Understanding Bipolar Disorders: Symptoms, Diagnoses, and Treatments, Exercises of Nursing

Download Understanding Bipolar Disorders: Symptoms, Diagnoses, and Treatments and more Exercises Nursing in PDF only on Docsity! 1 2 , 5 PLEASE TAKE A NOTE…JUST AS WITH PIGLET/GAD AND EEYORE/PERSISTENT DEPRESSIVE DISORDER: Dr. S will use a silly cartoon character to illustrate bipolar disorders/symptoms, but with a little more creative license.This is done because it will help you remember the symptoms, I hope. NOT because I think the disorders are silly.They are not. I take these disorders very seriously.They cause massive dysfunction if untreated. 6 And, my have a cousin that died secondary to bipolar I disorder (when he was in manic episode, he used huge amounts of drugs) 7 Tony the Tiger • Go with me on this one, guys: let’s pretend Tony the Tiger is a “real person.” Here is tony in his normal state. Tony is a very happy tiger. He works hard, plays hard, he is married with kids, he is a responsible adult who is highly successful. • A captain of industry at Kellogg’s! • But….he has a Bipolar Disorder Tony the Tiger is the cartoon character for the breakfast cereal “Frosted Flakes” made by the Kellogg Corporation. 10 What is a manic episode? Symptoms? 11 The first symptom is REQUIRED: 1 or both parts: A. ELEVATED Mood- (EUPHORIC). Def.: A Period of abnormally and persistently elevated mood). --TONY: “I am M*F* greaaAT, Dr. Sydeman!” Mania (a Manic Episode) 12  [AS IF on a CNS stimulant drug like cocaine/crystal meth]! AND B. Increased Energy Level -lots and lots of extra energy compared to usual 15 Additional symptoms of a Manic Episode more of: 4. Pressured speech (racing thoughts) or being (very) overly talkative 16 Tony talks 1.5 to 2x as fast as normal! And, he won’t stop talking! 17 “How are the kids doing at school?” When Tony is asked a directed question, Tony talks about many things, can’t keep train of thought, goes on and on. 6. Extreme increase in activities Symptoms of a Manic Episode 5. Very easily distractible 20 Symptoms of a Manic Episode • DURATION: > 1 WEEK -INTENSITY/SEVERITY CRITERIA: PSYCHOSOCIAL DYSFUNCTION ORTHE EPISODE SYMPTOMS PSYCHIATRIC HOSPITALIZATION OR TONY BECOMES PSYCHOTIC (HAS A BREAK WITH REALITY: SEEING THINGS/HEARING THINGS NOT THERE, OR DELUSIONAL: FIRMLY HELD FALSE BELIEFS {EXAMPLE: HE THINKS HE IS THE SECOND COMING OF JESUS CHRIST} *-DEVIATES FROM CULTURAL NORMS 21 ypomanic Episode ALMOST ALL THE SAME SYMPTOMS OF A FULL MANIC EPISODE BUT: SHORTER DURATION: > FOUR DAYS INTENSITY/SEVERITY:THE PERSON IS STILL FULLY FUNCTIONAL: THEY DO NOT HAVE THAT SYMPTOM #7: RISKY BEHAVIORS HYPOMANIC SYMPTOMS ARE NOT SEVERE ENOUGH FOR IMPAIRMENT, HOSPITALIZATION, OR PSYCHOTIC FEATURES Symptoms of a H 22 USUALLY DOES NOT INCLUDE HAVING POOR JUDGMENT So you may be thinking: I WOULD love to feel GREAT, have more energy, get more done, etc. So why is hypomanic episode (or a manic episode) a problem? 25 So, here we go: the three (3) Bipolar Disorders are… Which do you think is most serious/severe? 2. Bipolar II: Full MDEs & hypomania (no experiences of full manic episode) 3. Cyclothymia: Has > 2 years cycling between mild depression & hypomania 26 1. Bipolar I: Full major depressive episodes (MDE) AND full mania (current or past episode of mania) 27 30 • Typical age of onset: ~15-years old to mid-40’s 31 Etiology of Bipolar Disorders: Biological 32 Strongly Biological 1. Strong genetic predisposition 40% concordance rate among monozygotic twins 35 Treatment of Bipolar Disorders Psychotropic Medicine: Mood Stabilizers • Person needs to stay on meds rest of life • Lithium carbonate** • Lamictal, Tegretol, Depakote] 36 • HOWEVER: it is almost inevitable: that the patient will STOP taking their medications. When this happens • They will become depressed OR go into manic episode 37 Treatment of Bipolar Disorders • How effective? • 70% of patients show meaningful improvement in symptoms when medicated • Helps prevent future manic episodes (Lithium) • IF needed, additional antidepressant in addition to mood stabilizer for swings down to depression • SSRIs/SNRIs