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Bipolar II Disorder
Diagnosis requieres
- at least one major depressive episode
- one hypomanic episode
As soon as manic episodes appear --> Bipolar I without exception
Manic episode
Period of abnormally and persitently elevated, expanisve or irritable mood
- lasting at least 1 week and is present most of the day on almost all days
- three key symptoms (restlessness, grandiosity, distractability, etc.)
- sufficently severe, leading to significant impairment in life or even hospitalization
- canot be attributed to a substance or other medical condition
Hypomanic episode
distinct period of abnormally elevated, expansive or irritable mood
- lasting at least 4 consecutive days (shorter than full maniac phase)
- at least three key symptoms
- observebal by others, but not severe enough to cause impairment or hospitalization
Major Depressive Episode
Key Symptoms: depressed mood and loss of interest or pleasure
+ Insomina or hyersomnia
+ Pychomotor agitation or retardation
+ Fatigue
+ feeling of worthlessness/inapropriat guilt
+ diminished ability to concentrate
+ suicidal thoughts, plans or attempts
- at least 5 symptoms ( one of the key ones + 4 others) need to be present for two weeks consitently every day most of the time
- significantly distress or impairment
- not due to drugs or other medical issues
Manic episode symptoms
predominant mood is often irritability
- especially if whishes are denied or substance abuse
rapid mood shifts --> liability
engagement in multiple overlapping new projects, mostly without appropriat knowlede
Inflated self esteem and grandiosity lead to overexpectaion and dangerous behavior
decreased need for sleep
rapid speech , coversations are held in an intrusive manner
flight of ideas
increase in goal directed activity
Major Depression Symptoms
increased irritablility
reduced interest
changes in appetit and sleep pattern
- some eat more/sleep more, some eat less/sleep less
decreased energy, tiredness, fatigue
sense of worthlessness and guilt --> ruminations of delusional proportions
inability to think, concentrate or make decisions
memory dificulties
Features suporting the diagnosis of Mania
Rejection of diagnosis and treatment during manic episode --> can lead to resistance
sudden, drastic changes of apperance --> more sexual
hostile or threatening behavior towards others --> can lead to serious consequences
Prevalence BPD I
0.6% in US, range from 0 --> 0.6% for other countries
1:1 female-male ratio
Bipolar I vs. Bipolar II
Bipolar II is not a less severe form of BPD I
- greater chronicity
- higher duration of depressive episodes
Bipolar II common features
- more excessive depressive episodes (necessary for diagnosis)
- less intense maniac phases (hypomania)
Impulsivity --> can contribute to suicidal attempts
hightend levels of creativity
Prevalence of Bipolar II disorder
12-month prevalence: 0,3%
higher rates in young people and females
Bipolar I Disorder
modern understanding of "manic-depressive disorder"
Necessary for diganosis: Manic episode
- depressive episode usually also part of disease, but not requiered for diagnosis
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