1Listen to the audio lecture while viewing these slidesPsychology 311Abnormal Psychology1Mania and Bipolar Disorders2Psyc 311 – Abnormal PsychologyMania• Is hard to distinguish from a normal person with high spirits• Is more than just hyperactivity3Psyc 311 – Abnormal PsychologySymptoms• Extreme hyperactivity• Increased psychomotor activity• Person literally bounces off the wall• Is more talkative• Has a flight of ideas• Person goes from one thought to another to another.• Often no connection between the thoughts• Often have a grandiose self-image• Attention• Is easily distracted• Sleep is infrequent• Easily frustrated4Psyc 311 – Abnormal PsychologyAdditional Points• Is important to take a good history• Some pharmacologic medications or drugs can mimic manic symptoms.• Excessive caffeine•Ephedrine• Anabolic Steroids•Diet aids• Amphetamines• Other diseases can cause symptoms too• E.g., Thyroid Disease5Psyc 311 – Abnormal PsychologyGeneral Treatment• Behavioral interventions can work well• Relaxation training can help• Goal is to reduce symptoms• Drugs often used• Benzodiazepines (Valium)•Antipsychotics (Zyprexa)•Valproic Acid (Valproate)• Lithium can stabilize mood• Often combination therapies are used.6Psyc 311 – Abnormal PsychologyBipolar Disorders27Psyc 311 – Abnormal PsychologyBipolar Disorders• In the past called• Manic – Depressive Psychosis• Occurs in up to 4% of the population• Number differences depend on the reference• Number of cases are rising•May be due to better screening•Found more in artistic populations (poets, artists)• 55% have a history of substance abuse• May be an attempt to self medicate8Psyc 311 – Abnormal PsychologyBackground Continued• One of every 4 or 5 untreated or inadequately treated individuals commits suicide.• Also increases of accidents or other disorders • A person at age 25 who does not receive treatment can expect to:• Lose 9 years of life• Lost 14 years of effective activity• Lose 12 years of normal health• Persons with four illness episodes in 12 months are called rapid cyclers• May not be permanent and may disappear• Is divided into groups9Psyc 311 – Abnormal PsychologyGroups of Bipolar Disorder•Bipolar I Disorder•Bipolar II Disorder• Cyclothymic Disorder10Psyc 311 – Abnormal PsychologyBipolar I Disorder• Usually have an episode of Mania, then a major Depressive episode• Often requires hospitalization or severely interferes with normal functioning11Psyc 311 – Abnormal PsychologySymptoms•Mania• Symptoms are same as described earlier•Hypomania• Is a mildly elevated state• May not be recognized by others• Before a diagnosis, mania from all other causes must be ruled out•Tumors•Drugs12Psyc 311 – Abnormal PsychologyBipolar II• Is less severe than Bipolar I• Usually manic stage is not as severe •Hypomania•Key: • Person does not need to be hospitalized• Can still function• Other people may see the mania• Person with disorder may not• Feels very energetic and creative.313Psyc 311 – Abnormal PsychologyCyclothymic Disorder• Is a chronic state of mood disturbances• Most noticeable is a change in energy levels• Swing between mania and depression but the severity is lower than Bipolar II• Tend to have a seasonal pattern• More common in spring and fall14Psyc 311 – Abnormal PsychologyCauses of Bipolar Disorders• 2/3 have a history of mood disorders• Monozygotic twins have a 40-70% chance of having bipolar disorders when one twin has the disorder• VS. 5-10% for dizygotic twins• What may be inherited is not the disorder but the vulnerability• Stress seems to influence the rate15Psyc 311 – Abnormal PsychologyTreatment• Cannot be cured• Is a lifelong chronic condition• Treatment can reduce the frequency of episodes• The more episodes the person experiences, the poorer the long-term outcome is16Psyc 311 – Abnormal PsychologyDrug Treatments•Many types used• Lithium Carbonate (Lithium)• Newer drugs with Bipolar• Valproic Acid (Valproate, Depakote)• Gabapentin (Neurontin) •Others17Psyc 311 – Abnormal PsychologyLithium• Most recommended drug for Bipolar• Effective in treating 60-80% of acute hypomanic and manic episodes• Takes about 1-2 weeks before stable levels are reached18Psyc 311 – Abnormal PsychologyProblem• Very narrow window between therapeutic effectiveness and toxic amounts.• Must be monitored very closely• Many side effects• Gastrointestinal problems• Thyroid, kidneys, cardiovascular system and other all influenced• Depression, hope, mood increase• All contribute to many patients discontinuing the drug.419Psyc 311 – Abnormal PsychologyNewer Drugs• Have been used alone but usually are used in combination with Lithium•Usually for manic phase• Target the GABA receptor• Cause neurons to not fire as much• Result – less activity• Also have better safety margins20Psyc 311 – Abnormal PsychologyConclusions• Mania/Bipolar cause problems for many individuals.• Can be treated effectively• Need more research on the