BIPOLAR

DISORD
ER
Group 3
CASE SCENARIO
Patient’s Profile
Name: Patient Eric

Age: 22 year old

Sex: Male

Nationality: Filipino

Religion: Roman Catholic

Address: Pasig City

Marital Status: Single

Chief According to patient “Inaaway ako” “Hindi ako

Complaints: nakakatulog” “May bulong”

Admitting Bipolar type 1 manic episode with psychotic

Diagnosis: symptoms
CASE SCENARIO
History of Past and Present Illness:
The patient has been mentally ill since 2013. He was diagnosed having Bipolar
Type 1. He was readmitted 2016 with same medical diagnosis. The client was
maintained with Clozapine 100 mg/1 tab ODHS. Patient was reportedly compliance to
the medication.

Patient last OPS follow up was 2017 and maintained on the same medication but with
on and off relapse. However relapse was tolerated at home.

Few days PTA, patient experience auditory hallucinations and become suspicious to
other people.
Resistance of symptoms led the patient to bring himself to the psychiatric institution
for consultation
and subsequently voluntarily admitted himself 2019 for management and treatment

Medication prescribed as part of the treatment plan:

Aripiprazole 10 mg OD PO.
CASE SCENARIO
Personal and Social History:
Denies alcohol and cigarette use. Stated that sometimes he uses prohibited
drugs like marijuana and shabu (methamphetamine) but refused to give details of the
frequency and
amount of drugs taken.

Educational and Occupational Background:

He stated that he graduated elementary and he only reached up to 3rd year level in
high school,
he said that he stopped due to lack of financial and family support. He is a jeepney
barker along
Pasig City

Mental Status Examination:

Seen and examined as a young adult male of average height and weight, speech is
hypoproductive
and not spontaneous, low soft volume. Mood is anxious, shared that he had decrease
CASE SCENARIO
Psychosocial
Development:
Stages of Development Patient’s Development

Pre-Natal & Perinatal Patient was born full-term, delivered via NSD w/out
(Pregnancy-Birth) any
complications or defect. The pregnancy was planned
and
wanted. No drugs were taken by the mother during
pregnancy

Early childhood Patient had a good relationship with his mother and
(0-6) other
siblings. His primary caregiver was his mother. No
delay in
development was noted. No unusual behavior was also
CASE SCENARIO
Stages of Development Patient’s Development

Middle childhood / School Patient claimed he is active in school and graduated

Age primary in
(6-12) their place. He also stated that he had a good
relationship with
his parents and other siblings. However parents are too
busy in
working to provide a living and sustain their schooling

Late childhood. During adolescence, the patient claimed he started to

Adolescence have poor relationship with his parents and siblings.
(12-18) This is the reason he often hanged out with friends.
They have drinking sprees and used marijuana or
shabu which gave him pleasure and satisfaction. His
use of drugs became severe that caused him a lot of
trouble. He was then abandoned by his family when he
CASE SCENARIO

