BIPOLAR DISORDER

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BIPOLAR DISORDER
Amol Pai and Wai-Kam Leong
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Bipolar
Disorder
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What is Bipolar Disorder? Manic-Depression

• A brain disorder affecting moods and energy that
  effects over 2 million in the U.S.A.
• Emotions, thoughts and moods are distorted
  resulting in mood swings that are overly high
  to extremely sad and hopeless
• Defined as having one or more manic or mixed
  episodes and depression episodes lasting most of
  the day, every day for 2 weeks or more
• A long-term illness that typically develops in
  adolescence or early adulthood but symptoms often
  seen in childhood
• Often misdiagnosed as ADHD, OCD and depression
  and sometimes schizophrenia
• Often leads to suicidal thoughts
• Can be treated and lead full productive lives

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Signs and Symptoms

• DEPRESSION
• Ongoing sad, anxious or empty mood
• Lack of energy and ability to concentrate
• Sleeping too much or too little
• Lacks interest in others and activities,
  irritable, feeling hopeless and worthless
• Thoughts of death or suicide

• MANIC
• Feelings of grandiosity or very high self-esteem,
  euphoric
• Extreme talkativeness, racing thoughts
• Decreased need for sleep
• Highly distractible
• Engaged excessively with pleasurable activities,
  often recklessly

• SIGNS IN YOUNGER CHILDREN
• Poor sleep and night terrors
• High activity level
• Easily startled
• Bedwetting
• Oppositional behavior

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Range of Mood and Emotion
severe mania
mild to moderate mania (hypomania)
normal-balanced mood
mild to moderate depression
severe depression
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Treatment

• Just like long-term illnesses such as diabetes
  and heart disease, bipolar disorder is an illness
  that requires medication to improve quality of
  life
• Not all medications work for every person
• Severity of moods and side effects must be
  weighed
• Medical management by a psychiatrist is best
• A combination of medication and talk therapy is
  most effective, specifically cognitive behavior
  and family therapy
• Long-term management of symptoms reduces risk of
  suicide
• suicide rate 10-15, NIMH

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Medication
Mood-stabilizers
Medicine combinations

• Lithium reduces manic episodes and aggression.
  Eskalith, Lithobid, Lithonate
• Side effects upset stomach, tremors, headache,
  weight gain, tiredness and difficulty with
  memory.
• Anticonvulsants/Antiepileptics reduce seizures,
  mania, aggression. Side effects include upset
  stomach and drowsiness.
• Tegretol Carbamazepine nausea, irritability and
  agitation
• Depakene , Depakote Valproic hand tremors and
  loss of hair
• Neurontin/Gabapentin, Lamictal/lamotrigine,
  Topamax/topiramate and Gabitril tiagabine are
  the newest medications. Side effects are similar
  with the addition of rash, nausea dry mouth

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Family Issues and Interventions

• Attend to behavior such as rage with therapeutic
  hold, quiet retreat area and pick your battles,
  behavior modification does not work well
• Siblings relationships and marriages often become
  strained
• Get family therapy
• Dont ignore signs of suicide ideation or extreme
  hopelessness
• Educate family on disorder and how to deal with
  mood swings
• Seek support groups and parent resources

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Resources
WEBSITES National Institute of Mental Health
(NIMH) http//www.bipolarbrain.com/SoWhatsBipolarI
llness.html http//www.nimh.nih.gov/publicat/bipol
armenu.cfm http//www.nimh.nih.gov/publicat/manic.
cfm Excellent brochure and other pertinent
information  National research of mental health ,
booklet. Articles Northern County Psychiatric
Association (Maryland)  http//www.ncpamd.com/Bipo
lar.htm articles, links on disorder, meds,
suicide, etc Pediatric Psychiatry
Pamphlets http//www.klis.com/chandler/pamphlet/bi
polar/bipolarpamphlet.htm definition, case
studies, treatment, side effects Child and
Adolescent Bipolar Foundation (CABF) Wilmette,
IL Phone [phone]
http//www.bpkids.org/   National Mental Health
Associatopn (NMHA) http//www.nmha.org/infoctr/fac
tsheets/76.cfm Pediatrician Guide to Health and
Safety http//www.keepkidshealthy.com/ Illinois
State Board of Education (ISBE) http//www.isbe.st
ate.il.us/ Special education information,
IEP BOOKS The Bipolar Child by Demitri F.
Papolos M.D. The Explosive Child by Ross W.
Green Ph.D. MEDICAL TERMS AND MEDICATION
INFORMATION Dictionary http//www.medicinenet.com
/script/main/AlphaIdx.asp?liMNIpA_DICT RX
Drugs http//www.nlm.nih.gov/medlineplus/druginfo
/drug_Aa.html http//www.healthsqr.com/aindex.htm
 
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Thank You
The End