Bipolar Disorder

Nota:

• Bipolar Disorder: Axis 1 (DSM-IV TR) is characterized by many names: manic-depressive, bipolar mood disorder, Bipolar Affective disorder. It affects both 67%men and 75% women and symptoms usually show up in their early twenties. Signs & Symptoms: Epsiodes of mania (highs) *(3 or more symptoms for a week)  characterized by: psychomotor increased, in other words hyperactive, elevated mood ( " I am one with the universe"), impaired judgement, uninhibited, decreased sleep and appetite, inflated ego, reckless behavior, excessive spending, aggressive irritable, intrusive. Mania Depression: (5 or more symptoms for 2 weeks or longer ) characterized by: loss of interest in daily activies, fatigue, feeling worthless, unable to concentrate, appetite loss anxiety, thoughts of death and or suicide. Cause/or Etiology: Scientists and doctors seemed to think that biochemical genetics. psychological and environmental factors may be involved. An imbalance in brain chemicals: Neurotransmitters (i.e, Norepinephrine, Dopamine, and Serontin) Too little of these chemicals results in Depression & too much results in Mania. Thought Process: Flight of Ideas (speech in a continuous flow with abrupt changes from topic to topic), Clang Association (speech rhyming words with no meaning) Grandiosity: Inflated self, believe they are famous people, important with great powers in the world. Medication(s):May require different meds but Lithium Carbonate has been used for years to treat severe manic epsiodes(Acute Phase 1/recurrent). It usually takes one to two weeks or (7-14 days) to reach therapeutic levels. Theraputic Maintenance Blood Levels: 0.4 to 1.0 mEq/L Early Toxicity:1.5 mEq/L and can advance to severe toxicity=Medical Emergency! Risk for long term Therapy: (1) Kidney Impairment & (2) Hypothyroidism Important: to monitor blood levels on this medication often until the therapeutic level has been reached. Nursing Implications: Health Teaching: 1.MedicatIon Compliance and outpatient treatment adherence 2. Warning signs/symptoms 3.S/S side effect and toxic effects...whom to call or where to go in an emergency situation 4. Importance of adequate sleep, rest and nutritional meals 5. Group/Individual therapy for skills in relapse prevention& coping skills. NOTE: The rapid cycling must be 4 or more mood episodes in a 12-month period; Cyclothymia: hypomania alternating with minor depressive epsiodes at least 2 years in duration. Reference (s): Halter, M., & Varcarolis, E. (2010). Foundations of psychiatric mental health nursing: A clinical approach (6th ed.). New York: Saunders.

1. BIPOLAR DISORDER
   1. Snippets of Information
      1. Onset Symptoms, Neurotransmitters, Medications

         Nota:

         • Scientists and doctors don't fully understand the causes of this disorder characterized by "highs"(Mania) and "Lows"(Depression). Beyond environmental, psychological & genetics are: THREE BRAIN NEUROTRANSMITTERS ARE INDICATED:(1) Norepinehrine=excitability in the brain, Serotonin=sleep, eating, sex, memory, impulsivity, learning , & Dopamine=Brain pleasure. In Bipolar there is either too little or too much.
         1. Treatment Regimen & Nursing Interventions

            Nota:

            • NURSING IMPLICATONS/HEALTH TEACHING: INPATIENT: (Safety) Protect client and others from hyperactive manic behaviors, promote reality-orientation, encourage group therapy, problem-solving, coping skills, medication-compliance, monitor meals intake and sleep, decrease environmental stimuli, Discharge/Outpatient: 1. Importance of medication compliance and adherence to outpatient treatment 2. To report signs and symtoms of  meds adverse effects to doctor or nurse., especially if meds (Lithium) causes toxic effects( diarrhea, vomiting, abd cramping, nausea, unsteadiness, drowinsess, muscle weaknesses) and to discontinue the med immediately, notify the doctor. 3. Importance of getting adequate rest, sleep and nutrition 4. Attend group therapy to enhance coping skills,
            1. Some Famous People Who Suffered With Bipolar

               Nota:

               • Some Famous People who suffered with Bipolar Disorder:( Manic or Depression). Past and Present. Patty Duke Austin-Actor; Abraham Lincoln-President, Jim Carey- TV Actor Robin Williams-Comedian/TV Actor Charles Dickens-Author Ellen DeGeneres-Comedian/Talk Show Host Janet Jackson-Singer Ludwig Van Beethoven-Artist Theodore Roosevelt-President Mark Twain-Author Jean-Claude Van Damme-Movie Action Hero Linda Hamilton-Actor Jane Pauley- TV News Anchor Mel Gibson-Movie Actor Wolfgang Amadeus Mozart- Musician/Composer
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