drugs. It was when he was 16 years he was admitted

to NCMH
for the first time due to behavioral changes and
reported he
hears voices inside his head
 01.
Describe the disease
process with a minimum of
300 words: definition,
epidemiology, signs and
symptoms, treatment and
management.
DISEASE PROCESS
Bipolar disorder causes mood, energy, and attention disturbances, among other symptoms (Newman,
2020). Researchers are currently exploring the underlying cause of bipolar illness, however some causes
appear to be a combination of events. Biologic variables including neurotransmitter or hormone
abnormalities may have a role (abuse, mental stress, significant loss, and other traumatic events). Bipolar
disorder is diagnosed using DSM-5 criteria. Classifying a patient's bipolar disorder depends on length and
symptoms. The National Institute of Mental Health (NIMH) says a person must have had bipolar I symptoms
for at least 7 days, or fewer if they required hospitalization. They may have suffered a 2-week depression.
Bipolar I requires manic episodes. Manic episodes are energetic. Sleep and appetite may decrease. They
may think they can multitask. During a manic episode, a person's mind races and they converse quickly
about many topics. Energy helps people feel good, but it also makes them more prone to make risky actions
like drinking too much, giving away money, or having unsafe sex. They may also become angry or worried.
This manic episode must last at least a week and need hospitalization to be considered a symptom of
bipolar I disorder. Depressive episodes are typical in bipolar I, but not essential for diagnosis. A person with
bipolar I shouldn't have another ailment that explains the symptoms. Bipolar I disorder treatment seeks to
stabilize the patient's mood, lessen symptoms, and improve daily function. Medication, psychotherapy,
physical intervention, and lifestyle solutions are used.
EPIDEMIOLOGY
● Bipolar disorder ranks second in global disability behind serious depression. Bipolar disorder has a 1.2%
lifetime risk and 15% suicide risk. Young males with a history of suicide attempts or alcohol abuse, as well as
those recently discharged from the hospital, have the highest risk of suicide early in the disease (Akiskal,
2017). Bipolar affects males and women equally. It's frequent among college graduates. Some bipolar illness
patients deny having mania, therefore prevalence numbers may be greater.
● Epidemiological studies show a lifetime incidence of 1% for bipolar type I. The lifetime prevalence of bipolar
spectrum disorders was 2.4%, with 0.6% for bipolar type I and 0.4% for bipolar type II. Although results varied
by country, they showed a lower frequency of bipolar type I and II than earlier study, with 1% prevalence of
bipolar type I in the U.S.
● Bipolar disorder research is ongoing and will continue. Community-based longitudinal studies of kids show that
bipolar disorder often begins in late adolescence and early adulthood, suggesting this time period could be a
focus for prevention. Two-thirds of people with bipolar disorder have received therapy at some time in their
lives. Teens and low- and middle-income countries have lower rates. Bipolar disorder is often associated with
anxiety and substance abuse. Comorbidities are common. Despite growing evidence of racial/ethnic variances
in subgroup analysis, studies have reported the same incidence of bipolar disorder by sex and ethnicity.
● Recent investigations of nongenetic risk factors for bipolar disorder have revealed childhood stresses such as
parental bereavement, mistreatment, and family violence. However, these risk variables lack specificity, and
studies rely on retrospective recall to measure them. A family history of bipolar disease is the greatest and
most consistent risk factor, and heritability estimates imply genes contribute to phenotypic diversity in bipolar
disorder. Finding causative genetic variants is complex and ongoing. Family and molecular genetic
investigations demonstrate inherited comorbidity between bipolar illnesses and significant depression and
schizophrenia. These findings highlight the need for a deeper understanding of bipolar disorder's boundaries
and common mental illness pathways.
 02.
Describe the importance of
assessing the psychosocial
development of patient
with
mental illness.
Assessing the psychosocial development
A psychosocial assessment is an evaluation of an individual's mental health and social well-being. It
assesses self-perception and the individual's ability to function in the community. It helps the nurse in
determining if the patient is in good mental health or suffering from mental illness. Assessing a patient's
psychosocial development contributes in the implementation of the highest quality of care and the
attainment of optimal health. In this example, Eric’s admitting prognosis is Bipolar Type 1 Manic Episode
with Psychotic Symptoms and he has been mentally ill since 2013 and based on the patient’s information in
the case scenario his mother’s sister or his auntie is positive for mental illness and it may the predisposing
factor of his illness because one of the predisposing factor of bipolar is biological which is through genetics
as a result of the psychosocial assessment. Psychosocial support is necessary for sustaining excellent
physical and mental health, as well as serving as a valuable coping mechanism for persons going through
stressful circumstances
 03.
Trace the pathophysiology
of disease process.
 04.
Make a drug study using
the 6 columns.
 Clozapin
e
DRUG NAME MECHANISM INDICATION & CONTRAINDICA COMMON SIDE NURSING
OF ACTION DRUG TIONS EFFECTS CONSIDERATION
RATIONALE S

Generic name: The mechanism Indications: Clozapine is No side effects to ● Baseline

