What is Bipolar Disorder? - ANSWER -A 4 symptoms characterized by decelerated
disorder of mood consisting of episodes of cognitive and behavioral activity.
depression and mania (or hypomania)
a.k.a. Manic-Depression Must cause impairment
What is a Manic Episode? - ANSWER -A S.I.G.E.C.A.P.S. - ANSWER -way to
period of elevated, euphoric or irritable mood remember characteristics of depressive episodes
lasting at least one week S-Sleep changes (usually increased)
I- loss of interest
3 (or 4, if mood is irritable) symptoms G- guilty feelings/worthlessness
characterized by accelerated cognitive and E- Energy low
behavioral activity which occur simultaneously C- difficulty concentrating
with the mood change.(DIGFAST) A-Appetite changes (usually increased, or could
be Reduced appetite but with carb craving)
Must cause severe impairment P-Psychomotor changes (usually retardation)
S-Suicidal ideation or recurrent thoughts of death
D.I.G.F.A.S.T. - ANSWER -way to
remember characteristics of manic episodes What is a Mixed Episode? - ANSWER -A
D-distractibility mood episode including symptoms of both
I-insomnia (decreased NEED for sleep) depression and mania occurring simultaneously
G-grandiosity Depressive Mixed Episode - mostly depressive
F-fast (racing) thoughts/flight of ideas with a couple of manic symptoms
A-activities (increased/goal directed) Mixed Manic Episode- mostly manic with a
S-speech (overtalkative) couple of depressed symptoms
T-thoughtlessness/reckless/impulsive DSM V reflects the above more closely than just
saying 'mixed'
What is a Hypomanic Episode? -
ANSWER -A period of elevated, euphoric Making the Bipolar Diagnosis if patient presents
or irritable mood lasting at least four days with depressive symptoms - ANSWER -If
the patient presents with a depressive episode,
3 (or 4, if mood is irritable) symptoms must rule out medical causes and other
characterized by accelerated cognitive and psychiatric illnesses that present with depression
behavioral activity which occur simultaneously AND search for a history of manic or hypomanic
with the mood change. (DIGFAST) episodes
Must NOT cause severe impairment
making bipolar diagnosis if patient presents with
manic/hypomanic symptoms - ANSWER -If
What is a Depressive Episode? - the patient presents in a manic or hypomanic
ANSWER -A period of sad mood or loss of episode, must rule out medical causes and other
interest in most things all day long, nearly every psychiatric illnesses that present with mania or
day for at least two weeks. hypomania
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, Bipolar disorder Test Questions and Answers Rated A
episodes.
Medical Causes of Mania and Depression -
ANSWER -Substance abuse: Stimulant
(cocaine, meth, caffeine, pseudoephedrine) Type I bipolar - ANSWER -One manic
intoxication/withdrawal, Alcohol, Opiate episode = type 1 (don't need any other
Medications: Steroids symptoms)
Neurological conditions: MS, Frontal lobe
syndromes, Temporal Lobe Epilepsy, Stroke
Endocrine conditions: Hyper-hypo-thyroidism, type II bipolar - ANSWER -hypomanic
Cushing's syndrome episode + major depression = type 2 (NO mania
Infections: HIV (- can alter mood/cognition- can in type 2)
cause symptoms like depression/manic)
Autoimmune disease: SLE (same as HIV)
Metabolic states: Hypoxia Cyclothymia - ANSWER -rapid fluctuation
between hypomania and subthreshold
depressions (don't last more than 2 weeks).
Psychiatric Differential Diagnosis - Happens over 2 years to be diagnosed.
ANSWER -Unipolar Depression
Schizophrenia
Schizoaffective Disorder Reasons for Misdiagnosis - ANSWER -
Attention Deficit Hyperactivity Disorder patient's Lack of Insight
Borderline Personality Disorder patient's Poor Memory
Narcissistic Personality Disorder Unreliability of Hypomania
Antisocial Personality Disorder Involve families
Primary Substance Abuse
Post Traumatic Stress Disorder
unipolar disorder - ANSWER -major
depressive disorder
how many individuals that are bipolar have had
No history of manic or hypomanic episodes
depressive symptoms? how many have had only
manic symptoms? - ANSWER -90% have Different treatments, illness course, personality
had depressive symptoms that have bipolar, This variables and family history as compared to
means 10% have only had manic episodes Bipolar patients
(unipolar mania, predominant polar mania)
things that would point you toward bipolar
how many individuals with bipolar have dealt with
diagnosis rather than unipolar - ANSWER -
pscyhosis? - ANSWER -60% lifetime Atypical depression features= (increased
prevalence sleeping, increased appetite, etc) - might hint you
only 15% point prevalence toward bipolar
Psychotic symptoms during depression (poverty,
nihilism)- might hint you toward bipolar
how many patients who are bipolar deal with Postpartum depression (especially w/ psychotic
anxiety? - ANSWER -50% of bipolar symptoms)- might hint you toward bipolar
patients might have comorbid anxiety disorder, Early age of onset might hint you toward bipolar
generalized anxiety that comes up with the
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