Bipolar Disorder 1 and 2 with Case (Nursing)

by Brenda Marshall, EdD, MSN, RN

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    00:02 Let's talk a little bit about bipolar disorder and the statistics.

    00:06 For bipolar 1.

    00:08 It is usually diagnosed equally men and women both equally for bipolar disorder with a prevalence of 0.4% to 1.6%.

    00:21 The onset, the age of onset that we normally see is about 18 years old.

    00:28 This differs from bipolar 2, where we normally see women having more bipolar 2 than men.

    00:35 And that's in a prevalence of .5%.

    00:39 And we're seeing a little bit later in life in the mid 20's.

    00:44 Cyclothymic disorder, again, is equal between the genders and we're seeing it between 0.4% and 1.0%.

    00:53 And that we normally see an adolescence in early childhood.

    00:59 So when we're thinking about the differences between bipolar 1 and bipolar 2, we think about bipolar 1, which is depression and mania, that there's at least one manic episode and at least one depressive episode, major depressive episode that we can identify.

    01:21 We also want to be able to understand that the depressive episode has to have been either occurring right before or right after the manic episode.

    01:34 This gives us a much better understanding that this person think about bipolar is experiencing both depression and mania.

    01:45 Also, that manic episode may have required hospital care.

    01:50 And that's important to understand, it is also may require because not everyone requires hospital care when they are having a manic experience.

    02:02 So let's think again, when we're thinking about bipolar 1 and bipolar 2.

    02:09 The bipolar 1 is depression and mania and bipolar 2 is depression and hypomania.

    02:17 Now, manic episodes are usually characterized by exceptional energy, they are restless, the person has a really hard time concentrating on one thing, they are jumping from one thing to the next.

    02:33 They have euphoria all the time.

    02:36 And they don't need any sleep.

    02:39 They have some risky behaviors, there's increased sexuality, increased risk taking.

    02:47 Oftentimes, if they are too up, they might be using drugs to try to self medicate.

    02:54 And they also do not sleep.

    02:58 They can stay awake for days on end.

    03:02 Now, if we're thinking about bipolar 2 with hypomania, not with mania, now we have again, a sustained mood that's elevated, which is our hypomania.

    03:15 And also we end up seeing that there is that grandiosity, that expansive belief that they can do anything, they also are able to differentiate.

    03:32 Because when they're up, it's not just like happiness.

    03:36 It's not like a normal being up.

    03:39 When they are up, it is very up.

    03:44 And it really is exactly when they are not depressed.

    03:48 There is no period of time in between the two that we're noticing where they're up, and now they have what we call Euthymia, which means a normal mood.

    04:00 They're either very up or very sad.

    04:06 So in mania, that mood is extremely abnormal, right? And it is usually so much activity and energy, which is also so abnormal.

    04:19 But with hypomania, we don't normally see any of the psychosis that we will see with mania.

    04:25 Mania, they will become paranoid, after so much not sleeping, not eating.

    04:32 There are some real psychotic symptoms that come along with prolonged mania that we don't see with hypomania.

    04:44 Now, when you're thinking about bipolar disorder, you want to make sure that as these people are going really up and really down that we are watching and trying to help them.

    04:59 It is such a disruptive feeling to be that high and that low that they cannot continue with their normal life as it is.

    05:10 They also usually have to have this diagnosis with bipolar disorder that they've had this manic episode and a depressive episode.

    05:19 And otherwise, it is not considered bipolar 1.

    05:25 Now, with bipolar 2, we can see that depressive episode.

    05:30 And again, that depressive episode has to be at least 2 weeks long.

    05:36 And then they have also the hypomanic episode.

    05:42 Bipolar disease is more common that we know of with some of the people who are extremely famous, Winston Churchill suffered from bipolar disease, Mel Gibson, and Kurt Vonnegut, the writer, Ernest Hemingway, another great writer, Frank Sinatra, and Demi Moore, all have had bipolar disease and all have come out and been able to help other people with bipolar disease understand that it can be treated.

    06:23 So this mania, this manic piece, it has to be greater than a week to be considered manic.

    06:34 And they have high distractibility.

    06:37 Again, this insomnia, they can't sleep, this grandiose opinion of themselves, taking amazing risks and not being able to stop talking.

    06:48 Once they start talking with you, it's amazing.

    06:52 If you are taking a history on a person who is manic, it's really hard to get them to answer your questions easily.

    06:59 They will give you a full history.

    About the Lecture

    The lecture Bipolar Disorder 1 and 2 with Case (Nursing) by Brenda Marshall, EdD, MSN, RN is from the course Mood Disorders: Major Depressive and Bipolar Disorders (Nursing).

    Included Quiz Questions

    1. About 18 years old
    2. Mid 20’s
    3. About 30 years old
    4. About 10 years old
    1. At least one manic and one major depressive episode occurring one after the other
    2. At least one hypomanic and one major depressive episode occurring one after the other
    3. At least one manic and one major depressive episode with a period of euthymia between the two episodes
    4. At least three manic and one major depressive episode with a period of euthymia between the two episodes
    1. Restlessness
    2. Risky behaviors
    3. Difficulty concentrating
    4. Dysthymia
    5. Anhedonia
    1. There are no psychotic symptoms in hypomania.
    2. Hypomania is less severe than mania.
    3. Hypomania is seen in bipolar I while mania is seen in bipolar II.
    4. There is no mood elevation in hypomania.

    Author of lecture Bipolar Disorder 1 and 2 with Case (Nursing)

     Brenda Marshall, EdD, MSN, RN

    Brenda Marshall, EdD, MSN, RN

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