5.1 Bipolar and Related Disorders

Please read pages 123-154 in the DSM-5

Bipolar and Related Disorders

• Are separate from depressive disorders in the DSM-5
• These disorders are seen as a “bridge” between the depressive disorders and the schizophrenia spectrum and other psychotic disorders
• There are 7 diagnoses that fall under this Bipolar Classification
  • Bipolar I
  • Bipolar II
  • Cyclothymic Disorder
  • Substance/medication-induced bipolar and related disorder
  • Bipolar and related disorder due to another medical condition
  • Other specific bipolar and related disorder
  • Unspecified bipolar and related disorder
•  Bipolar I Disorder (Previous name was Manic Depressive Disorder)
  • The primary criteria for manic and hypomanic episodes (Criterion A) now includes an emphasis on changes in activity and energy, not just mood, and has been added for both manic and Hypomanic episodes
  •  A specifier is an extension to the diagnosis that further clarifies the course, severity, or special features of a disorder or illness; the goal is to pinpoint the predominant mood
  • There are 10 specifiers to Bipolar I (p. 127)
  • An individual diagnosed with Bipolar I can experience THREE different types of EPISODES
    • Manic Episode—a period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased goal-directed activity or energy, lasts at least 1 week and present most of the day, nearly every day.
      • Plus three additional symptoms from Criterion B
      • If the mood is irritable rather than elevated or expansive, at least 4 Criterion B symptoms must be present
    • Hypomanic Episode—a distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasts at least 4 consecutive days and present most of the day, nearly every day.
    • Major Depressive Episode—5 or more of the symptoms (p. 125) have been present during the same 2 week period and represents a change from previous functioning, as least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure
    • Specifiers for Bipolar and Related Disorders (p. 149)

Treatment Interventions

When working with an individual diagnosed with bipolar, the most effective treatment plan includes a combination of medication and psychotherapy. Bipolar disorder is a lifelong illness. Episodes of mania and depression typically come back over time. It’s important to be up today with current medications that are used to treat the individual with a bipolar diagnosis. Let’s talk about medication, no I don’t want you to go to medical school, with that being said, you do need to know the basics.

Medication intervention is called Psychopharmacology, it’s a study of how a substance that can impact different mental states. The drugs utilized can produce changes in one’s mood, thinking or behavior. The usage of medication started in 1900’s. Since the conception of this intervention types of medications available has increased while the side effects of many of the medication used has decreased.  Psychopharmacology intervention is used for any type of psychological difficulties any one may experience. Please understand there are many advantages and disadvantages in using medication which need to be part of the conversation with the individuals you serve. There is NO medication that can deal with the complexity of life.

You nor I will ever prescribe medication, only a medical doctor (preferable a psychiatrist) can prescribe. It’s important for us as Human Service Professionals to have some basic understanding.

The National Institute of Mental Health classifies Psychotropic Medication into five groups: Antipsychotics, Mood-stabilizing drugs, antidepressants, anti-anxiety, and stimulants.

All of the medications list above are extremely helpful, the recommendation is medication management along with therapy. Most effective treatment protocol to treat bipolar and it’s related disorders

Please go to Canvas to read about the case of Pam State