Bipolar Disorder and the Creative Genius
Bipolar disorder, also known as manic depression, is a psychopathology that affects approximately 1% of the population. (1) Unlike unipolar disorder, also known as major affective disorder or depression, bipolar disorder is characterized by vacillating between periods of elation (either mania or hypomania) and depression. (1, 2) Bipolar disorder is also not an illness that remedies itself over time; people affected with manic depression are manic-depressives for their entire lives. (2, 3) For this reason, researchers have been struggling to, first, more quickly diagnose the onset of bipolar disorder in a patient and, second, to more effectively treat it. (4) As more and more studies have been
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A hypomanic episode must be a period of at least four days, during which the affected person feels elevated or irritated--a marked difference from the depressed period. (2, 7) The symptoms are: inflated self-esteem or grandiosity, decreased need for sleep, more talkative than usual, flight of ideas or racing thoughts, distractibility, psychomotor agitation or an increase in goal-directed activity, excessive involvement in pleasurable activities that may have negative consequences. (2, 7) This change in mood is observable by others and medications, substance abuse, or another medical condition does not cause the symptoms. (7)
In contrast to hypomania is mania, which is a more extreme case of hypomania. A manic episode is a period of an elevated or irritable mood for at least one week. (2, 7) The symptoms must cause problems in daily functioning and cannot be caused by a medical condition or drugs. (7) Manic symptoms are: inflated self-esteem or grandiosity, decreased need for sleep, more talkative than usual, flight of ideas or racing thoughts, attention easily drawn to unimportant or irrelevant items, increase in goal-directed activity or psychomotor agitation, and excessive involvement in pleasurable activities which may have negative consequences. (2, 7) Lastly, bipolar disorder patients may also go through mixed episodes, which are periods when the patient meets the criteria for both a manic episode and a major depressive episode
These mood episodes include the manic episodes and the depressive episodes. The mood changes of mania include a long period of an overly happy mood and irritability; the behavioral changes are talking quickly, having racing thoughts, being distracted, increasing of activities, being restless, getting little or no sleep, being impulsive, and engaging in high-risk, pleasurable activities or behaviors (NIMH, 2015). The mood changes of the depressive episodes are loss of interest in activities that were once enjoyed and a long period of sadness; the behavioral changes are feeling very tired, having trouble with decision making and problem solving, being irritable, changing normal habits, and negative thinking (NIMH, 2015). Sometimes symptoms from both episodes can be present in a person’s current mood episode. This is called a mixed state. In the mixed state, a person can feel agitated, have a change in eating habits, and have suicidal thoughts; they also feel very hopeless and very energized at the same time (NIMH, 2015). About ten percent of people have at least four mood episodes every year which is called rapid cycling bipolar disorder (Schacter el at.,
There are four types of mood episodes in bipolar disorder: mania, hypomania, depression, and mixed episodes. Each mood episode comes with a series of symptoms. In the manic phase of bipolar disorder, feelings of increased energy and extreme happiness are the most common. People who are experiencing a manic episode often cannot stop talking, their talking is fast and very hard to understand, they sleep very little, and are very hyperactive. They feel they are invincible and can do anything in the world. Hypomania is a less severe type of mania.
Bipolar disorder is a mood disorder known for severe persistent mood instabilities between mania and depression, . It causes unusual changes in mood, energy, and activity levels which makes ability to perform daily tasks very hard. (Concepts Advisory Panel [CAP], 2015). BPD affects more than 2.3 million adult Americans, or 1% of the population. (Guo, Patel, Li, & Keck 2010). There are four basic types of bipolar spectrum; All of them involve clear change in the mood energy, and activity levels (CAP,2015). These mood incidences’ ranges from periods of extremely high and energized behavior known as Manic episodes to very sad, or hopeless periods known as depressive episodes. Bipolar I disorder, the client has at least one episode of manic followed by major depression. Bipolar II disorder, the client has one or more hypomanic and major depressive episodes, the other not so severe and less diagnoses type of Bipolar is chronic mood disorder that lasts more two years with combination of hypomania and dysthymia. (CAP,2015). This paper will go into, Bipolar I, Manic episodes, the pathophysiology, Sign and symptoms, treatments, comorbidity, nursing intervention and nursing and patient therapeutic relationship.
