BIPOLAR DISORDER

both manic and depressive episodes

shoplifting [of items she could not afford] • (Oct 08) spent P14000 for shopping . • (3rd rd year) : very talkative in class • (Oct 08) noted to be very talkative on their way to a cemetery in Marikina • (3rd rd year) : numerous ideas running in her mind • “hyperactive” • (1993) grabbed car’s steering wheel while her mom was driving • (3rd rd year) .Manic Episode DSM-IV-TR Criteria • • A distinct period of abnormally and persistently elevated. maxing out her 2 credit cards .shopped for clothing items & jewelries. expansive. or irritable mood. lasting at least 1 week (or any duration if hospitalization is necessary). During the period of mood disturbance. three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree: – inflated self-esteem or grandiosity – decreased need for sleep – more talkative than usual or pressure to keep talking – flight of ideas or subjective experience that thoughts are racing – distractibility – increase in goal-directed activity or psychomotor agitation – excessive involvement in pleasurable activities that have a high potential for painful consequences PATIENT • No mood elevations • There were episodes of irritable mood but not enough to consider as the prevailing mood in this case. stayed at an apartelle for 3 days .

g. or other treatment) or a general medical condition (e. a medication. or to necessitate hospitalization to prevent harm to self or others. hyperthyroidism).. • The symptoms are not due to the direct physiological effects of a substance (e.g. • The mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others..Manic Episode DSM-IV-TR Criteria • The symptoms do not meet criteria for a mixed episode. PATIENT . or there are psychotic features. a drug of abuse.

– depressed mood most of the day. nearly every day. present during the same 2week period and represent a change from previous functioning. or indecisiveness. activities most of the day. present during the same 2- Five (or more) of the ff. recurrent suicidal ideation without a specific plan. or almost all.Major Depressive Disorder • DSM-IV-TR Criteria Five (or more) of the ff. irritable mood – markedly diminished interest or pleasure in all. nearly every day – recurrent thoughts of death (not just fear of dying). nearly every day – significant weight loss when not dieting or weight gain – insomnia or hypersomnia nearly every day – psychomotor agitation or retardation nearly every day – fatigue or loss of energy nearly every day – feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day – diminished ability to think or concentrate. (feels sad or empty) or appears tearful . at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure. or a suicide attempt or a specific plan for committing suicide PATIENT • Dec 2002: bus ride – approached by a man and was told that she looks miserable and sick .no other description in the hx that is indicative of a depressed state .

suicidal ideation. DSM-IV-TR Criteria PATIENT . a drug of abuse. hypothyroidism). • The symptoms cause clinically significant distress or impairment in social. or other important areas of functioning. morbid preoccupation with worthlessness.e. i. a medication) or a general medical condition (e. • The symptoms are not due to the direct physiological effects of a substance (e..Major Depressive Disorder • The symptoms do not meet criteria for a mixed episode. • The symptoms are not better accounted for by bereavement.. or psychomotor retardation. after the loss of a loved one.. the symptoms persist for longer than 2 months or are characterized by marked functional impairment.g. psychotic symptoms.g. occupational.

the symptoms persist for longer than 2 months or are characterized by marked functional impairment. after the loss of a loved one.Major Depressive Disorder • The symptoms do not meet criteria for a mixed episode. occupational. hypothyroidism). suicidal ideation.e. • The symptoms are not due to the direct physiological effects of a substance (e.g.. psychotic symptoms.g. • The symptoms are not better accounted for by bereavement. • The symptoms cause clinically significant distress or impairment in social. i. morbid preoccupation with worthlessness.. a drug of abuse. DSM-IV-TR Criteria PATIENT . or other important areas of functioning. a medication) or a general medical condition (e.. or psychomotor retardation.

Maxing out credit card .BP characteristics • Excited. talkative. hyperactive • Euphoric or irritable (low frustration tolerance) • Delusions in 75% [ patient: (+) delusion of refernce & non bizaare delusion) • Intact orientation & memory • Assaultive or threatening • Hallmark: impaired judgment: may break laws .Shoplifting .