DAY 11 ASSIGNMENT

Give brief to below given questions

Question 1 – What do understand by Manic disorder?

A manic episode lasts at least for a period of one week, when a person is very high spirited of
irritable in an extreme way most of the day for most days, has more energy than usual and
experiences at least three of the following change in behavior:
 Exaggerated self-esteem or grandiosity
 Less need for sleep
 Talking more than usual, talking loudly and quickly
 Easily distracted
 Doing many activities at once, scheduling more events in a day than can be
accomplished
 Increased risky behavior (e.g. reckless driving, spending sprees)
 Uncontrollable racing thoughts or quickly changing ideas or topics
As per ICD 10, Maniac disorder is categorized under F30 Maniac episode
F30.1 Mania without psychotic symptoms
Mood is elevated out of keeping with the individual's circumstances and may vary from carefree
joviality to almost uncontrollable excitement. Elation is accompanied by increased energy,
resulting in over activity, pressure of speech, and a decreased need for sleep. Normal social
inhibitions are lost, attention cannot be sustained, and there is often marked distractibility. Self-
esteem is inflated, and grandiose or over-optimistic ideas are freely expressed.
F30.2 Mania with psychotic symptoms
The clinical picture is that of a more severe form of mania as described in F30.1.Inflated self-
esteem and grandiose ideas may develop into delusions, and irritability and suspiciousness into
delusions of persecution. In severe cases, grandiose or religious delusions of identity or role
may be prominent, and flight of ideas and pressure of speech may result in the individual
becoming incomprehensible. Severe and sustained physical activity and excitement may result
in aggression or violence, and neglect of eating, drinking, and personal hygiene may result in
dangerous states of dehydration and self-neglect. If required, delusions or hallucinations can be
specified as congruent or incongruent with the mood. "Incongruent" should be taken as
including affectively neutral delusions and hallucinations; for example, delusions of reference
with no guilty or accusatory content, or voices speaking to the individual about events that have
no special emotional significance.
Question 2- What is difference between depressive and manic episode?

Parameter Depressive episode Maniac Episode

The individual usually suffers from It is a distinct period of an abnormally

depressed mood, loss of interest and and persistently elevated, expansive, or
enjoyment, and reduced energy leading irritable mood lasting for at least 1
ICD 10
to increased fatigability and diminished week(or less if the patient is hospitalized)
activity. Marked tiredness after only slight
effort is common.

Mania refers to a syndrome in which the

central features are over activity, mood
change and self important ideas.

Loss of energy, decrease in activity and Increased energy, increase in activity

Energy
interest in activities. and/or goal directed activities. May
Levels
spend more money.

Changes in Disrupted sleep patterns, with trouble Decreased need for sleep without feeling
sleep falling or staying asleep, waking too tired.
pattern early, sleeping too much.

Feeling down, low, empty, hopeless, Feeling good, high or exhilarated. May
Thoughts worthless. Think they are useless, a think they are chosen, special, gifted,
and burden, and the cause of their own entitled. Increased libido. Increased
feelings problems. Decreased libido. Impaired thinking, disorganised, flood of ideas.
thinking, concentration, decision making

Speech can be slowed, with few ideas. Pressured speech, maybe without
Speech Dulled perception and sensation, but in enough time to convey all of the ideas,
and some cases some senses can be inappropriate. Heightened perception
sensations heightened (e.g., taste and smell). and sensation. May have underlying
agitation in severe cases

In severe cases of depression, there can In severe cases of mania, there may be
Delusions,
be nihilistic delusions (e.g., may think grandiose delusions (e.g., may think they
hallucinatio
their body is decaying). are God, or they are a superhero sent to
ns
save the world).
Question 3- What will be the treatment plan for bipolar?

Treatment can help a person with bipolar illness manage their symptoms and function well in
everyday life. Medication alone or a combination of talk herapy (psychotherapy) and medication
are often used to manage the disorder over time.
Each person is different and each treatment is individualized. People with bipolar disorder may
need to try different medications and therapy before finding what works for them. Bipolar
disorder is recurrent illness, meaning that t can come back. Ongoing preventive treatment is
recommended. If left unattended bipolar disorder can have a major impact on social and
occupational functioning. I also include the risk of suicide.
Following are recommended treatments for bipolar disorder –
Psychotherapy –
Research has shown tha for mania, psychotherapy helps people recognize mood symptoms
early and helps them follow a course of treatment more closely. A number of psychotherapy
techniques may be helpful depending on the nature of the person’s problem.

 Cognitive Behavior Therapy – Helps a person recognize patterns of thinking that may
help him to manage illness. Overall it trains a person to recognize feelings, thoughts
and behaviors to be aware of its overall effect.
 Psychodynamic therapy – It helps in sortin conflicts in important relationships or
explore the history that has contributed to current problems.
 Family focused therapy – helps patient and his family to understand the bipolar
disorder and to manage it in better way. Family members learn to recognize warning
signs of mania and depression.
 Interpersonal therapy – IT therapy teaches skills to improve interaction with other
people. It helps in improving interpersonal relationship and daily routines.
Medications-
A person with bipolar disorder tends to experience extreme highs (mania) and Extreme lows
(depression). Certain medications can help stabilize mood.

 Mood stabilizer – This is most commonly prescribed medication for BD. This is used
during maintenance phase in order to prevent relapses.
 Antidepressants – This are used to reat symptoms of depression in bipolar disorder. This
drug group exercises is effect on neurotransmitters that improve mood (serotonin,
noradrenaline and dopamine , etc)
 Atypical antipsychotics – they are seperae from first generation conventional
antipsychotics.
Finding right medication for a patient may take some trail and error approach.
Electroconvulsive Therapy –
When people do not get better with medications and psycho-therapy , ECT is an effective
option. His sometimes is called “shock” therapy. ECT uses quick shocks which can sometimes
correct problems in the brain. ECT is highly effective and safe treatment for both depressive and
manic phases.