Clozapine by which Primary indications contraindicated in the patient but blood tests
clozapine exerts for clozapine in patients with common could should check
Brand name: its effects involves patients with serious be: white cell
Clozaril, FazaClo the blocking of 5- schizophrenia or hypersensitivity count,
ODT, and HT2A/5-HT2C schizoaffective reactions to ● Drowsiness troponins,
Versacloz serotonin disorder are clozapine or any ● Dizziness CRP and
receptors and the schizophrenia component of the ● Feeling possibly BNP.
Classification: D1-4 dopamine symptoms partially formulation. unsteady ● Patients with
Atypical receptors, with or fully resistant to ● Having a history of
antipsychotics treatment with ● Neutropeni trouble cardiac
the highest
affinity for the D4 other antipsychotic a (due to keeping disease or
Dosage: drugs, or the risk of your abnormal
dopamine
100mg accompanied by agranulocyt balance cardiac
receptor
persistent suicidal osis) ● Increased findings on
Frequency: or self-injurious ● Orthostatic salivation examination
1 tab behavior hypotensio ● Dry mouth (such as QT
n ● Restlessne prolongation)
Route of Rationale: ● Seizures ss should be
administration Clozapine is the ● Myocarditis ● Headache referred to a
: only drug with ● Dementia cardiologist
Oral established
efficacy in
reducing
DRUG NAME MECHANISM INDICATION & CONTRAINDICA COMMON SIDE NURSING
OF ACTION DRUG TIONS EFFECTS CONSIDERATION
RATIONALE S

risk of relapse for ● Monitor

adults with patients
treatment‑resistant regularly for
schizophrenia signs and
symptoms of
diabetes
mellitus.
● Encourage
voiding
before taking
drugs to
decrease
anticholinergi
c effects of
urinary
retention.
● Follow
guidelines for
discontinuati
on or
reinstitution
of the drug.
● Educate
patients on
the
seriousness
DRUG NAME MECHANISM INDICATION & CONTRAINDICA COMMON NURSING
OF ACTION DRUG TIONS SIDE EFFECTS CONSIDERATION
RATIONALE S

risk of relapse for agranulocytos

adults with is
treatment‑resistant ● Full physical
schizophrenia examination
and medical
history.
● Specialist
examination if
there are any
cardiac
problems.
● Investigations
for
myocarditis or
cardiomyopat
hy in the
presence of
tachycardia.
● Stop taking if
cardiomyopat
hy or
myocarditis is
suspected
 ARIPIPRAZO
LE
DRUG NAME MECHANISM INDICATION & CONTRAINDICA COMMON SIDE NURSING
OF ACTION DRUG TIONS EFFECTS CONSIDERATION
RATIONALE S

Generic name: Aripiprazole is a Indications: The following There no side ● Monitor

Aripiprazole partial agonist at D2 Aripiprazole is conditions are effects to the diabetics for
receptors. It may act indicated for manic contraindicated patient but loss of
Brand name: as an antipsychotic and mixed episodes with this drug. common side glycemic
Abilify, Abilify by: Lowering associated with effects could be; control.
Maintena, and dopaminergic bipolar I disorder, Who should not ● Monitor
Aristada. neurotransmission in irritability associated take Aripiprazole? What side effects cardiovascula
the mesolimbic with autism spectrum can this r status.
pathway.Enhancing disorder, treatment of ● Diabetes
Classification: ● Overweight medication Assess for
atypical dopaminergic activity schizophrenia, cause? and report
in the mesocortical treatment of ● Very low
antipsychotics levels of orthostatic
pathway Tourette's disorder, ● Headache.
granulocyte hypotension.
and as an adjunctive ● Nervousne
Dosage: s, a type of ● Take BP
treatment of major ss.
10 mg white blood supine then
depressive disorder ● Restlessne
cell. in sitting
Frequency: ss. position.
Rationale: ● Low levels ● Dizziness
Once a day of white Report
Aripiprazole ● Feeling
blood cells systolic drop
rebalances unsteady
Route of ● Low levels of >15–20
dopamine and ● Having
Administration of a type of mm Hg.
serotonin to trouble
: white blood ● Patients at
improve thinking, keeping
Oral increased
mood, and your risk are those
behavior balance. who are
DRUG NAME MECHANISM INDICATION & CONTRAINDICA COMMON SIDE NURSING
OF ACTION DRUG TIONS EFFECTS CONSIDERATION
RATIONALE S

cell called ● Constipatio ●

neutrophils n. hypovolemic,
● Confusion ● Diarrhea. or receiving
● Suicidal ● Stomach concurrent
thoughts. pain. antihyperten
● Alzheimer’s sive therapy.
disease ● Monitor body
temperature
in situations
likely to
elevate core
temperature
(e.g.,
exercising
strenuously,
exposure to
extreme
heat,
receiving
drugs with
anticholinergi
c activity, or
being subject
to
dehydration).
● Monitor for
DRUG NAME MECHANISM INDICATION & CONTRAINDICA COMMON SIDE NURSING
OF ACTION DRUG TIONS EFFECTS CONSIDERATION
RATIONALE S

tardive
dyskinesia.

