BIPOLAR DISORDER

Which bipolar order is this?

Alterations between major depressive episodes and manic episodes

Which Bipolar Disorder is this?

Alternations between less severe depressive and hypomanic periods

Patient: Mark, a 35-year-old marketing executive.

Presenting Symptoms: Mark's wife brings him to the clinic, stating he has been acting strangely for the past two weeks. She describes a sudden and dramatic shift in his behavior. He's been sleeping only 2-3 hours a night but claims to feel "more energized than ever." He's been talking a mile a minute, jumping from one idea to another, and has impulsively bought two sports cars, a boat, and a professional-grade sound system for his home. He's also been taking on numerous new projects at work, many of which he can't possibly complete, and has been making grandiose claims about his professional future. His wife notes that his mood is highly irritable and that he lashed out at her and the children over minor issues. A few months ago, Mark experienced a severe depressive episode that left him unable to get out of bed for three weeks.

• BIPOLAR I

• BIPOLAR II

• CYCLOTHYMIA

Patient: Mark, a 35-year-old marketing executive.

Presenting Symptoms: Mark's wife brings him to the clinic, stating he has been acting strangely for the past two weeks. She describes a sudden and dramatic shift in his behavior. He's been sleeping only 2-3 hours a night but claims to feel "more energized than ever." He's been talking a mile a minute, jumping from one idea to another, and has impulsively bought two sports cars, a boat, and a professional-grade sound system for his home. He's also been taking on numerous new projects at work, many of which he can't possibly complete, and has been making grandiose claims about his professional future. His wife notes that his mood is highly irritable and that he lashed out at her and the children over minor issues. A few months ago, Mark experienced a severe depressive episode that left him unable to get out of bed for three weeks.

• BIPOLAR I

• BIPOLAR II

• CYCLOTHYMIA

Patient: Mark, a 35-year-old marketing executive.

Sarah seeks help because she is "burned out" from what she describes as cyclical periods of intense depression. She recounts several episodes in the past two years where she felt hopeless, had no energy, and lost interest in all her hobbies. These periods lasted for several weeks at a time. However, she also describes other times where she felt unusually productive and creative. She would stay up late working on projects, feeling a surge of energy and a heightened sense of self-confidence. She'd talk faster than usual, and her friends would comment on her "bubbly" and "high-strung" mood. These periods of elevated mood would last for a few days before she would return to her baseline or, more often, swing back into a depressive state. She reports that while these elevated periods were noticeable to others, they never caused her to lose her job or get into serious financial trouble. She describes them as "a mixed blessing," as they allowed her to be very productive but often led to a crash afterward.

• BIPOLAR I

• BIPOLAR II

• CYCLOTHYMIA

Alex comes in for an evaluation, concerned about his unpredictable mood. He says he feels like he's on a "mood roller coaster." For weeks at a time, he feels low-energy, unmotivated, and a bit sad. He describes it as feeling "blah" and having a hard time focusing on schoolwork. These periods are not severe enough to be considered a major depressive episode; he is still able to go to class and socialize, albeit with some effort. Then, his mood will suddenly shift. He'll feel restless and highly energetic, needing less sleep and being more talkative than usual. He might impulsively start a new hobby or a new club on campus, but his interest wanes after a few days. These shifts in mood are noticeable to him and his friends, but they don't prevent him from attending classes or maintaining his relationships. These mood swings have been happening for as long as he can remember, at least for the past two years.

• BIPOLAR I

• BIPOLAR II

• CYCLOTHYMIA

What diagnostic specifier is this?

• Moving quickly in and out of mania and depression

• Individual experiences at least four manic or depressive episodes within a year

• Occurs in between 20 to 50% of cases

• Associated with greater severity

Which neurotransmitter is related to mood disorder? It permits other neurotransmitters to vary more widely, increasing vulnerability to depression.

Serotonin regulates which neurotransmitter?

• norepinephrine

• glutamate

• dopamine

______ hormones decrease neurogenesis in the hippocampus