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Bipolar Disorder

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  • 1. Bipolar Disorder
  • 2. What is it?
    • Clinically referred to as ‘mania’
    • Cyclical illness characterized by alternating of manic(elevated) and depressive episodes
    • Causes unusual shifts in persons mood, energy, and ability to function
  • 3. Manic Episode
    • Distinct period of elevated, expansive, or irritable mood state
    • Increased energy, low attention span
    • Desire to indulge in substance abuse, increase in sex drive, aggressive behavior
    • May begin to experience psychosis in extreme cases
    • 3 or more symptoms last most of day for week or longer
  • 4. Depressive Episode
    • Persistent feelings of guilt, isolation, anxiety, self-loathing, shyness, irritability
    • Disturbances in sleep or appetite
    • Fatigue or chronic pain(with or without known cause)
    • 5 or more symptoms last most of day for 2 weeks or longer
  • 5. Classification
    • Bipolar I
    • One or more manic episodes with or without major depressive episode
    • Chronic, rapid cycling, catatonic, melancholic
    • Bipolar II
    • Hypomanic episodes with at least one depressive episode
    • Harder to diagnose
    • Chronic, rapid cycling, catatonic, melancholic
  • 6. Classification
    • Cyclothymia
    • Low-grade cycling of hypomanic episodes and periods of mild depression
    • Bipolar NOS
    • “ Not Otherwise Specified”
  • 7. Possible Causes
    • “ There is no single cause for bipolar disorder”
    • Genetic, more than 2/3 have 1 close relative w/ disorder
    • High monozygotic concordance rate (70% in some studies)
    • ‘ Kindling’ theory  people genetically predisposed can experience series of stressful events which lower threshold for mood episodes
  • 8. Brain Parts Involved?
    • Research continues to try to find areas of brain associated w/ disorder
    • Possibly amygdala & hypothalamus due to emotional regulation factors**
    • Possibly frontal & temporal areas in either hemisphere sending irregular signals to throw off Behavioral Activation System & Behavioral Inhibition System**
    • **Guesswork conducted by Cory Barefield
  • 9. Treatment: Medication
    • Mood-stabilizers  lithium ‘the gold standard’, control and prevention; decreases norepinephrine release and increases serotonin synthesis
    • Anticonvulsants  sodium valproate & others, more effective in rapid cycling & extreme cases; block voltage activated Na+ channels
    • Anti-psychotics  maintenance of extreme cases; blocks dopamine receptors in brain
    • Antidepressants  risky, must be taken in conjunction w/ mood-stabilizer; may cause manic episode; serotonin & norepinephrine reuptake inhibitors
  • 10. Treatment: Psychosocial
    • Cognitive-behavioral therapy stresses modification of negative thought processes
    • Education teaches recognition of signs of relapse
    • Interpersonal/Social rhythm therapy helps regularize daily routines and sleep patterns to protect against manic episodes

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