BIPOLAR

DISORDER

group 6
Astrero, Mirazol
Cudal, Jasmin
Daliri, Adonis
Lauria, Des
Malsi, Carmela
Ngayan, Rizanette
Obedeza, Denisse
Samosam, Genalyn
Simangan, Ryan
Disease
Bipolar I
The diagnosis given to an individual
who is experiencing, or has
Overview experienced, a full syndrome of
manic or mixed symptoms.

Bipolar disorders are

Bipolar II
characterized by mood Characterized by recurrent
bouts of major depression
swings from profound with the episodic
depression to extreme occurrence of hypomania.

euphoria (mania), with Cyclothymic

intervening periods of A chronic mood disturbance of at

least 2 years’ duration, involving
normalcy. numerous periods of depression
and hypomania, but not sufficient
severity and duration to meet the
criteria for either bipolar I or II
disorder.
 Other Types

Bipolar Disorder due to - Characterized by a prominent and persistent disturbance in mood

General Medical (bipolar symptomatology) that is judged to be the direct result of the

Condition physiological effects of a general medical condition.

Substance-Induced - Considered to be the direct result of the physiological effects of a

Bipolar Disorder substance (e.g., use or abuse of a drug or a medication, or toxin

exposure).
Etiology
Causes
The DSM-5-TR lists the following causes of bipolar disorder 1 and 2:
Genetics: Bipolar disorder is thought to be caused by a combination of genetic and
environmental factors. Studies have shown that people with a family history of
bipolar disorder are more likely to develop the disorder themselves.
Brain chemistry: People with bipolar disorder may have imbalances in certain brain chemicals,
such as dopamine and serotonin. These imbalances may contribute to the
symptoms of bipolar disorder.
Environmental factors: Stressful life events, such as the death of a loved one, a divorce, or a job loss,
may trigger the onset of bipolar disorder. Traumatic experiences, such as physical
or sexual abuse, may also increase the risk of developing bipolar disorder.
Substance abuse: Alcohol and drugs can trigger or worsen the symptoms of bipolar disorder.

Medical conditions: Certain medical conditions, such as thyroid problems or head injuries, may
increase the risk of developing bipolar disorder.
It is important to note that the exact causes of bipolar disorder are not fully understood. However, the factors listed
above are thought to play a role in the development of the disorder.
 Signs &
symptoms
Symptoms of MANIA can include:
• feeling happy or excited, even if things aren’t going well,
• being full of new and exciting ideas,
• moving quickly from one idea to another,
• racing thoughts or alterations in thought processes and communication
patterns and are manifested by the following:

o Flight of Ideas. There is a continuous, rapid shift from one topic to another.
o Loquaciousness. The pressure of the speech is so forceful and strong that it is
difficult to interrupt maladaptive thought processes.
o Delusions of Grandeur. The individual believes he or she is all important, all
powerful, with feelings of greatness and magnificence.
o Delusions of Persecution. The individual believes someone or something
desires to harm or violate him or her in some way.
Signs &
symptoms
HYPOMANIA
Hypomania is like mania but with milder symptoms. The slight difference between
mania and hypomania include:

MANIA
Behaviour is so extreme that regular activities
cannot be maintained.
Delusions or hallucinations may occur.
Feelings of invincibility are common.
HYPOMANIA
People might notice changes, but regular
activities may still be maintained.
Typically, delusions and hallucinations
do not occur.
Risk-taking is common.
 Signs &
symptoms
DEPRESSION
• Symptoms of depression can include:
• low mood,
• having less energy and feeling tired,
• feeling hopeless or negative,
• feeling guilty, worthless or helpless,
• being less interested in things you normally like doing,
• difficulty concentrating, remembering or making
decisions,
• feeling restless or irritable,
• sleeping too much or not being able to sleep,
• eating less or over eating,
• losing or gaining weight, when you don’t mean to, and
• thoughts of death or suicide, or suicide attempts.
 Signs &
symptoms
PSYCHOSIS
psychotic symptoms during a severe episode of
mania or depression. Symptoms of psychosis can
be:

hallucinations. This means that you may hear, see,

or feel things that are not there, and
delusions. This means you may believe things that
aren’t true. Other people will usually find your
beliefs unusual.
Psychopharmacology

