Bipolar Mood Disorder

Managment of patient with BMD

1. BIPOLAR MOOD DISORDER (BMD) PREPARED BY MRS. DIVYA PANCHOLI ASSISTANT PROFESSOR, SSRCN, VAPI MRS. DIVYA PANCHOLI 1

2. BIPOLAR MOOD DISORDER It is characterized by recurrent episodes of mania and depression in the same patient at different times . Patient experiences extreme highs (mania or hypomania) alternating with extreme lows (depression), Onset: between 20 to 30 Symptoms sometimes appear in late childhood or early adolescence. MRS. DIVYA PANCHOLI 2

3. CLASSIFICATION F31.0- bipolar affective disorder, current episode hypomania F31.1- bipolar affective disorder, current episode mania without psychotic symptoms F31.2-bipolar affective disorder, current episode mania with psychotic symptoms F31.3-bipolar affective disorder, current episode mild or moderate depression F31.4-bipolar affective disorder, current episode severe depression without psychotic symptoms F31.5-bipolar affective disorder, current episode severe depression with psychotic symptoms F31.6-bipolar affective disorder, current episode mixed MRS. DIVYA PANCHOLI 3

4. ETIOLOGY Precise cause unknown Genetic, biochemical and psychological factors may play a role May be triggered by stressful events, antidepressant use Sleep deprivation and hypothyroidism MRS. DIVYA PANCHOLI 4

5. SIGNS AND SYMPTOMS OF BIPOLAR MOOD DISORDERS Manic phase: Expansive, grandiose or hyperirritable mood Increased psychomotor activity, such as agitation, pacing Excessive social extroversion Rapid speech with frequent topic changes Decreased need for sleep and food Impulsivity Impaired judgment MRS. DIVYA PANCHOLI 5

6. Depressive phase: Low self-esteem Feelings of hopelessness, helplessness, worthlessness, apathy or self-reproach Difficulty concentrating or thinking clearly Psychomotor retardation Anhedonia Suicidal ideation MRS. DIVYA PANCHOLI 6

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8. DIAGNOSIS Based on signs and symptoms Based on DSM-5 criteria MRS. DIVYA PANCHOLI 8

9. TREATMENT MRS. DIVYA PANCHOLI 9

10. COURSE Average manic episode- lasts for 3-4months Average depressive episode- lasts for 4-9 months MRS. DIVYA PANCHOLI 10

11. RECURRENT DEPRESSIVE DISORDER Characterized by recurrent depressive episodes. The current episode is specified as mild, moderate and severe, without psychotic symptoms, with psychotic symptoms. MRS. DIVYA PANCHOLI 11

12. PERSISTENT MOOD DISORDER Classification F34.0- Cylcothymia F34.1- Dysthymia F34.0- Other persistent disorders F34.0- Persistent mood disorder, unspecified MRS. DIVYA PANCHOLI 12

13. CYCLOTHYMIA It is characterized by short periods of mild depression alternating with short periods of hypomania, between the depressive and manic episodes, brief period of normal mood occur. Both depressive and hypomanic phases are shorter and less severe than those in bipolar I or II disorder. MRS. DIVYA PANCHOLI 13

14. ETIOLOGY Genetic factors- family history of bipolar mood disorder, major depression, substance abuse or suicide in many paitents . MRS. DIVYA PANCHOLI 14

15. CLINICAL FEATURES OF CYCLOTHYMIA Hypomanic phase Insomnia Hyperactivity and physical restlessness Irritability and aggressiveness Grandiosity or inflated self-esteem Increased productivity, creativity Depressive phase Insomnia or hypersomnia Feelings of inadequacy Decreased productivity Social withdrawal Loss of libido or interest in pleasurable activities Lethargy Suicidal ideation MRS. DIVYA PANCHOLI 15

16. DIAGNOSIS Based on DSM-5 criteria MRS. DIVYA PANCHOLI 16

17. TREATMENT MRS. DIVYA PANCHOLI 17

18. NURSING INTERVENTIONS Explore ways to help patient cope with frequent mood changes Encourage vocational opportunities that allow flexible hours Encourage patients with artistic ability to pursue their talents as a creative outlet MRS. DIVYA PANCHOLI 18

19. DYSTHYMIA It refers to mild depression that lasts at least 2 years in adults and 1 year in children. Twice as common in women as in men More prevalent among poor and unmanrried . MRS. DIVYA PANCHOLI 19

20. ETIOLOGY Below –normal serotonin levels Increased vulnerability when multiple stressors and personality problems are combined with inadequate coping skills’ MRS. DIVYA PANCHOLI 20

21. CLINICAL FEATURES OF DYSTHYMIA PSYCHOLOGICAL SYMPTOMS Persistent sad, anxious, or empty mood Excessive crying Increased feelings of guilt, helplessness, hopelessness PHYSIOLOGICAL SYMPTOMS Weight or appetite changes Sleep disturbances Reduced energy level MRS. DIVYA PANCHOLI 21

22. DIAGNOSIS History Mental status examination Based on DSM -5 criteria MRS. DIVYA PANCHOLI 22

23. TREATMENT Short-term psychotherapy Behavioural therapy Group therapy Antidepressants such as SSRIs, TCAs, specially for patients who exhibit pessimism. MRS. DIVYA PANCHOLI 23

24. Follow up, home care and rehabilitation MRS. DIVYA PANCHOLI 24

25. You can refer following link also https://www.youtube.com/watch?v=KSvk8LLBo2g&t=89s https://www.youtube.com/watch?v=CDK50WQEOJc https://www.youtube.com/watch?v=_HpUAJFt4Og https://www.youtube.com/watch?v=j3qVUWtq6aY https://www.youtube.com/watch?v=KXgXZ5bdzbE https://www.youtube.com/watch?v=o4QCbsLbFEI https://www.youtube.com/watch?v=zNF6-rW-POQ&t=117s MRS. DIVYA PANCHOLI 25

26. MOVIES RELATED TO BMD MRS. DIVYA PANCHOLI 26

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