Bipolar Flashcards

Question

Age of Onset

Answer 1

-20-30, ½ time 1st episode is manic, ½ time 1st episode is depressed -5-10% of people who present with a history of only depression will convert to bipolar -Particularly if younger age, heightened guilt, psychomotor retardation, and a family history of bipolar

Answer 2

-Episodes typically last about 2 months -Previously 8 months, prior to effective treatments

Answer 3

-Mood stabilizer (lithium) and anti-convulsants for bipolar -People often go off medications because lithium can leave them at a much less desirable state, takes away those really happy periods, and often prescribed at a very high dose, close to the overdose amount

Answer 4

-Anti-depressants (e.g., tricyclics, SSRIs) for unipolar -Anti-depressants can trigger manic episodes in bipolar

Answer 5

-Risk of death by suicide are 15x the general population -Some estimates of inpatients with bipolar suggest 11% die by suicide

Answer 6

-Younger age -Recent illness onset -Male gender -Prior suicide attempts -Family history of suicide -Comorbid AUD/SUD -Rapid cycling course -Social isolation

Answer 7

-Stress appears to increase in 1st 6 months prior to an episode -Frequently relapse following a stressful experience -Goal-attainment events significantly associated with manic episodes -When achieve a goal, become very happy; subsequently dysregulated; spiral into mania

Answer 8

-electrically stimulated siezures in rats turned sponteanous -People use this as a metaphor about how stress affects the brain and those with bipolar - first episode requires a very high level of stress , second episode requires a little bit less, 3rd episode requires even, etc

Answer 9

-Less sleep on day N predicts increases in manic symptoms on day N+ 1 -Exposure to bright light, which can change circadian rhythms, can trigger manic symptoms

Answer 10

-Striatum is a central part of basal ganglia -Facilitates voluntary movement -Reward processing -nucleus accumbens: Reward & reinforcement

Answer 11

-Enlarged striatum functionally is perhaps related to heightened reward sensitivity -Enlarged in men and women with bipolar disorder

Answer 12

-Enlargement in both affected and unaffected monozygotic twins discordant for bipolar disorder - genetics do not explain full story - we see genetically identical people where one twin has it and the other doesn’t

Answer 13

-Typically see abnormally elevated activity within VS during: Reward anticipation, Reward consumption, To reward-predictive cues -A failure to prefrontal regions to effectively down-regulate VS responses

Answer 14

Inserted electrodes into brain of monkeys - trained them to associate a cue with a reward – see dopamine signaling shifting from the cue to the reward predicting the reward

Answer 15

-have deficits in both anticipatory activity (can you pursue the reward and work to make that happen) and consummatory reward processing (do you enjoy it when you get the reward) -Hyperactivity to cues that signal possibility of reward (anticipatory) - brains become very excited and behave in ways that could give them reward -In those with MDD - anticipatory reward system is suppressed in relation to cues

Answer 16

-needed for diagnosis -hospitalization -Psychotic features -Extreme impairments in several domains

Answer 17

-Self-reported distress NOT a factor in mania– poor insight and often feel very little pain, especially in the manic stage of bipolar people often feel euphoric

Answer 18

-a high potential for painful consequences: -Shopping sprees, foolish business investments, sexual indiscretions -Not attributable to physiological effects of a substance or another medical condition -Overlaps with several other disorders, making diagnosis difficult

Answer 19

This contributes to high rates of relationship dissolution - high rates of infidelities and divorce following manic episode

Answer 20

-Can also be social -Talk to strangers, call at all hours of the night, working on several projects at once (but never finish)

Answer 21

-Reported or observed -Can contribute to the flight of ideas -Sometimes leads to diagnostic difficulties with ADHD - it can be hard to differentiate when hypomania?, acute mania is usually pretty differentiable from ADHD

Answer 22

urgency to get words out & communicate with people

Answer 23

Irritability often stems from inability to down-regulate / slow down - depleted all of their energy resources

Answer 24

-constantly trying to catch a hold of ideas, but new ones are constantly coming up -Jump from one idea / thought to the next

Answer 25

-Appears similar to loose associations in Schizophrenia - listeners have a hard time following logic of what people with schizophrenia are saying -with bipolar, it's not completely unbound from reality - there is somewhat a structure that people can kind of grasp onto, but generally listeners can figure out and piece together how they got from one place to the next, unlike schizophrenia

Answer 26

not just a slightly inflated ego, but sense of “I might be the smartest person in all of Canada”

Answer 27

-onsist of “elevated, expansive mood,” or “extreme irritability” -Persistently increased goal-directed activity or energy – tend to have extremely lofty goals, yet generally do not follow through with them

Answer 28

-Diagnosed based on the presence of a manic episode, lasting at least one week (most of the day, nearly every day) -Must be distinct period – i.e., distinct change from normal functioning

Answer 29

1. Grandiosity 2. Lack of Tiredness 3. Pressured Speech 4. Flight of Ideas 5. Distractibitly 6.Goal Seeking Behaviour 7. Increased Libido 8. Increased Irritation 9. Increased Pleasure Seeking

Bipolar Flashcards

(53 cards)