1. Bipolar Disorder
&
Catherine Zeta Jones
Presented by
Autumn Placek

2. What is Bipolar Disorder?
• It is often referred to as Manic Depressive
• It is characterized by two poles
– One being manic
– One being depressive
• Labeled as the 6th most disabling illness in the
U.S.
• Chronic and not curable but can be controlled

3. Types of Bipolar Disorder
• Bipolar I
-manic or mixed episodes that last seven
days requiring hospitalization
• Bipolar II
-pattern of depressive episodes with
hypomanic episodes
• Bipolar NOS ( Not Otherwise Specified)
-symptoms that do not last long enough or
too few symptoms
• Cyclothymic Disorder (Cyclothymia)
-a mild form with episodes of hypomania with shifts to
mild depression

4. Catherine Zeta Jones BIO
• Born September 25th, 1969
in Wales, UK
• Married to Michael
Douglas- separated in May
of 2013
• Has One son, Dylan
• One Daughter, Carys

5. The Symptoms and Struggle
• Was diagnosed in her twenties for depression
• Traumatic event of husbands struggle with throat
cancer triggers voluntary commitment
• Bipolar Disorder II diagnosis was in 2011
• Hospitalized in June 2013 for stabilization
• Simple things became overwhelming
• Bolted from one idea to another and was “hard to
stay focused”

6. Bipolar Condition
http://www.youtube.com/watch?v=ZHlyUpMew
HI

7. Nursing Process- Assessment
Assess client for bipolar disorder and periods of
mania or depression by observing behavior and
actions

8. Characteristics
Symptoms of mania or a manic episode include:
Symptoms of depression or a depressive episode
include:
•Mood Changes
A long period of feeling "high," or an overly happy or
outgoing mood
•Extremely irritable mood, agitation, feeling "jumpy"
or "wired."
•Behavioral Changes
Talking very fast, jumping from one idea to another,
having racing thoughts
•Being easily distracted
•Increasing goal-directed activities, such as taking on
new projects
•Being restless
•Sleeping little
•Having an unrealistic belief in one's abilities
•Behaving impulsively and taking part in a lot of
pleasurable,
high-risk behaviors, such as spending sprees,
impulsive sex, and impulsive business investments.
•Mood Changes
A long period of feeling worried or empty
•Loss of interest in activities once enjoyed, including
sex.
•Behavioral Changes
Feeling tired or "slowed down"
•Having problems concentrating, remembering, and
making decisions
•Being restless or irritable
•Changing eating, sleeping, or other habits
•Thinking of death or suicide, or attempting suicide.
(Kessler, 2008)

9. Nursing Process- Diagnosis
• Determine the patients nursing diagnosis
Such as : Impaired Social, Impaired Self Care,
Defensive Coping, Ineffective coping, &
Disturbed Thought Processes

10. Nursing Process- Plan
• Set out a plan of action to treat with drug
therapy, individual therapy (talk therapy) and
in some cases when drug therapy fails, ECT
• Allow client to set goals for mood
stabilization, self care activities, impulse
control,

11. Nursing Process-Implement
• Implement goals and treatment

12. Treatment
• Mood stabilizers such as
Lithium, Depakene, Depako
te, Tegretol, & Lamictal
• Antipsychotics such as
Zyprexa, Risperdal, Seroque
l, Abilify, Geodon, Saphris
• Antidepressants such as
Paxil and Remeron

13. Treatment
• ECT
• Individual Therapy
• Family Therapy

14. Side Effects
•
•
•
•
•
•
•
•
Weight Gain
Suicidal Ideations
Insomnia
Hypotension
Dry Mouth
Fatigue
Blurred Vision
Memory Loss

15. Nursing Process- Evaluate
• Evaluate the goals and compliance of the
treatment and change or adjust as needed

16. NCLEX Question 1
During family support group, a family member asks: “How is bipolar
disorder different from depression?” Which of the following is the best
response?
A. Often, individuals with bipolar disorder can feel elated, are
productive, and do not think there is anything wrong when they have
manic feelings.”
B. “Individuals with bipolar disorder start out happy enough, but they
eventually develop irritability.”
C. “Sleep patterns, self-care, and intake are affected only in
depression.”
D. “People with bipolar disorder do not seek help. People with
depression readily seek treatment from health care providers.”

