Essay on Bipolar Disorder ( Disorder )

Essay on Bipolar Disorder ( Disorder )

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a) Bipolar Disorder
i) Bipolar I Disorder
(1) DSM-V Diagnostic Criteria
(a) Experience at least 1 Manic Episode
(b) Not better accounted for by a delusional disorder, or other specified/unspecified schizophrenia spectrum or other psychotic disorders
(c) Rapid cycling
(i) Frequently switch from depression to mania
(ii) Little or no period of euthymic (i.e., normal) mood
(iii) 4 cycles or more per year

(d) Manic episode
(i) Criterion A
1. Abnormally and persistently elevated, expansive, or irritable mood
2. Increased goal directed activity/energy
3. Lasting at least 1 week
4. Present for most of day and almost daily
(ii) Criterion B
1. During Criterion A, ≥ 3 of the following symptoms:
a. Inflated self-esteem or grandiosity
b. Decreased need for sleep
c. More talkative or pressured speech
d. Flight of ideas or racing thoughts
e. Distractibility
f. Increase in goal oriented activity or psychomotor agitation
g. Excessive involvement in activities that have high potential for painful consequences
(iii) Mood disturbance is severe and causes significant impairment in functioning or requires hospitalization to prevent harm to self or others, or psychotic features
(iv) Not attributed to physiological effects of a substance or to another medical condition

ii) Bipolar II disorder
(1) DSM-V Diagnostic Criteria
(a) At least 1 Hypomanic Episode AND at least 1 Major Depressive Episode
(b) NEVER been a Manic Episode
(c) Not better accounted for by a delusional disorder, or other specified/unspecified schizophrenia spectrum or other psychotic disorders
(d) Clinically significant distress or impairment in functioning
(e) Hypomanic episode
(i) The only difference between hypomanic and manic = lasting at least 4 consecutive days

... middle of paper ... will decrease the half life of many drugs. So it is important to have the list that it interacts with.
(iii) Other
1. Lithium
a. Anti-manic mood stabilizer. It is best for acute manic episodes as well as for maintenance of Bipolar I and II.
b. It is less effective if there are psychotic features, mixed bipolar episodes, or if there is a comorbid substance use issues as well.
c. It can be used to treat SIADH because it is a potent diuretic
d. Side effects: LOTS
i. N/V/D, ataxia, tremor
ii. Narrow therapeutic index. If toxic, will caused GI symptoms, or symptoms related to cognition or coordination.
iii. It may also cause nephrogenic diabetes, nephrotoxicity, thyroid dysfunction, dermatologic issues, weight gain, cardiac abnormalities, and if used in pregnancy, may cause the ebstein anomaly
e. Importantly, it interacts with NSAIDs, diuretics, ACEIs, and caffeine.

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