Notes: Bipolar Disorder
CLASS DISCUSSION
Bipolar disorder
● One of the most severe types of disorders that is seen in adolescents and into adulthood
● It was not recognized before in the pediatric population
○ Children were not diagnosed with it
○ It rarely occurs in children
● Patients indicate that approximately thirty percent experienced a very early onset of their
symptoms
○ These are ages 13 and even younger
○ Approximately 40% of them experienced early onset on ages 13 to 18
● ADHD
○ A comorbid disorder
● Mania
○ Ideas are fast
○ The desire to seduce and be seduced is irresistible
○ Things become interestingly interesting
○ Unbelievable feelings of ease, power, and well-being
○ Euphoria
● Rapid cycling
○ Mood changes multiple times a day
○ This is usually seen in children
■ Some parents do not recognize it
● They do not know
■ 70% of children are rapid cyclers
○ Frequency
■ Symptoms occur most days in a week
○ Intensity and severity of symptoms
■ It is enough to cause moderate to severe disruptions
■ It occurs three to four times a day
○ Duration
■ Symptoms occur for four or more hours a day
○ Hypomania
■ DSM diagnosis
● It requires a four-day period of expansive or irritable mood
● Early stages
○ It begins with a depressive episode typically
○ If left untreated, this disorder tends to worsen
● Some types of Bipolar disorder
○ Bipolar I
■ This is the most severe form of bipolar disorder
■ It has mania with depression
● Mania
○ The flight of ideas
■ It is the feeling of being excited about one thing and then a minute passed
and you jump to something else
■ Distractibility
● They have a problem of being focused in a task
■ Grandiose
● In extreme conditions, they have this feeling of being able to fly
○ They jump off a building
, Notes: Bipolar Disorder
■ Increased goal activity
■ Decreased need for sleep
■ They will be poor in judgment on a lot of things
■ Excessive involvement in pleasurable activities with potential for painful
consequences
● Example
○ A teenager who drives around the neighborhood at 80
miles per hour
■ Poor judgment
■ They don’t think about the consequences
■ Intense irritability
● Combative behavior
● It varies
■ The pressure to speech
● They speak very quickly
● Their thoughts are flying too quickly
■ People with this do not realize they have it
● They just know that they are depressed
■ People who have this do not make good historians
○ Bipolar II
■ It is not as extreme as Bipolar I
■ Hypomania
● It could be an early sign of manic depression
■ Depression
■ This can evolve into Bipolar I
■ Cyclothymia
● It is chronic hypomania and depression
○ Prolonged episodes of both
● Ideology of mood disorders
○ Bipolar and depression are disorders of the brain
■ These are dysregulations of neurotransmitters systems
■ There is atrophy in certain parts of the brain sometimes
○ Bipolar I and II medication
■ Antidepressants
● Take these in a therapeutic dose
○ Is it working?
■ If no, try other medications
● These decreased the suicide rate of teenagers
■ Mood stabilizers
● Lithium
○ It is a salt-based substance
○ It is the “go-to” for many years
○ It can cause weight gain
■ It could make you more depressed
○ It poses a possibility of toxicity
■ It should be at a therapeutic level in the
bloodstream
● Too much will kill you
● Too less is not going to work well
■ Psychotic or Neuroleptic medication
● These can be used for Schizophrenia as well
CLASS DISCUSSION
Bipolar disorder
● One of the most severe types of disorders that is seen in adolescents and into adulthood
● It was not recognized before in the pediatric population
○ Children were not diagnosed with it
○ It rarely occurs in children
● Patients indicate that approximately thirty percent experienced a very early onset of their
symptoms
○ These are ages 13 and even younger
○ Approximately 40% of them experienced early onset on ages 13 to 18
● ADHD
○ A comorbid disorder
● Mania
○ Ideas are fast
○ The desire to seduce and be seduced is irresistible
○ Things become interestingly interesting
○ Unbelievable feelings of ease, power, and well-being
○ Euphoria
● Rapid cycling
○ Mood changes multiple times a day
○ This is usually seen in children
■ Some parents do not recognize it
● They do not know
■ 70% of children are rapid cyclers
○ Frequency
■ Symptoms occur most days in a week
○ Intensity and severity of symptoms
■ It is enough to cause moderate to severe disruptions
■ It occurs three to four times a day
○ Duration
■ Symptoms occur for four or more hours a day
○ Hypomania
■ DSM diagnosis
● It requires a four-day period of expansive or irritable mood
● Early stages
○ It begins with a depressive episode typically
○ If left untreated, this disorder tends to worsen
● Some types of Bipolar disorder
○ Bipolar I
■ This is the most severe form of bipolar disorder
■ It has mania with depression
● Mania
○ The flight of ideas
■ It is the feeling of being excited about one thing and then a minute passed
and you jump to something else
■ Distractibility
● They have a problem of being focused in a task
■ Grandiose
● In extreme conditions, they have this feeling of being able to fly
○ They jump off a building
, Notes: Bipolar Disorder
■ Increased goal activity
■ Decreased need for sleep
■ They will be poor in judgment on a lot of things
■ Excessive involvement in pleasurable activities with potential for painful
consequences
● Example
○ A teenager who drives around the neighborhood at 80
miles per hour
■ Poor judgment
■ They don’t think about the consequences
■ Intense irritability
● Combative behavior
● It varies
■ The pressure to speech
● They speak very quickly
● Their thoughts are flying too quickly
■ People with this do not realize they have it
● They just know that they are depressed
■ People who have this do not make good historians
○ Bipolar II
■ It is not as extreme as Bipolar I
■ Hypomania
● It could be an early sign of manic depression
■ Depression
■ This can evolve into Bipolar I
■ Cyclothymia
● It is chronic hypomania and depression
○ Prolonged episodes of both
● Ideology of mood disorders
○ Bipolar and depression are disorders of the brain
■ These are dysregulations of neurotransmitters systems
■ There is atrophy in certain parts of the brain sometimes
○ Bipolar I and II medication
■ Antidepressants
● Take these in a therapeutic dose
○ Is it working?
■ If no, try other medications
● These decreased the suicide rate of teenagers
■ Mood stabilizers
● Lithium
○ It is a salt-based substance
○ It is the “go-to” for many years
○ It can cause weight gain
■ It could make you more depressed
○ It poses a possibility of toxicity
■ It should be at a therapeutic level in the
bloodstream
● Too much will kill you
● Too less is not going to work well
■ Psychotic or Neuroleptic medication
● These can be used for Schizophrenia as well
