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Treatments
Kristina Macdonald,
Amy MacHarg,
Tabitha Mason,
Angela Mcfalls,
Jessica McMichael
Bipolar Disorder’s Criteria
Most commonly
diagnosed between
ages of 18 and 24
Mania, Hypomania,
Psychosis, depression
Characteristics of Mania
Feeling of creativity
Don’t worry about problems seriously
Feeling as if nothing can bring you down
Have confidence in yourself
Bipolar I Bipolar II
Episodes of full mania Episodes of major
alternating with depression and
episodes of major hypomania
depression
Diagnosed in patients
typically in early 20’s
Evaluation of Patient
Safety of individual
Lifetime= 1%
Males and Females = no difference
Age = all ages
– Highest prevalence is in the 18 to 24 year age group
Difficulties
(Griswold, 2000)
Substance Abuse
– Cigarette smoking is prevalent among bipolar
patients, particularly those who have frequent or
severe psychotic symptoms. Some experts
speculate that, as in schizophrenia, nicotine use
may be a form of self-medication because of its
specific effects on the brain.
– Up to 60% of patients with bipolar disorder abuse
other substances (most commonly alcohol,
followed by marijuana or cocaine) at some point
in the course of their illness.
Seriousness of Disorder Cont.
Economic Burden
– In 1991, the National Institute of Mental Health
estimated that the disorder cost the country $45
billion, including direct costs (patient care,
suicides, and institutionalization) and indirect
costs (lost productivity, and involvement of the
criminal justice system.)
– In one major survey, 13% of patients had no
insurance and 15% were unable to afford medical
treatment.
Treatment of Bipolar Disorder
(a four phase process)
Inpatient Care
Assess the patient
Diagnose the condition
Ensure safety of patient and others
– This care is necessary for:
Psychotic features
Antidepressant therapy
Mood stabilizer
– Lithium carbonate
– Sodium divalproex
– Carbamazepine
Antipsychotic Agents
– Risperidone
– Haloperidol
Treatments
- role playing
- modeling
- “guided in vivo practice” (Wilkinson 2002)
Multi-family Therapy
Bipolar Disorder. (2002). Well Connected A.D.A.M. Inc. Retrieved from www.well-connected .com .
Dinan, Timothy G. (2002, April 27). Lithium in bipolar mood disorder. British
Medical Journal, 324 (7344), 898-991.
Griswold, Kim S. (2000, September). Management of Bipolar Disorder. American Family Physician.
www.findarticles.com/cf_0/m3225/6_62/65286755/print.jhtml
Hirshfeld, R., Clayton, P.J., Cohen, I., Fawcett, J., Keck, P., McClellan, J., et al. (2000). Practice Guidelines for the
Treatment of Patients With Bipolar Disorder. American Psychiatric Association Practice Guidelines for the
Treatment of Psychiatric Disorders, Compendium 2000, 503-562.
Nathan, Peter F., Gorman, Jack M. (1998). A guide to treatments that work.
New York: Oxford University Press.
Schlozman, Steven C. (2002, November). The Shrink in the Classroom. An Explosive Debate: The Bipolar Child.
Association for Supervision and Curriculum Development. (89-90).
Shulman, Kenneth I. (2003, May 3). Changing prescription patters for lithium
and valproic acid in old age: Shifting practice without evidence. British Medical Journal, 326
(7396), 960-962.
Works Cited Cont.
Srinath, Rajeev J. et al. (2003, February). The Index Manic Episode in Juvenile-
Onset Bipolar Disorder: The Pattern of Recovery. Canadian Journal of
Psychiatry. Vol. 48 (1). Retrieved Oct. 22, 2003, from EBSCO Academic
Search Elite Database.
Sternstein, Aliya & Gross, Neil. (2002, August 12). Some uplifting news about
depression.
Business Week, (3795), 69.
Treatment. Journal of Mental Health Counseling, (24) 348+. Retrieved Oct 21,
2003, from EBSCO Academic Search Elite database.