Treatment for bipolar disorder involves a lifetime regimen of medications— either an

anti-manic agent called lithium or anticonvulsant medications used as mood
stabilizers
● Lithium. Lithium is a salt contained in the human body; it is similar to gold, copper,
magnesium, manganese, and other trace elements.
• It can stabilize bipolar disorder by reducing the degree and frequency of
cycling or eliminating manic episodes
• it is thought to work in the synapses to hasten destruction of catecholamines
• (dopamine, norepinephrine), inhibit neurotransmitter release, and decrease the
sensitivity of postsynaptic receptors
• Lithium use during pregnancy is not recommended because it can lead to
• first-trimester developmental abnormalities.
 Psychopharmacology
Anticovulsant Drug. Several anticonvulsants traditionally used to treat seizure disorders
have proved helpful in stabilizing the moods of people with bipolar illness. These drugs are
categorized as miscellaneous anticonvulsants. Their mechanism of action is largely
unknown, but they may raise the brain’s threshold for dealing with stimulation; this prevents
the person from being bombarded with external and internal stimuli

ANTICONVUSANT THAT IS USED AS MOOD STABILIZERS

Carbamazepine (Tegretol)
-had been used for grand mal and temporal lobe epilepsy
as well as for trigeminal neuralgia, was the first
anticonvulsant found to have mood-stabilizing properties,
but the threat of agranulocytosis was of great concern.
Divalproex (Depakote)
-also known as divalproex sodium or sodium valproate, is
an anticonvulsant used for simple absence and mixed
seizures, migraine prophylaxis, and mania.
 Psychopharmacology

Gabapentin (Neurontin), Lamotrigine (Lamictal), Topiramate

(Topamax)
--are other anticonvulsants sometimes used as mood stabilizers,
but they are used less frequently than valproic acid.

Clonazepam (Klonopin)
-- is an anticonvulsant and a benzodiazepine (a schedule IV
controlled substance) used in simple absence and minor motor
seizures, panic disorder, and bipolar disorder. Physiological
dependence can develop with long-term use. This drug may be
used in lithium or other mood stabilizers, but is not used alone to
manage bipolar disorder.
 Psychopharmacology
Aripiprazole (Abilify), brexpiprazole (Rexulti), and cariprazine
(Vraylar)
-- are dopamine system stabilizer antipsychotic medications used as
adjuncts to other mood-stabilizing drugs. When other mood stabilizers
alone are inadequate in controlling symptoms, the addition of these
medications is effective in both the acute and maintenances phases of
treatment

 Second-generation antipsychotic medications are often used in

conjunction with mood stabilizers or antidepressants to treat bipolar
disorder. Ziprasidone (Geodon), lurasidone (Latuda), and quetiapine
(Seroquel) are most effective. They prevent a “switch to mania”
when persons are treated for a depressed episode and manage
psychotic symptoms that are associated with mania in some people
THERAPY

Cognitive Behavioral Therapy (CBT)

is an individual therapy focused on the relationship between a
person's thoughts, feelings and behaviors.

Family-focused therapy (FFT)

is a psychoeducational treatment for patients with BD
focused on alleviation of mood symptoms, relapse
prevention and enhanced psychosocial functioning.

Interpersonal and Social Rhythm Therapy | Interpersonal

and Social Rhythm Therapy (IPSRT)
is designed to help people improve their moods by
understanding and working with their biological and social
 NURSING INTERVENTIONS

 Promoting Physical Safety

 Promoting Independence in Self-Care Activities

 Reducing Anxiety

 Promoting Appropriate Behavior

 Providing Therapeutic Communication

 Providing for Social needs

 Promoting Adequate Nutrition & increase water intake.

 Promote Balanced Activity and Rest

 Managing Medications
These are combined interventions for the patient who are at risk of injury,
Risk For Violence: Self-Directed or Other Directed and Impaired Social
Interaction in patient with bipolar disorders

● Provide structured solitary activities with the assistance of a nurse or aide.

● Encourage the client to communicate openly about their feelings and concerns, and
provide a nonjudgmental and supportive environment.
● Maintain a low level of stimuli in the client’s environment (e.g., loud noises, bright light,
low-temperature ventilation).
● Encourage the client to engage in activities that are safe and structured, such as
exercise or creative activities.
● Provide a safe and supportive environment for the client, including ensuring that the
client’s room is free from potential hazards and that safety measures are in place (such
as bed rails or padded walls).
● Redirect violent behavior.
● Protect the client from giving away money and possessions. Hold valuables in a
hospital safe until rational judgment returns.
● Work with the client to develop a safety plan that includes methods to manage mood
swings and prevent injury, as well as emergency contacts and resources.
● Assist in transferring the client to the appropriate facility or with the admission
process.
● Place the client in suicide precautions
● Use a calm and firm approach.
● Use short, simple, and brief explanations or statements.
● Remain neutral as possible; do not argue with the client.
● Chart, in nurse’s notes, behaviors; interventions; what seemed to escalate
agitation; what helped to calm agitation; when as-needed (PRN) medications
were given and their effect; and what proved most helpful
● Consider using restraints carefully and in line with protocols and the client’s
rights.
● Provide information to the client and family on bipolar disorder and its impact on
social interaction.