17. Question 1
Answer:
A. “Often, individuals with bipolar disorder can
feel elated, are productive, and do not think
there is anything wrong when they have manic
feelings.”

18. NCLEX Question 2
2. At 10:00 P.M., the nurse offers trazodone (Desyrel) 150
milligrams to a newly admitted client experiencing mania.
The client responds, “I feel great, and I don’t need to
sleep.” The nurse’s most therapeutic response is:
A. “You and your family stated you did not sleep at all
last night. That can be tough on your system.”
B. “The medication will potentiate your mood stabilizer
so that you’ll be discharged sooner.”
C. “Remember that unit rules are to be quiet with lights
out by 11:00 P.M.”
D. “The medication should help you get to sleep so that
you’re at your best tomorrow.”

19. Question 2
Answer:
A. “You and your family stated you did not sleep
at all last night. That can be tough on your
system.”

20. NCLEX Question 3
3. .” Your client states, “I’m going to participate in an experimental
brain imaging study. My primary health care provider thinks I have
bipolar I disorder. Are there lab tests that can help diagnose mood
disorders?” Your first response is:
A. “You should probably ask your primary health care provider.”
B. “Although some abnormal results are found in individuals with
mood disorders, there are no diagnostic lab tests specific to mood
disorders at this time.”
C. “There’s the dexamethasone suppression test, but we don’t know
whether mood disorder causes the non-suppression or whether the
non-suppression causes the disorder.”
D. “Are you hoping for diagnosis based on the imaging study?”

21. Question 3
Answer
B. “Although some abnormal results are found
in individuals with mood disorders, there are
no diagnostic lab tests specific to mood
disorders at this time.”

22. NCLEX Question 4
4. Based on your knowledge of circadian rhythms, discharge teaching
for clients with mood disorders should include which of the
following?
A. Disruption of the client’s usual diurnal pattern does not influence
the course of illness.
B. Antidepressants and mood stabilizers can help restore circadian
rhythms.
C. Particularly during times of decreased stress, the client should do
everything possible to maintain similar routines.
D. Nonprescription medications and dietary supplements do not alter
activity and rest cycles.

23. Question 4
Answer:
B. Antidepressants and mood stabilizers can
help restore circadian rhythms.

24. NCLEX Question 5
5. A colleague expresses frustration with a client with bipolar
disorder on his seventh admission within 2 years. “I wish he
would try taking his medication. Instead he keeps stopping the
medicine and coming back here.” Your best initial response is:
A. “Maybe you would rather work in the NICU, where all of
your clients adhere to the prescribed treatment regimen.”
B. “He stays on his meds. He is a rapid cycler and he has more
episodes anyway.”
C. “It can be frustrating to care for chronically ill clients.”
D. “Get control of your anger so that you do not take it out
on the client.”

25. Question 5
Answer :
C. “It can be frustrating to care for chronically ill
clients.”

26. Conclusion
• Bipolar Disorder is chronic and hard to
manage
• Many clients do not remain medication or
treatment compliant
• It disrupts not only ones life but social
interactions and relationships

27. References
Columbia Pictures. (Photographer). Still Photos of Catherine Zeta Jones[Print
Photo].
Retrieved from
http://www.imdb.com/media/index/rg1176148480?refine=nm0000 120
Kessler, R. National Institute of Health,(2008). Nimh: Bipolar disorder.
Retrieved from National Institute of Mental Health website:
http://www.nimh.nih.gov/health/publications/bipolar-disorder/index.shtml

28. References
Perth, E. (2013, April). Catherine Zeta-Jones - famous bipolar actress.
Retrieved from
http://www.famousbipolarpeople.com/Catherinezetajones.html
Ren Kneisl , C., & Trigoboff, E. (2010). Contemporary psychiatric-mental
health nursing. (2nd ed.). New York, NY: Pearson Prentiss Hall.
Varcarolis, E. (2013). Essentials of psychiatric mental health nursing. (2nd ed.).
St. Louis, MO: Elsevier.