Mania & BPD

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Mania & BPD by Mind Map: Mania & BPD

1. BPD (bipolar disorder)

1.1. High prevalence, 5-10% population

1.1.1. Common psychiatric disorder

1.1.2. only 2% modern diagnoses would've been diagnosed as BPD 30 y/a

1.2. Mild severity - treated out of hospital

1.3. Diagnosis from 1 week of hospital admission

1.4. Old diagnosis

1.4.1. BPD = manic disorder

1.4.2. Prevalence was rare, only 0.1% population treated in hospital for BPD

1.5. Can be diagnosed in children / teens // manic depression = just adults

1.5.1. Children / teens can grow out of it - period of turmoil is normal

2. Bipolar 1 & Bipolar 2

2.1. Separate disorders, not varying levels of severity

2.2. Bipolar 1

2.2.1. Rare & severe

2.2.2. Equivalent to older cases of manic depression

2.3. Bipolar 2

2.3.1. More commonly diagnosed

2.3.2. 90% Bipolar diagnoses = BPD2

2.3.3. Combination of mixed diagnoses

2.3.3.1. High trait neuroticism, unstable emotions / mood swings

2.3.3.2. Major depressive disorder, high mood, energetic, talkative

2.3.4. Drug effects can cause BPD2

2.3.4.1. Side effects / withdrawal

2.3.5. Respond to sedation

3. Diagnosis

3.1. Cocktail of drugs

3.1.1. Change behaviour from destabilising the brain

4. Stephen Fry - BPD

4.1. Does cocaine (destabilises the brain)

4.2. DSM states that BPD shouldn't be diagnosed in cocaine users

5. Hypomania & mania

5.1. Hypomania = level below complete mania

5.1.1. Severe w/ psychotic symptoms, e.g. hallucinations, delusions, thought disorder & catatonia - any or all

5.2. Same thing - varying levels of severity

5.3. Mania = psychosis

5.3.1. High mood (ecstatic, happy, angry, etc.) Irritable Overactive / over talkative

5.4. NO insight

5.4.1. Difficult to treat - not aware they're ill

5.4.2. Brought into hospital against their will

5.4.3. Generally feel fine / better than fine

6. Features of mania

6.1. High energy, never tired (hyperactive)

6.1.1. Don't want or need sleep

6.2. Speech fast & loud - can't be interrupted

6.3. Poor attention, easily distracted

6.4. "Grandiose"

6.4.1. Inflated self-esteem

6.4.2. Think they're very powerful / important

6.5. Reckless / impulsive behaviour

6.5.1. Destructive - prison, addiction or overspend in periods of mania

6.5.2. Includes suicide

6.5.2.1. Crash from high to low & act before they think

7. Psychotic features of mania

7.1. Hallucinations

7.1.1. Voices, mood congruent

7.2. Delusions

7.2.1. False beliefs, also mood congruent

8. Outcomes

8.1. Impulsivity --> destruction

8.2. Used to die from exhaustion when untreated

8.3. Hospital treatment compulsory to prevent suicide / exhaustion due to lack of insight

9. Treatment

9.1. Emergency sedation

9.1.1. BZs - lorazepam or antihistamines - promethazine

9.1.1.1. Powerful sleeping agent

9.2. Antipsychotics / neuroleptics

9.2.1. Tranquilizers - chlorpromazine

9.2.1.1. Demovtivate

9.2.1.2. Blunt emotions

9.3. ECT

9.3.1. Last resort // highly effective

10. Preventative treatment

10.1. Main treatment WAS lithium - given as carbonate ion to prevent mania

10.1.1. // side effects & difficult to find right dosage

10.2. Now given cocktail of drugs (antipsychotics) to prevent highs & lows

10.3. Anticonvulsants common

10.3.1. All major classes of psychiatric drugs taken = long-term damage

10.3.2. Must cope with side effects & interactions between drugs

10.3.3. Chase side effects not symptoms