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Bipolar & Related Disorders for NCMHCE Study

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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.

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Bipolar & Related Disorders for NCMHCE Study

  1. 1. Review of DSM5 Mental Disorders for NCMHCE Study
  2. 2. 1. Bipolar I Disorders 2. Bipolar II Disorder 3. Cyclothymic Disorder 4. Substance/ Medication Induced Biolar and Related Disorder
  3. 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. 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. 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. 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. 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. 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. 9. 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
  10. 10. S1. Find Out Affective functioning Cognitive functioning Symptom development Family history Trauma history Substance use S2. Assess & Refer Refer for psychological testing
  11. 11. 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
  12. 12. 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
  13. 13. Diagnosis 1 or more hypomanic episodes (4 days or more), and no mania 1 or more major depressive episodes (2 weeks or more)
  14. 14. 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
  15. 15. 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
  16. 16. 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

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