Bipolar Disorder

Mental Health "Psychiatric Care"

Pathophysiology
Bipolar is a mood disorder with cycling periods of lows with Depression followed by highs with Acute Mania.

During depression: clients have low mood, low energy, & motivation & high risk for suicide.
During acute mania: high energy, hyperactivity, elevated mood, & even aggression with violence.

HESI Question
Four or more mood MEMORY TRICK
Depression Acute Mania
episodes in a
12-month period, the Depression Mania
Declined mood More energy + Maniac
patient is said to be
Rapid cycling

ATI Question
Five acute manic
episodes in one year
Rapid cycling

Types of Bipolar Disorders

Bipolar 1 - 1 episode of mania that lasts over 1 week or need for hospitalization
Bipolar 2 - 2 episodes of milder high hypomania, which can last longer
Cyclothymia - milder lows & milder highs cycling over a period of 2 years
Rapid Cycling - 4 episodes of depression & mania within a 12 month period

Causes & Risk Factors

The cause is unknown but what does play a big part is:
• Genetics - having a family member with bipolar, clients are 10x more likely to have it.
• SSRIs (antidepressants) can trigger a manic episode
SSRIs can trigger a manic episode
Genetics SSRI

10x

Signs & Symptoms

M
More energy & Mood Swings
Euphoric energy, impulsive, grandiosity
ATI Question Kaplan Question
Hallucinations & delusions of grandeur
Q1: Acute manic phase: Which symptom
symptoms with manic behavior? does the nurse expect?

A Agitation
Set limits & structured environment
• More talkative than usual
• Easily distracted
• Hyperactivity & irritable

Q2: “I just bought myself a home

• Intense need for activity computer and a large screen TV for

N
the family.” Which interpretation is
Non-stop talking & Flight of ideas most accurate?
Colorful bizarre clothing choices
HESI Question • Mood disturbance and judgement
that is poor at this time
manic phase?

I Insomnia
Cannot sleep for days
Select all that apply.
• The client is quickly angered
• Flight of ideas
Saunders
Assessment finding that requires

A
• Going rapidly from one activity immediate intervention?
Attention span POOR to another • Nonstop physical activity and poor
Easily distracted = reduce stimuli
• Colorful & outlandish clothing nutritional intake
• Constant delusions