Bipolar Disorder
Bipolar Disorder
Overview
- There are two main types of bipolar disorder: Bipolar 1 and Bipolar 2
- Bipolar 1 involves at least one single manic episode with or without a depressive episode; whereas, Bipolar 2 involves at least one hypomanic episode and at least one depressive episode.
- Emphasize that any manic episode makes the diagnosis Bipolar 1, so let's see what a manic episode entails.
Symptoms
A manic episode requires at least one week of at least 3 "DIG FAST" symptoms, which stand for:
- Distractibility
- Impulsivity
- Grandiosity
- Flight of ideas (racing thoughts)
- Agitation
- Decreased sleep
- Talkativeness (pressured speech)
Superman
- We draw a picture of Superman rushing to the hospital to encapsulate that although manic patients may feel like they are on top of the world, the end outcome is typically self-destructive rather than productive.
Hospitalization
- Hospitalization, by definition, qualifies the event as mania (as opposed to hypomania).
Hypomania
- A hypomanic episode involves less severe mania for at least 4 days and does NOT cause marked social impairment or (as shown) hospitalization.
Differential Diagnosis
Cyclothymia
- A non-episodic (persistent) manifestation, called cyclothymia, which we symbolize with a cycle, because the individual will cycle between hypomania and depression.
- The disorder must last at least two years with symptoms present for at least one-half of the time and cannot be asymptomatic for two consecutive months at any period of time.
- In essence this is the bipolar equivalent of dysthymia.
Board Review
USMLE & COMLEX-USA
USMLE Step 1 / COMLEX-USA Level 1
USMLE Step 2 / COMLEX-USA Level 2
USMLE Step 3 / COMLEX-USA Level 3
Nurse Practitioner (NP)
Nurse Practitioner Licensing Exam
Physician Assistant (PA)
Physician Assistant Licensing Exam
Neurology (ABPN)
American Board of Psychiatry & Neurology (ABPN) Exam
Internal Medicine (ABIM)
American Board of Internal Medicine (ABIM) Exam