Some signs and symptoms of a manic episode are: increased energy, activity, and restlessness; excessively high, overly good, euphoric mood; racing thoughts and talking fast, jumping from one idea to another; distractibility or lack of concentration; spending sprees; poor judgment; increased sex drive; and denial that anything is wrong (Nevid, Rathus, & Greene, 2006). A manic episode is diagnosed if elevated mood occurs with three or more of the other symptoms most of the day, nearly every day, for one week or longer (Psychology Today, 2011). If the mood is irritable, four additional symptoms must be present.
Bipolar disorder, also called a manic-depressive illness, is a common disorder which causes mood swings, lasting periods of depression, and episodes of mania. “Extreme changes in energy, activity, sleep, and behavior go along with these changes in mood” (National Institute of Mental Health [NIMH], 2008). A person becomes more goal-oriented and has grandeur visions of success. Patient M shows all these symptoms while talking to her friends and professors in college. She describes herself as a person who is above the two standard genders, what she calls a “third sex”, and who switched souls with a senior senator from her state. The latter belief inspires her to start a political campaign and achieve a high position in the government. She
Bipolar Disorder is a brain disorder that is characterized by abnormal changes in mood, energy and activity levels (“National Institute of Mental Health”). Manic-depressive illness is also another name that bipolar disorder is commonly referred to as (“National Institute of Mental Health”). This disorder has four basic types including, bipolar I, bipolar II, cyclothymic, and any other which do not perfectly fit the first three. All four of the types have episodes of extreme highs, manic periods, and extreme lows, depressive periods. Symptoms can range greatly and depend on what type of episode the affected is having. Manic episodes can include, but are not limited to: having extraordinarily high amounts of energy, activity,
Approximately 0.5-1 percent of Americans will develop bipolar II disorder in their lifetime, worldwide the prevalence is 0.4 percent (Rosenberg & Kosslyn, 2011). Bipolar disorder is one of the main causes of disability, because of its cognitive and functional impairment, the high rate of medical and psychiatric comorbidity, and the relevant suicide risk (Dell 'Osso, et al., 2016). Bipolar II disorder is one of the two most commonly diagnosed subtypes of Bipolar disorder, which are distinguished by the amount of burden the depression causes, the number, frequency, duration, and severity of the depressive episodes, and the occurrence of specific sub threshold episodes (Dell 'Osso, et al., 2016). Although bipolar II disorder diagnosis are on the rise we lack extensive research on the features and treatments of this disorder (Datto, Pottorf, Feeley, Laporte, & Liss, 2016). Bipolar II disorder is now recognized in the latest Diagnostic and Statistical Manual of Mental Disorders (DSM-5) under a new chapter dedicated specifically to bipolar disorders. Which proves that bipolar disorders are their own set of disorders in terms of symptomatology, family history, and genetics (Möller, et al., 2014). This allows an enhancement in the accuracy of diagnosis, which in turn leads to earlier treatment. In the DSM-5 it states that bipolar II disorder can lead to effects such as disability, comorbidity, mortality, and an impact on the quality of life (Datto, Pottorf,
People with bipolar I disorder have full manic and major depressive episodes. Most of them experience an alternation of the episodes; for example, weeks of mania may be followed by a period of wellness, followed, in turn, by an episode of depression. Some, however, have mixed episodes, in which they display both manic and depressive symptoms within the same episode—for example, having racing thoughts amidst feelings of extreme sadness. In bipolar II disorder, hypomanic—that is, mildy manic—episodes alternate with major depressive episodes over the course of time. When a person experiences numerous periods of hypomanic symptoms and mild depressive symptoms, but not full-blown episodes, DSM-5 assigns a diagnosis of cyclothymic disorder. The symptoms of this milder form of bipolar disorder continue for two or more years, interrupted occasionally by normal moods that may last for only days or weeks.
