Psychiatric Mental Health Nursing Bipolar Disorder ppt

2. BIPOLAR
DISORDER
Dr. Rahul Sharma
Associate Professor
H.O.D. of Mental Health Nursing
Ph. D Coordinator
Seedling School of Nursing,
Jaipur National University, Jaipur

3. 

4. Rigid
Fatigue
Dullness
Blunt affect
Sad
Empty mood
Spend alone
Sleeping disturbance
Suicidal tendancy
Feeling hopelessness
Self blaming
Poverty in thinking
Poor concentration
Loss of energy
Menstrual or sexual disturbances
Lack of confidence

6. Hereditary : Monozygotic twin (40 %-70%) Dizygotic twins(20%)
Neurophysiological factor : Imbalance in Excitory and Inhibitory process may predispose
manic depressive psychosis (MDP)
Physical factors. : Viral infection eg: Hepatitis
Biochemical factors : Imbalance of catecholamine (epinephrine and nor epinephrine) result in MDP . If catecholamine increase leads to mania if it decreases then leads to depression. Deficiency of serotonin level result in MDP.
Neurohormonal factors. : Decrease cortisol secretion alteration in
hipocampus function predispose for MDP.
Social factors. : Stressful life events , social pressure, rejection of children by parents,
difficulty in IPR, social cultural factors,loss of loved ones.
Physiological factors. : Feeling of hopelessness, helplessness, premorbid personality
pattern – lack of energy, uncontrollable behaviour. Psychoanalytical factor – Loss of
conflict.

7. PHYSICAL
EXAMINATION
MENTAL STATUS
EXAMINATION

8. Pharmacotherapy
Antidepressants : Treatment Of
Choice for a vast majority . It may
take upto 3 weeks before any
appreciable response may notice .
Before stopping / changing a drug
,the particular drug should be given
in a therapeutically adequate dose
for atleast 6 weeks.
Tricyclic Antidepressants :
Imipramine ( 75 mg – 150mg –
300mg). Amitriptyline is not used
due to dry mouth , blurred vision and
hypertension .
Newer Antidepressants : Selective
Serotonin Reuptake Inhibitor(SSRI)
eg: fluoxetine,sertraline. Serotonin
Nor Epinephrine Reuptake Inhibitor
(SnRI) eg: ventafaxine,duolexetine.
Antipsychotic drugs : olanzapine
,clonazapine ,respiridine,quetipine
,aripiprazole.

9. Family therapy
Supportive psychotherapy
Group therapy
Inter personal therapy
Behavioural therapy
Electro convulsive therapy
Cognitive therapy.