Bipolar Disorder

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Bipolar Disorder

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

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