Bipolar disorder
Background
- mental disorder characterized by periods of elevated moods and periods of depression
- spectrum of disorders including Bipolar Type I, Bipolar Type II, and Bipolar NOS
Clinical Features
Manic Episode
- abnormally and persistently elevated, expansive, or irritable mood lasting at least 1 week
- at least 3 of the following symptoms (4 if only irritable)
- inflated self esteem or grandiosity
- decreased need for sleep
- more talkative/pressured speech
- flight of ideas/racing thoughts
- easily distractible
- increase in goal-directed activity or psychomotor agitation
- involvement in high pleasure, high risk activities
- gambling, shopping sprees, sexual indiscretions
- sufficient to cause impairment in functioning, relationships, or hospitalization
- not as a result of substance abuse or medical condition (e.g. hyperthyroid)
Hypomanic Episode
- Same features as manic episode however less intense
- Symptoms only need to persist for 4 days
Major Depressive Episode
- Sleep - increased or decreased
- Interest - losing interest or pleasure in activities
- Guilt - excessive guilt
- Energy - feels of fatigue, low energy
- Concentration - cognitive decine, indecisiveness
- Appetite - weight loss/gain
- Psychomotor agitation or depression
- Suicidal ideation
Must have 5 symptoms in a 2 week period including depressed mood and loss of interest
Mixed Episode
- fulfill features of both manic and major depressive episode
- must last at least 1 week
Differential Diagnosis
General Psychiatric
- Organic causes
- Psychiatric causes