Dirty Psychiatry Series: Bipolar Spectrum Disorders

Overview

• Discussion on the bipolar spectrum disorders, their symptoms, and brief mention of treatments.
• Focus on three disorders:
  • Bipolar I Disorder
  • Bipolar II Disorder
  • Cyclothymia
• Introduction to "Dig Fast" symptoms as diagnostic criteria.

Dig Fast Symptoms

• D: Distractibility
  • Easily distracted by external stimuli.
• I: Impulsivity
  • Engaging in risky, impulsive behaviors.
• G: Grandiosity
  • Inflated self-esteem or self-importance.
• F: Flight of Ideas
  • Rapid, non-stop thoughts and speech.
• A: Activity Increase
  • Increased goal-directed activities.
• S: Decreased Sleep Need
  • Less need for sleep without feeling tired.
• T: Talkativeness
  • Rapid, continuous speech.

Bipolar I Disorder

• Criteria:
  • Manic episode (+/- depressive episode)
  • Manic = 4 of 7 Dig Fast symptoms for at least 1 week, hospitalization, or psychotic features.
  • "One Fun Week": Mnemonic for mania criteria.

Treatment Overview

• Mood Stabilizers:
  • Lithium, Valproic Acid, Carbamazepine, Olanzapine, Risperidone
• Never give SSRIs alone due to risk of triggering mania.

Bipolar II Disorder

• Criteria:
  • Hypomanic episodes + Major Depressive Episodes
  • Hypomania = 3 of 7 Dig Fast symptoms for at least 4 days.
  • "Hypo Main Threa": Mnemonic for hypomania criteria.

Graph Representation

• Alternates between hypomanic and major depressive episodes.

Cyclothymia

• Criteria:
  • Alternating hypomanic and dysthymic episodes for at least 2 years.
  • Dysthymia = 2-4 Sig E CAPS symptoms, cannot meet MDD criteria.

Graph Representation

• Alternation between hypomanic and mild depressive episodes.

Additional Causes of Mania

• Steroid-induced mania
• Substance-induced mania (e.g., cocaine, methamphetamine)
• Drug-induced mania
• Autoimmune induced mania (e.g., lupus)
• Neurosyphilis, HIV, Vitamin B12 deficiency, Hyperthyroidism, Lyme disease, Wilson's disease

Conclusion

• Key understanding of bipolar spectrum disorders, diagnostic criteria, and mood fluctuation representations.
• Upcoming videos on mood stabilizers and more detailed psychiatric topics.