Wednesday, 29 April 2026

Chapter 20 / Module 19 – bipolar disorder

 

What is Bipolar Disorder?

Bipolar disorder is a long-term mood condition that causes extreme changes in:

  • Mood
  • Energy
  • Thinking
  • Behaviour
  • Daily functioning

People experience cycles between:

  • High moods (mania or hypomania)
  • Low moods (depression)

These changes can significantly affect daily life and relationships.


Main Mood Phases

Mania (High Phase)

Mania is a period of very elevated mood and energy.

Signs include:

  • Very high energy
  • Reduced need for sleep
  • Racing thoughts
  • Talking very quickly
  • Impulsive or risky behaviour (spending, decisions)
  • Inflated self-confidence or grand ideas

Depression (Low Phase)

Depression is a period of low mood and reduced functioning.

Signs include:

  • Low mood or sadness
  • Fatigue and low energy
  • Loss of interest in activities
  • Poor concentration
  • Feelings of worthlessness
  • Sleep changes

Types of Bipolar Disorder

Bipolar I

  • At least one full manic episode
  • May include depression, but not required for diagnosis
  • Mania can require hospital care

Bipolar II

  • Hypomania (less severe mania)
  • Major depressive episodes
  • No full manic episodes

Cyclothymia

  • Long-term mood fluctuations
  • Milder highs and lows
  • Lasts at least 2 years

Impact on Daily Life

Bipolar disorder can affect:

  • Work and education
  • Relationships
  • Financial decisions
  • Sleep patterns
  • Personal safety

During mania, people may take risks they would not normally take.


Nursing Care and Support

Safety First

  • Prevent self-harm or risky behaviour
  • May require inpatient care during severe episodes

Environment

  • Keep surroundings calm and low-stimulation
  • Reduce noise and distractions

Communication

  • Use clear, simple language
  • Stay calm and consistent
  • Set firm boundaries

Nutrition & Self-Care

  • Encourage high-calorie, high-protein finger foods
  • Monitor sleep and hydration

Treatment Approaches

Medication

  • Lithium – first-line mood stabiliser
  • Anticonvulsants (e.g., valproate)
  • Antipsychotics (for acute mania)

Psychological Therapies

  • Cognitive Behavioural Therapy (CBT)
  • Family-focused therapy
  • Psychoeducation

Important Medication Safety

Lithium monitoring

Watch for signs of toxicity:

  • Tremors
  • Vomiting or diarrhoea
  • Confusion
  • Unsteady movement

Maintain:

  • Regular blood tests
  • Consistent salt and fluid intake

Managing Acute Mania (Key Interventions)

  • Reduce stimulation (quiet environment)
  • Set clear boundaries
  • Encourage rest and nutrition
  • Ensure safety (remove hazards)
  • Administer prescribed medication

Key Takeaway

Bipolar disorder is not just “mood swings”.

It is a serious medical condition involving:

  • Extreme mood highs and lows
  • Changes in thinking and behaviour
  • Long-term management needs

With treatment and support, many people manage symptoms and live stable lives.

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