Bipolar disorder is characterized by mood swings between periods of profound depression and extreme euphoria or mania, with normal mood periods in between. It involves recurrent episodes of mania and depression in the same patient at different times, typically with extreme highs and lows. The disorder is classified based on current mood episode and presence of psychotic symptoms. Both biological and psychosocial factors are thought to play a role in its etiology. Treatment involves medication and nursing management focuses on safety, stabilization of mood, and prevention of relapse.

1. BIPOLAR
DISORDER

2. BIPOLAR
DISORDER
Bipolar disorder is
characterized by
mood swings from
profound depression
to extreme
euphoria(mania) with
intervening period of
normalcy

3. DEFINITION
• BPAD is characterized by recurrent
episodes of mania and depression in
the same patient at different times
.Typically the patient experiences
extreme heights (mania/hypomania)
alternating with extreme lows
(depression), Interspersed between the
heights and lows are the periods of
normal mood.

4. CLASSIFICATION
• F31.0- BPAD, current episode mania
• F31.1- BPAD, current episode mania without
psychotic symptoms
• 31.2- BPAD, current episode mania with psychotic
symptoms
• F31.3- BPAD, current episode mild or moderate
depression
• F31.4- BPAD, current episode severe depression
without psychotic symptoms
• F31.5- BPAD, current episode severe depression with
psychotic symptoms
• F31.6- BPAD, current episode mixed.

5. ETIOLOGY
• Etiology of Bipolar depression
– Biological theories
• Genetics
• Biochemical influences
• Neuro endocrine disturbances
• Physiological influences

6. Etiology of Bipolar depression
• Psychosocial theories
– Psychoanalytic Theory
– Behavioral theory
– Sociological theory
– Cognitive theory

7. ETIOLOGY OF BIPOLAR MANIA
• Biological theories
• Psychosocial theories

8. BIPOLAR DISORDER MIXED
• symptom presentation includes rapidly
alternating moods - sadness , irritability
, euphoria, accompanied by symptoms
associated with depression and mania.
• This disturbance is severe enough to
cause marked impairment in social and
occupational functioning .Require
hospitalization
• Psychotic features present .

9. BIPOLAR 1 DISORDER
• Manic and depressive episodes

10. BIPOLAR 2 DISORDER
• Hypo manic and depressed

11. CYCLOTHYMIC DISORDER
• Characterized by short periods of mild
depression alternating with short
periods of hypomania; between the
manic and depressive episode there will
be brief periods of normal mood occur.
• Manic and depressive episode is short
and less severe than those in bipolar 1
and bipolar 2 disorder.

12. CLINICAL FEATURES
• BIPOLAR MANIA
Elevated mood : 4 stages
Expansive mood: unceasing and
unselective
Irritable mood
Psychomotor activity
Speech and thought
Attention

13. CLINICAL FEATURES
• BIPOLAR DEPRESSION
– DEPRESSED MOOD
– DEPRESSIVE COGNITIONS
• Hopelessness
• Helplessness
• Worthlessness
• Unreasonable guilty feeling
• Self blame

14. BIPOLAR DEPRESSION
• SUICIDAL THOUGHTS:
• PSYCHOMOTOR ACTIVITY:
– Psychomotor retardation
– Thinks, walks and acts slowly
– Monotonous
– Delay in answering questions

15. BIPOLAR DEPRESSION
• Somatic symptoms
– Significant decrease in appetite or weight
– Early morning awakening
– Pervasive lack of interest and lack of reactivity to
pleasurable stimuli
– Posture is stooped
– Reddened eyes from crying
– Persons look 10 years older than their
chronological age.
– Constipation and anorexia
– dry mouth, headache, sleep disturbance, fatigue
and lowered libido

16. DIAGNOSIS
• ICD 10 diagnostic criteria
• Based on signs and symptoms

17. COURSE OF ILLNESS
• Average manic episode lasts for 3-4
months and a depressive episode lasts
for 4-9 months.

18. TREATMENT

19. NURSING MANAGEMENT

20. ASSESSMENT

21. NURSING DIAGNOSIS
• DEPRESSIVE EPISODE

22. • MANIC EPISODE

23. THANK YOU