BIPOLAR DISORDERS & SUBSTANCE ABUSE .
BIPOLAR I
● Most severe form; highest mortality rate
● At least ~1 manic episode alternating w/MDD
● MANIA: abnormally elated, expansive, elaborate or irritable mood, high level of energy
○ Last @ least 1 week every day all day
○ PSYCHIATRIC EMERGENCY!!
○ S+S:
■ Euphoria & energized
■ Clothes are mismatched + vibrant colors
■ Dont sleep or eat
■ Perpetual motion
■ Feel important + powerful
■ Take hazardous risk - poor judgement/impulse
■ Can become psychotic
● Hallucination, delusions, hear voices
■ Crash w/exhaustion → depression
BIPOLAR II
● At least ~1 hypomanic episode + ~1 major depressive episode
● HYPOMANIA:
○ Low level + less dramatic mania
○ Not as pronounced + prolonged
■ Activity & energy for at least 4 days
○ Increases functioning = NO issues w/jobs + social function
○ Hospitalization = rate
○ Does not include psychotic features @ mania
CYCLOTHYMIC DISORDER
, ● Alternating symptoms of mile to moderate depression w/hypomania (~2 years for
adults/~1 year for children)
● Rapid cycling possible
● RF:
○ Biological — genetic, neurobiological, brain structure
○ Psychological factors
○ Environmental factors
3 DISEASE PHASES
● Acute phase: Acute mania
○ Hospitalization can be required.
○ Reduction of mania and client safety are the goals of treatment.
○ Risk of harm to self or others is determined.
○ One-to-one supervision can be indicated for client safety.
● Continuation phase
○ Remission of manifestations
○ Treatment is generally 4 to 9 months in duration.
○ Relapse prevention through education, medication adherence, and psychotherapy is
the goal of treatment.
● Maintenance phase
○ Increased ability to function
○ Treatment generally continues throughout the client’s lifetime.
○ Prevention of future manic episodes is the goal of treatment.
NURSING PROCESS: ASSESSMENT
● Thought processes
○ Grandiose delusions
○ Persecutory delusions
BIPOLAR I
● Most severe form; highest mortality rate
● At least ~1 manic episode alternating w/MDD
● MANIA: abnormally elated, expansive, elaborate or irritable mood, high level of energy
○ Last @ least 1 week every day all day
○ PSYCHIATRIC EMERGENCY!!
○ S+S:
■ Euphoria & energized
■ Clothes are mismatched + vibrant colors
■ Dont sleep or eat
■ Perpetual motion
■ Feel important + powerful
■ Take hazardous risk - poor judgement/impulse
■ Can become psychotic
● Hallucination, delusions, hear voices
■ Crash w/exhaustion → depression
BIPOLAR II
● At least ~1 hypomanic episode + ~1 major depressive episode
● HYPOMANIA:
○ Low level + less dramatic mania
○ Not as pronounced + prolonged
■ Activity & energy for at least 4 days
○ Increases functioning = NO issues w/jobs + social function
○ Hospitalization = rate
○ Does not include psychotic features @ mania
CYCLOTHYMIC DISORDER
, ● Alternating symptoms of mile to moderate depression w/hypomania (~2 years for
adults/~1 year for children)
● Rapid cycling possible
● RF:
○ Biological — genetic, neurobiological, brain structure
○ Psychological factors
○ Environmental factors
3 DISEASE PHASES
● Acute phase: Acute mania
○ Hospitalization can be required.
○ Reduction of mania and client safety are the goals of treatment.
○ Risk of harm to self or others is determined.
○ One-to-one supervision can be indicated for client safety.
● Continuation phase
○ Remission of manifestations
○ Treatment is generally 4 to 9 months in duration.
○ Relapse prevention through education, medication adherence, and psychotherapy is
the goal of treatment.
● Maintenance phase
○ Increased ability to function
○ Treatment generally continues throughout the client’s lifetime.
○ Prevention of future manic episodes is the goal of treatment.
NURSING PROCESS: ASSESSMENT
● Thought processes
○ Grandiose delusions
○ Persecutory delusions
