side effects)
Anti-psychotic, like Lamotrogine,
or anti-convulsants, like
Olanzapine
Can reduce manic phase from
months to days
Avoid antidepressants, which
trigger anxiety and mania
2. Therapies
CBT Cognitive
Behavioral Therapy
Behavioral family
therapy
IPSRT Interpersonal
Social Rhythm
Therapy
Reducing expression
of intense feelings
FFT Family Focused
Therapy
8. Cyclothymia
Alternating
between
hypomanic
symptoms, and
mild or moderate
depressive moods,
like Bipolar II
Less severe,
higher functioning
Bipolar II
1 or more
hypomanic
episodes
(4 days or more),
and no mania
1 or more major
depressive
episodes
(2 weeks or more)
Bipolar I
More severe
1 or more manic
or mixed episodes
Leading to:
Serious problems,
or
Hospitalization,
or
Psychotic
features
9.
10. Diagnosis
More severe
1 or more distinct manic episodes, or mixed
Often with aggression or lack of sexual inhibitions
Often with little sleep or appetite
Leading to:
Serious legal or work problems, or
Hospitalization to avoid harm or
Psychotic features
11. S1. Find Out
Affective functioning
Cognitive functioning
Symptom development
Family history
Trauma history
Substance use
S2. Assess & Refer
Refer for psychological
testing
12. S4.Treatments
1. Medication
Mood-stabilizing like Lithium
(useless against mania, and toxic
side effects)
Anti-psychotic, like Lamotrogine,
or anti-convulsants, like
Olanzapine
Can reduce manic phase from
months to days
Avoid antidepressants, which
trigger anxiety and mania
2. Therapies
Psychoeducation
CBT Cognitive
Behavioral Therapy
Behavioral family
therapy
Interpersonal Social
Rhythm Therapy
Reducing expression
of intense feelings
13. S5. Monitoring
1. Mood charting
2. Monitoring problematic
behavior
3. Affective functioning
4. Medication compliance
S6. Termination
Medication monitoring for
compliance and side effects
Psychotherapies
Support group
14.
15. Diagnosis
1 or more hypomanic episodes (4 days or more),
and no mania
1 or more major depressive episodes (2 weeks or more)
16.
17. Diagnosis
Symptoms
Alternating between elevated
mood (hypomanic symptoms),
and mild or moderate depressive
moods, like Bipolar II
Less severe symptoms and
higher functioning than Bipolar
Disorder I or II
S1. Assessment
Family history
Rule Out
Sleep problem
18. S5. Treatment
Therapy
Interpersonal and Social Rhythm
Therapy (IPSRT)
Family Focused Therapy (FFT)
Cognitive Behavioral Therapy
Group Therapy
Also
Career counseling
Interpersonal skill
Group counseling
Medications
Mood stabilizers, like
Lithium
Anti-seizure or
anticonvulsants, like
Depakote
Antipsychotics, Seroquel
or Risperdal
Anti-anxiety, like
benzodiazepines
Avoid Antidepressants,
which trigger mania
19. S4. Goals of Treatment
1.Decrease risk of developing into bipolar disorder
2.Reduce the frequency and severity of symptoms
3.Prevent a relapse of symptoms, through maintenance
treatment
4.Treat alcohol or other substance abuse problems, since they
can worsen cyclothymia symptoms