● Monitor for
and
immediately
report S&S of
neuroleptic
malignant
syndrome
(NMS) that
include:
hyperpyrexia,
muscle
rigidity,
altered
mental
status,
irregular
pulse or
blood
pressure,
tachycardia,
diaphoresis,
and cardiac
dysrhythmia.
 BIPERIDEN
DRUG NAME MECHANISM INDICATION & CONTRAINDICA COMMON SIDE NURSING
OF ACTION DRUG TIONS EFFECTS CONSIDERATION
RATIONALE S

Generic name: Restores the In Bipolar Disorder, ● There are ● There are ● Take
Biperiden natural balance of having too few of no no side biperiden
acetylcholine and these chemical contraindic effects exactly as
Brand name: dopamine in the messengers ations mentioned directed by
N/A CNS (Neurotransmitters mentioned in the case the doctor.
:norepinephrine, in the case scenario ● Take each
Classification: dopamine, and scenario however dose with a
Anticholinergic serotonin) will however the full glass of
result in the possible possible water.
Dosage: depression, and are: are: ● Take
2mg 1 tab having ● have ever ● Anticholine biperiden
an oversupply will had an rgic effects after a meal
Frequency: cause mania. allergic (dry if it upsets
OD Prescribing reaction to mouth, the stomach.
biperiden will it, blurred ● Educate and
Route of restore its balance. ● have vision, instruct the
administration narrow- constipatio patient to
: Mood disturbances angle n, paralytic report signs
PO are associated with glaucoma, ileus, and
intoxication from ● have an urinary symptoms of
substances such as obstruction retention, overdose
alcohol, in your ● tachycardi which include
amphetamines, bowel or a a, elevated large pupils;
complicatio temperatur warm, dry
DRUG NAME MECHANISM INDICATION & CONTRAINDICA COMMON SIDE NURSING
OF ACTION DRUG TIONS EFFECTS CONSIDERATION
RATIONALE S

cocaine, known as upset, sedation, ● mouth; fast

hallucinogens, megacolon; or dizziness, or irregular
inhalants, opioids, have myasthenia orthostatic heartbeat;
phencyclidine, gravis hypotension, anxiety;
sedatives, exacerbation of hallucination
hypnotics, and psychoses s; confusion;
anxiolytics. A agitation;
number of hyperactivity
medications have ; loss of
been known to consciousnes
evoke mood s; and
symptoms. seizures.
Classifications ● Use caution
include when driving,
anticholinergics operating
machinery,
or performing
other
hazardous
activities.
Biperiden
may cause
dizziness or
blurred
vision. If you
DRUG NAME MECHANISM INDICATION & CONTRAINDICA COMMON SIDE NURSING
OF ACTION DRUG TIONS EFFECTS CONSIDERATION
RATIONALE S

experience
dizziness or
blurred vision,
avoid these
activities.
● Avoid
becoming
overheated.
Biperiden may
cause
decreased
sweating. This
could lead to
heat stroke in
hot weather or
with vigorous
exercise. Try to
keep as cool
as possible
and watch for
signs of heat
stroke such as
decreased
sweating,
nausea, and
dizziness.
 Diphenhydramine Hydrochloride
DRUG NAME MECHANISM INDICATION & CONTRAINDICA COMMON SIDE NURSING
OF ACTION DRUG TIONS EFFECTS CONSIDERATION
RATIONALE S

Generic name: Interferes with Nighttime sleep aid There are no ● There are ● Overdose
Diphenhydramin histamine effects as patient contraindications no side S&S: Dry
e at histamine1- complained of mentioned in the effects mouth, fixed
Hydrochloride receptor sites; “Hindi ako case scenario mentioned or dilated
prevents but nakakatulog” however the in the case pupils,
Brand name: doesn’t reverse possible are: scenario flushing, GI
N/A histamine- however symptoms.
mediated Contraindicated in the ● Warn patient
Classification: response. Also patients possible not to take
Antihistamine possesses CNS hypersensitive to are: this drug with
depressant and drug ● CNS: any other
Dosage: anticholinergic drowsiness products that
50mg properties , dizziness, contain
headache, diphenhydra
Frequency: paradoxical mine
ODHS PRN excitation because
(increased ● of increased
Route of in adverse
administration children). reactions.
: EENT: ● Tell patient to
PO blurred take
vision, diphenhydra
tinnitus. mine with
CV: food or milk
DRUG NAME MECHANISM INDICATION & CONTRAINDICA COMMON SIDE NURSING
OF ACTION DRUG TIONS EFFECTS CONSIDERATION
RATIONALE S

