Made Ayu Puspa Mahendrayani

BIPOLAR DISORDER 1670121004

SGD 3
INTRODUCTION
• In 1980, the name bipolar disorder was adopted by the Diagnostic and Statistical
Manual for Mental Disorders (DSM) to replace the term manic depression.

• Bipolar disorder refers to a group of affective disorders, which together are

characterized by depressive and manic or hypomanic episodes.
BIPOLAR DISORDER SUBTYPES
Diagnostic and Statistical Manual for Mental Disorders DSM-IV :

 Bipolar Disorder type I  episodes of depression and mania

 Bipolar Disorder type II  episodes of depression and hypomanic

 Cyclothymic disorder  many periods of hypomanic and depressive symptoms

 Bipolar Disorder not otherwise specified  depressive and hypomanic-like

symptoms and episodes that might alternate rapidly
 SYMTOMS
MANIC EPISODE
Feeling very up, high, elated, or
extremely irritable or touchy
Feeling jumpy or wired, more active
than usual
Decreased need for sleep
Thinking you can do a lot of things once
without getting tired
Feeling talented or powerful
DEPRESSIVE EPISODE
Feeling very down or sad, or anxious
Feeling slowed down or restless
Trouble concentrating, falling asleep
Lack of interest in almost all activities
Unable to do even single things
Feeling hopeless or worthless, or
thinking death or suicide
WHAT CAUSES BIPOLAR DISORDER?
The exact cause of bipolar disorder is unknown. However, research suggests that there is no single cause. Instead,
a combination of factors may contribute to bipolar disorder.

GENES Brain Structure and Function

Bipolar disorder often runs in Researchers are learning that the

families, and research suggests that
this is mostly explained by
heredity—people with certain genes
are more likely to develop bipolar
disorder than others.
brain structure and function of people
with bipolar disorder may be
different from the brain structure and
function of people who do not have
bipolar disorder or other psychiatric
disorders.
 DIAGNOSE (CLINICAL STRATEGIES)
 Additional clinical rating scales help to detect sub threshold hypomanic symptoms in
depressed people.

 In DSM-5, diagnostic criteria for bipolar disorder now include both changes in mood and
changes in activity or energy; three manic symptoms within a major depressive episode;
and short duration hypomania is now acknowledged.

 Careful assessment for previous mania or hypomania should be done in all depressed
Patients.
NEURAL CIRCUITRY ABNORMALITIES

Neuroimaging techniques, through analysis of abnormalities in white matter

connectivity, abnormalities in grey matter, and functional abnormalities in neural
circuitry sub serving cognitive and emotional processes.

Bipolar : more white matter hyperintensities, differential patterns of amygdala

activity and prefrontal cortical–amygdala connectivity during emotion processing and
emotion regulation
 TREATMENTS
MEDICATION
oMood stabilizers such as lithium
oAtypical antipsychotics
oAdditional medications that target
sleep or anxiety
OTHER TREATMENTS
oElectroconvulsive therapy
o„Regular vigorous exercise, such as jogging,
swimming, or bicycling
oKeeping a life chart, can help people and
their doctors track and treat bipolar
disorder.
REFERENCE
Phillips, M. L., & Kupfer, D. J. (2013). Bipolar Disorder 2 - Bipolar disorder diagnosis:
Challenges and future directions. The Lancet, 381(9878), 1663–1671.
https://doi.org/10.1016/S0140-6736(13)60989-7

National Institutes of Mental Health (NIH). 2018. Bipolar Disorder. NIH Publication No.
QF 18-3679. Accessed https://www.nimh.nih.gov/health/publications/bipolar-
disorder/qf18-3679-bipolardisorder-508_152248.pdf
contains four main
subtypes of bipolar disorder: bipolar disorder type I
(episodes of depression and at least one episode of
fullblown
mania); bipolar disorder type II (several protracted
episodes of de pression and at least one
hypomanic episode but no manic episodes);
cyclothymic
disorder (many periods of hypomanic and depressive
symptoms, in which the depressive symptoms do not
meet the criteria for depressive episodes); and
bipolar
disorder not otherwise specifi ed (depressive and
hypomanic-like symptoms and episodes that might
alternate rapidly, but do not meet the full diagnostic
criteria for any of the aforementioned illnesses; panel
1).