Despite the similarities, there are more common symptoms in bipolar depression than it is in regular depression. For example, bipolar depression has individuals feeling guilty, hopeless, sad, empty, unpredictable mood swings, and feelings of restlessness. People with bipolar depression also tend to move very slow, gain weight, and sleep a lot (Hatchett). On the other hand the hypomania state has led observers to feel that bipolar patients are "addicted" to their mania. Paranoia or irritable characteristics begin to manifest in this stage. Hyperactive behavior can sometimes lead to violence and speech becomes very rapid (Hirschfeld, 1995). A mixed episode is when you have both manic and depressive symptoms at the same time. According to Hirschfield, “Those afflicted are a special risk because there is a combination of hopelessness, agitation, and anxiety that makes them feel like they,” “could jump out of their skin” (Hirschfeld, 1995). Up to 50% of all patients with mania have a mixture of depressed moods. This episode is considered very dangerous because individuals feel as if they could commit suicide.
For an episode to be categorized as manic, the patients’ mood has been irritable or abnormally elevated for at least 1 week. A person must also exhibit at least 3 of the following symptoms (4 if the mood is only irritable): extreme feelings of personal greatness; a decreased need for sleep, marked talkativeness; distractibility; extreme focus on a goal-directed activity; reports of ‘racing’ thoughts or a flight of ideas; or excessive involvement in pleasurable activities that have a high potential for painful consequences (i.e. sexual indiscretions or unintelligent business investments). As in the criteria for a depressed episode, the DSM-IV specifies that these symptoms should not be better explained as being a side effect of a drug or illness to qualify as a manic episode. These symptoms must interfere with the person’s normal functioning and must not meet the criteria for a mixed episode. As with adults, childhood-onset bipolar disorder has many faces. Children with Bipolar I Disorder have episodes of mania and episodes of depression, sometimes there are long periods of normal moods between episodes. Adults usually tend to have more depressed episodes than manic episodes. However, some children will have chronic mania (symptoms of mania lasting for long periods of time or marked by frequent recurrence) and seldom experience a depressed episode.
A manic episode is characterized by an abnormality of mood that is euphoric, expansive, and elevated or irritable with increased energy, along with signs and symptoms such as inflated self-esteem or grandiosity, decreased need for sleep. Pressure of speech or being extremely talkative, racing thoughts or flight of ideas, distractibility, an increase in goal-directed behavior, agitation, poor judgment and impulsive decision making are more signs and symptoms of a manic episode. A manic episode can result in unwise and potentially dangerous behavior. Destructive behaviors can often occur with spending money, sexual
Bipolar disorder, or manic depressive disorder, is a disorder characterized by extreme mood changes. People with this disorder undergo unusual shifts in his or her mood, activity levels, energy and the ability to carry out daily activities (National Institute of Mental Health, n.d.). A person can go from being very outgoing and energetic to feeling irritated and worthless over a period of a few days, months, or even years. People with bipolar disorder experience “mood episodes”, represented by a drastic change in a person’s unusual mood or behavior (National Institute of Mental Health, n.d.). A manic episode he or she may experience is overexcited and overly joyful; however, someone in a
Bipolar disorder, also known as manic-depressive illness affects about 1.2 percent of the U.S. population (8). It is defined by fluctuating states of depression and mania throughout ones life. Those who are depressed may be restless, irritable, have slowed thinking or speech, decreased sexual activity, changes in appetite and sleep patterns, suicidal thoughts as well as other changes. Those in a manic state may have increased activity or energy, more thoughts and faster thinking, grandiose thoughts, decreased sleep and need for sleep, increased sexual activity, elated mood, irritable mood, as well as other symptoms. Mixed state is when both depression and mania are exhibited at the same time in a cycle. Rapid cycling