frequency, ● Warn
urinary retention. patients to
Derm: avoid alcohol
photosensitivity. and
Resp: chest hazardous
tightness, activities that
thickened require
bronchial alertness
secretions, until CNS
wheezing effects of
drugs are
known.
● Inform
patients that
sugarless
gum, hard
candy, or ice
chips may
relieve dry
mouth.
 05.
Make at least two nursing
care plan based on your
assessment that needs to
prioritize.
 NCP 1
ASSESSMENT DIAGNOSIS PLANNING INTERVENTIO RATIONALE EVALUATION
N

SUBJECTIVE: Disturbed SHORT-TERM INDEPENDENT: SHORT-TERM

Thought GOAL: GOAL:
● The patient Process related 1. Explore how 1. Exploring the
verbalizes: to substance After 1 week of the hallucinations hallucinations After 1 week of
“Inaaway ako”, abuse nursing are experienced and sharing the nursing
“May bulong” secondary to interventions, the by the patient. experience can interventions, the
Bipolar patient will be help give the patient was able
OBJECTIVE: disorder as able to: person a sense of to:
evidenced by 2. Maintain a power that he or
● Upon suspiciousness ● Maintain pleasant and she might be able ● Maintain
examination, , delusional reality quiet to manage the reality
patient claimed thinking and orientation environment and hallucinatory orientation
that he was hallucinations and clearly approach voices. and clearly
mauled outside, communic patients in a slow communic
and admitted , ate with and calm manner. 2. Patients may ate with
and admitted other respond with other
with an people. 3. Keep to simple, anxious or people.
auditory basic, reality- aggressive
hallucination ● Demonstra based topics of behaviors if ● Demonstra
● Admitting te conversation. startled or te
Diagnosis: techniques overstimulated techniques
Bipolar type 1 that can that can
manic episode help him 3. Patient’ help him
with psychotic distract thinking might be distract
symptoms from the confused and from the
 NCP 1
ASSESSMENT DIAGNOSIS PLANNING INTERVENTIO RATIONALE EVALUATION
N

● Develop 4. Encourage 4. Verbalization of ● Developed

coping patients to feelings in a non- coping
strategies verbalize true threatening strategies
to deal feelings. Avoid environment may to deal
with becoming help patients with
psychotic defensive when come to terms psychotic
symptoms. angry feelings with long- symptoms.
are directed at unresolved
LONG-TERM him or her. issues. LONG-TERM
GOAL: GOAL:
5. Redirecting
After 1 month of 5. Engage clients the client’s After 1 month of
nursing in reality-based energies to nursing
interventions activities such as acceptable interventions
card playing, activities can
● The patient writing, drawing, decrease the ● The patient
will no doing simple arts possibility of no longer
longer and crafts or acting on shows
show signs listening to hallucinations signs of
of music. and help distract suspicious
suspicious from voices ness,
ness, 6. Provide delusional
delusional positive 6. When the thinking
thinking reinforcement patient and
and differentiates hallucinati
 NCP 1
ASSESSMENT DIAGNOSIS PLANNING INTERVENTIO RATIONALE EVALUATION
N

reinforcement. - GOAL
MET!
7. Teach patients 7. Thought
to intervene, stopping involves
using thought- using the
stopping command “stop!”
techniques, when or a loud noise
irrational or (such as hand
negative clapping) to
thoughts prevail interrupt
unwanted
thoughts. This
noise or
command
distracts the
individual from
the undesirable
thinking that
often precedes
undesirable
DEPENDENT: emotions or
behaviors
1. Administer the
right prescribe
medication
 NCP 1
ASSESSMENT DIAGNOSIS PLANNING INTERVENTIO RATIONALE EVALUATION
N

the serum lithium

level to a
treatment level
or reduced it to a
maintenance
COLLABORATIV level
E:

