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Bipolar & related disorder, Manic episode
Distinct period of…
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Manic episode
- Distinct period of abnormally and persistently elevated, expansive or irritable mood and abnormally
- Lasting at least 1 week and present most of the day, nearly every day
- Mood disturbance and increased energy or activity three of the following symptoms
Three or more sign & symptoms
- Inflated self-esteem or grandiosity
- talkactive
- flight of ideas / racing thought
- decreased need for sleep
- distractibility
- psychomotor agitation
- reckless or excessive involvement in activities that a high potential for painful consequnces ( unrestrained buying sprees or foolish busines investments)
Hypomanic
- Distinct period of abnormally and persistently elevated, expansive, or irritable mood and adnormally & persistently increased activity or energy
- Lasting at least 4 consecutive days and present most the da, nearly every day
Three or more sign & symptoms
- Inflated self- esteem or grandiosity
- Decreased need for sleep ( feels rested after only 3 hours of sleep)
- Flight of ideas or subjctive experience that thoughts are racing
- Distractibility ( attention too easily drawn to unimportant or irelevant external stimuli)
Major Depressive episode
- 5 or more of the following symptoms have been present during the same 2 week period and represent a change from previous functioning at least one of the symptoms is either ( depressed mood or loss of interest or pleasure)
Depressed mood
anhedonia
weight loss when not dieting or weight gain
insomnia or hypersomnia
psychomotor agitation or retardation nearly every day
criteria have been met for at least one manic episode
- is not better explained by schizoaffective, schizophrenia,schizopreniform, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorder
criteria have been met for at least one hypomanic episode and at least one major depressive episode
- the symptoms of depresion or the unpredictability caused by frequent alternation between periods of depression and hypomania cause clinically significant distress or impairment in functioning ( occupational and social)
For at least 2 years (at least 1 year in children and adolescents)
- above 2 year period ,the hypomanic and depressive periods have been present for at least half the time and the inddividual has not been without the symptoms for more than 2 monhs at a time
- the symptoms are not attributable to the physiological effects of a substance (drug of abuse, a medication) or another medical condition
substance / medication induced
- characterized by expansive r irritable mood with or without depressed mood or markedly diminished interest or pleasure in all or almost all activities
other specified bipolar and related disorder
- short - duration hypomanic episodes (2-3 days) and MDE
- Hypomanic episodes with insufficient symptoms and MDE
- Hypomanic episode without prior major depressive episode
- short duration cyclothymia ( less than 24 months)
Etiology
- Development and course ( early onset )
- Culture realted diagnostic issues
- Gender related disorder ( females with bipolar 1 or 2 disorder are more likely to experience depressive symptoms than males
- suicide risk
Bipolar disorder is a lifelong condition
- Medications
- Continued treatment
- Day treatment programs
- substance abuse treatment
- Hospitalization
- The primary tx for bipolar include medications and psychological counseling (psychotherapy) to control symptoms and also may include education and support groups
phychosocial intervention
- Interpersonal and social rhythm therapy (IPSRT)
- Cognitive Behaviour Therapy (CBT)
- Psycheducation
- Family - focused therapy
- Support program