PSYX 340 Psychological Disorders · Unit 2: Mood, suicide, body and addiction · on Exam 2
2.2 Bipolar disorders
Study notes for Bipolar disorders in PSYX 340 Psychological Disorders at Montana State University: the big ideas, a worked example, common mistakes and an exam tip. The same topic has endless practice questions and flashcards in Mathub.
Big ideas
- A manic episode is a distinct period of abnormally elevated, expansive or irritable mood and increased energy lasting at least 1 week (any length if hospitalized), with 3 or more symptoms (4 if the mood is only irritable): inflated self-esteem, less need for sleep, pressured speech, racing thoughts, distractibility, more goal-directed activity and risky behavior. It causes marked impairment, hospitalization or psychosis.
- A hypomanic episode has the same kinds of symptoms for at least 4 days but is not severe enough to cause marked impairment or hospitalization, and has no psychotic features.
- Bipolar I disorder: at least one manic episode (depressive episodes are common but not required). Bipolar II disorder: at least one hypomanic episode and one major depressive episode, and never a full manic episode. Cyclothymic disorder: at least 2 years (1 in youth) of many hypomanic and depressive symptoms that never meet full episode criteria.
- Causes: bipolar disorders are among the most heritable disorders; theories involve neurotransmitter activity, ion activity in neurons, brain structure and genetics.
- Treatment centers on mood stabilizers: lithium (needs blood-level monitoring) and anticonvulsants such as valproate and lamotrigine, plus second-generation antipsychotics. Psychotherapy (psychoeducation, family therapy, CBT, a regular sleep routine) adds to medication but does not replace it.
Worked example
Dana had a major depressive episode last year. This month she had 5 days of little sleep, big plans, fast speech and unusual confidence; friends noticed, but she kept going to work and was not hospitalized. Which diagnosis fits?
Show the solution
Bipolar II disorder. Five days of these symptoms without marked impairment, hospitalization or psychosis is a hypomanic episode (at least 4 days). Hypomania plus a past major depressive episode, with no manic episode ever, is bipolar II.
Common mistakes
- Thinking bipolar II is the milder bipolar I. It is a separate pattern that often includes long, severe depressions.
- Requiring depression for bipolar I. One manic episode is enough.
- Mixing up the durations: mania is 1 week, hypomania 4 days, cyclothymia 2 years.
- Giving an antidepressant alone to someone with bipolar disorder can trigger mania. Mood stabilizers come first.
Exam tipBuild the diagnosis from episodes: first decide whether each period was manic, hypomanic or depressive, then combine the episodes into bipolar I, bipolar II or cyclothymia.
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