This document provides information about bipolar disorder, including its symptoms, causes, diagnosis, treatment, and management. Some key points: - Bipolar disorder is a serious mental illness characterized by extreme mood swings from mania to depression. It has a significant public health impact due to high treatment costs and non-adherence to medication. - Symptoms of mania include inflated self-esteem, decreased need for sleep, and risky behavior. Symptoms of depression include low mood, loss of interest, and changes in appetite and sleep. - Causes are thought to involve genetic and biological factors like neurotransmitter levels. Stressful life events can also trigger episodes. - Treatment involves medication

1. BIPOLAR DISORDER
Spring Hospital,
Dr. Muhammad Ismail Tariq
Dr Harim Mohsin

2. Bipolar disorder awareness
• Objectives:
• Increase awareness of bipolar disorder (including both
mania and depression)
• Promote early detection and accurate diagnosis
• Reduce Stigma
• Minimize the Impact on those who live with this medical
illness.

3. Bipolar Disorder-
Major Public Health Issue
• Costs of treatment for an individual exceed $17,000 per
year.
• 1 in 3 people with bipolar disorder fail to comply with
medications.
• Non-adherence to treatment often results in
hospitalization and suicide

4. Prevalence Rates and Course
• Bipolar I
• Lifetime: .4-1.6%
• = in men and women
• Men>manic episodes
• Women>dep episodes
• Women>rapid cycling
• Ave. age onset = 20
• Recurrent
• 60-70% of manic episodes occur before or after a
depressive episode

5. What is Bipolar Disorder?
Bipolar disorder
is a serious
mental illness
that is
characterized
by extreme
mood swings
from mania to
depression.
Mania is an
abnormally
elevated mood,
while
depression is
an abnormally
low mood.

6. Severe mania
Hypomania
Mild depression
Severe depression
Moods Alternate Between “Poles”
High
Lows
Normal Mood

7. BiologicalApproach
The biological
approach to bipolar
disorder suggests
that high or low
levels of
neurotransmitters
such as dopamine,
serotonin, or
norepinephrine is
the cause.

9. Case 1: Shoaib
• 35 years old male brought
forcefully by family. Since a week
had not slept, and had been busy
writing a novel, getting banners
published and building huge
projects. His children were afraid
of his aggressive behavior and he
had recently started using
recreational drugs too. He was
usually flirting and acting
inappropriately with women. He
was fired from his job but he said
that he didn’t need it as he was
going to launch his own company
soon.

10. Case 2: Shaista
• 23 year old female
presented with crying
spells, no interest in
activities, disturbed
sleep, decreased
appetite, social
withdrawal and a
suicidal attempt of over-
dosing of sleeping pills.
• Her mother often
suffered from the same
symptoms and was
diagnosed with bipolar
disorder.

11. Famous people with bipolar disorder.
Beethoven
Musician.
Abraham Lincolin
U.S President
Catherine Zeta Jones
Hollywood Actress
• Winston Churchill-
• British Prime Minister.
• Isaac Newton-
• Scientist
• Vincent Van Gogh-
• Artist

12. Mania
 Persistent
abnormally elevated
irritable mood
 > one week

13. Symptoms of Mania
 Inflated self-esteem/grandiosity
 Decreased need for sleep
 Racing thoughts or "flight of ideas"
 Spending sprees
 Increased physical/mental energy
 Irritability/aggressive behavior
 Impulsive/risk taking
 Increased sexual drive

14. Depression
• Feeling down
• Loss of interest in
enjoyable things
• > 2 weeks

15. Symptoms of Depression (Cont.)
 Weight loss/gain
 Insomnia/hypersomnia
 Psychomotor agitation/slow down
 Fatigue/loss of energy
 Decreased ability to concentrate/make decisions
 Recurrent thoughts of death/suicide

16.  Hypomania
 Mixed state
Between Mania and Depression

17. What is it Like to be Bipolar?

18. Etiological Factors
• Hereditary Factors
• Biochemical Hypothesis
• Stressful Life Events
• Family environment HEE
• Cognitive Styles as Vulnerabilities

19. Triggerers
Stressful
life
events
Stimulating
internal/external
environment
Excessive
Caffeine/
nicotine
Alcohol/
drug use
Seasonal change
Non-
compliance
with
medication
Changes
in routine
Stressful
relationships
Prolonged
untreated
or poorly
managed
illness.

20. B.D. comorbidities & Differential Diagnosis
• Bipolar vs. unipolar
• ADHD
• Schizophrenia
• Substance abuse

21. Prognostic Indicators of
Treatment Outcome
1. Suicidality
2. Presence of a personality disorder
3. Quality of family and social support
4. Substance use
5. History of severity of prior episodes
6. Bipolar I type is most severe
7. Treatment onset-the sooner the better
8. Age of onset-the younger the more severe

22. Management
• Refer to a Psychiatrist Immediately.
• Early detection of Individual ‘signature’ signs.
• Ensure the safety of patient and others.
• Suicidal behavior
• Homicidal behavior
• Risk taking behavior (financial,sexual,driving etc.)
• Exhaustion

23. The Warning Signs of Suicide
 Talking about death, self-harm, or suicide
 Feeling hopeless/helpless/worthless
 Withdraw from friends/family
 Acting recklessly
 Putting affairs in order or saying goodbye
 Seeking out weapons or pills

24. Recognize Warning Signs
Offer Support/Help/Listen
Take It Seriously/Get Them
Help
How to Help Someone Who
is Suicidal

25. Treatment
• Medication-
Antipsychotics,
Benzodiazepines, Mood
stabilizers.
• Electroconvulsive
therapy.
• Psychoeducation for
patient and family
• Psychological therapy
(Interpersonal and
social rhythm therapy,
CBT & others)

26. Monitoring and prevention
• Continually monitor psychiatric status
• Identify individual’s triggerers
• Identify early warnings and seek help
• Prevent relapse and encourage adherence to treatment.

27. Help for care givers
• Medication-refer to
psychiatrist
• Take care of own health-
seek professional help for
own psychiatric issues
(e.g depression).
• Family, couples therapy,
Group therapy
• Join a Support group.

28. Self-Help For Bipolar Disorder
 Monitor your moods
 Make healthy choices
 Seek support
 Keep stress in check
 Get educated