Question

1. What is the clinical picture of Bipolar I and Bipolar II?
2. What are the risk factors for Bipolar Disorders?
3. What are 3 signs and symptoms of Bipolar Disorder?
4. What are the 3 interventions that can be used for Mania episodes?
5. What are some approved drugs used for Bipolar Disorder?
6. What is the clinical picture of Depressive Disorders?
7. What are the risk factors for Depressive Disorders?
8. What are 3 signs and symptoms of Bipolar Disorder?
9. What are the vegetative signs of depression?
10. What are the 3 phases in treatment and recovery from major depression?
11. What are the 3 interventions used for Depression treatment?

Answer 1

# Clinical picture of bipolar l and bipolar ll

Bipolar l disorder involves period of severe mood episodes from mania to depression.Bipolar ll disorder is a milder form of mood elevation, involving milder episodes of hypomania that alternative with periods of severe depression.

# Risk factors of bipolar disorder

* Having a first degree relative such as parent or siblings,with bipolar disorder

* May be triggered by stressful events,such as the death of loved once or other traumatic event.

* Drugs or alcohol abuse .

* Sleep deprivation and hypothyroidism

# 3 signs and symptoms of bipolar disorder.

There are three types of bipolar disorder they are

* Bipolar l disorder - defined by manic episodes.In this patient have hyperirritable mood , increased psychomotor activity,excessive social extroversion,rapid speech with frequent topic change .Manic symptoms are so severe ,so patient need immediate hospitalization.

* Bipolar ll disorder - defined by depressive episodes and hypomanic episodes.In this patient have lowself esteem , feelings of hopelessness,apathy, difficulty in concentrating or thinking clearly, psychomotor retradation ,sucidual ideation .

* Cyclothymic disorder/ Cyclothymia - defined by periods of hypomanic symptoms as well as periods of depressive symptoms lasting for at least 2 years .In this patient have hyperactivity and physical restlessness, irritability, social withdrawal,lethargy ,deceased productivity, feeling of inadequacy.

# 3 intervention used for mania episode.

*Psychopharamacotherapy

Mood stabilizer,( lithium 900 - 2100mg /day 3divided dose ,carabamazapine 600 - 1800mg /day , sodium valproate 600 - 2600 mg / day ). Other drugs are antipsychotics medications and antianxiety drugs ( eg : diazepam, Clonazepam)

* Electro convulsive therapy (ECT) it is in the case of acute mania .if the patient is not adequately responding to antipsychotics and lithium.

* Therapies

Individual therapy- it is a form of therapies ,which the clieyis treated on a one on one basis with a therapist.

Family therapy- it is a type of psychological counseling that can help family members improve communication and resolve conflict.

Marital therapy- it is a form of psychotherapy with the aim of helping the partners to enjoy a more rewarding relationships.

# Drugs approved for bipolar disorder.

* Mood stabilizer

Lithium, Valpronic acid , carabamazapine,lamotrigine

* Antipsychotics

Clozapine,cariprazine , risperidone,lurasidone ,olanzapine .

* Antidepressants

Selective serotonin reuptake inhibitor, tricyic antidepressants.

# clinical picture of depressive disorder.

* Low sel-esteem

* Over whelming inertia

* Feeling of hopelessness,apathy

* Difficulty in concentrating or in thinking clearly ( without obvious ddisorientation or intellectual impairement)

* Psychomotor retradation

* Anhedonia

* Sucidual ideation.

# Risk factors of depressive disorder

* Genetics- a history of depression in your family may make it more likely for you to get it.

* Death or loss - sadness and greif are normal reaction.some time big stresses can bring serious symptoms of depression like thoughts of sucide or feeling of worthless.

* Conflict- disputes with family or friends may lead to depression.

* Abuse - past physical, sexual or emotional abuse can bring it on , as well

* Life events- even good thoughts could make you depressed.

# Vegetative signs of depression

* Insomnia or hypersomnia

* Fatigue and low energy

* Inattention

* Weight loss and anorexia .

# 3 phases of treatment of major depression.

* Acute phase - remission is induced ( minimum 6-8weeks in treatment), in this phase provide pharmacotherapy alone or both combination of psychotherapy and pharmacotherapy.

* Continuation phase - remission is preserved and relapse prevented ( usually 16-20 weeks in duration) , psychiatric management should continue in this phase .

* Maintance phase - suceptible patient are protected against recurrence or relapse of subsequent major depressive episodes.( Duration various with frequent and severity of previous episodes)

# 3 intervention for depressive treatment

* Cognitive behavioral therapy- focus on present thinking behaviors and communication other than on past experience and is oriented towards problems solving.

* Interpersonal therapy - it focused psychotherapy that centered on resolving interpersonal problems and symptoms recovery

* Psychodynamic therapy - form of therapy with focus on holistic prospective of the client.