1. Refer to
community 1. These
resources (e.g., measures are
day-care necessary to
programs, promote wellness
support groups,
drug/alcohol
rehabilitation,
mental health
treatment
programs)
 NCP 2
ASSESSMENT DIAGNOSIS PLANNING INTERVENTIO RATIONALE EVALUATION
N

SUBJECTIVE: Insomnia SHORT-TERM INDEPENDENT: SHORT-TERM GOAL:

related to GOAL:
● The patient intrusive 1. Assess sleep 1. Assess a After 3 days of
said, “Hindi thoughts After 8 hours of patterns baseline nursing intervention,
ako secondary to nursing understanding of the patient was able
nakakatulo Anxiety as interventions, the the patient’s to:
g” evidenced by patient will be sleep patterns in
difficulty falling able to: order to institute ● Exhibit
OBJECTIVE: asleep or scheduled naps decreased
decreased in ● Exhibit 2. Monitor for and bedtimes restlessness
● Decreased sleep decreased physical signs of and
in sleep restlessnes exhaustion 2. Patients with exhaustion to
s and bipolar disorder adequate
exhaustion may not feel a sleep
to need for sleep
adequate and will go days LONG-TERM GOAL:
sleep without
resting.They may After 1 month of
LONG-TERM not notice nursing intervention,
GOAL: symptoms of the patient was able
fatigue such as to:
After 1 month of tremors and
nursing increased blood ● Sleep at least
interventions, the pressure 6 - 7 hours per
patient will be night by
 NCP 2
ASSESSMENT DIAGNOSIS PLANNING INTERVENTIO RATIONALE EVALUATION
N

to: 3. Promote 3. Improve sleep ● Obtain

relaxation hygiene by optimal
● Sleep at instituting soft amounts of
least 6 - 7 music, dim sleep as
hours per lighting, and evidenced by
night by non-caffeinated rested
discharge teas before appearance,
bedtime verbalization
● Obtain of feeling
optimal DEPENDENT: rested, and
amounts improvement
of sleep as 1. Provide trial 1. Dark therapy in sleep
evidenced dark therapy, as is a behavioral pattern
by rested ordered treatment that
appearanc enhances - GOAL MET!
e, melatonin
verbalizati naturally by
on of keeping patients
feeling in a pitch-dark
rested, room during
and nighttime hours
improvem
ent in 2. Recommend 2. Cognitive
sleep CBT for insomnia behavioral
pattern therapy for
 NCP 2
ASSESSMENT DIAGNOSIS PLANNING INTERVENTIO RATIONALE EVALUATION
N

bipolar disorder
has proven not
only to improve
sleep but also to
lessen the
number of days
in a mood
episode
 06.
What are your discharge
plan or recommendation to
C.D. using the mnemonic
METHOD
M-Medication
Since the patient taking antipsychotic medications such as clozapine and aripiprazole nurse should
educate the patient/family:

● Advice the patient to take the medicines on schedule or at the same time of the day each day as to remember
to take it.
● If there's difficulty in remembering, advise the patient to use a chart or alarm for the schedule of medication.
● Immediately report symptoms of infection(flu like symptoms) and side effects.
● Use sunscreens and wear protective clothing while spending time outside.
● Teach the patient and family to not stop or Change medicine without talking to the doctor.
● Drinking sugar-free fluids can dry mouth
● Avoid driving and performing potentially hazardous activities until the response to the reflexes back to normal.
● If you do forget to take a dose, take it as soon as you remember. If you do not remember until the following day,
skip the missed dose. Do not take two doses at the same time to make up for a forgotten dose
E-Environment/Exercise
ENVIRONMENT
- The nurse may teach to provide quiet environment without
noise, television or other distraction during manic phase.
- Decreasing environment stimulation may assist the client to relax
- To provide safety to the client, ask the family to remove sharp objects, bottles or any materials
that can harm the client. Have a person to monitor 24 hrs for patients' actions.
- Make the bedroom a calming space, advise the patient to avoid caffeine at night to avoid staying
up late.
- Ask the family to spend more time with the patient.

EXERCISE
Physical health is important for people living with a mental illness. During episodes of mania exercise
allows to direct relentless powerful energy in a healthy way rather than a destructive way. It also tires
out so there's a better chance of being able to sleep.

These exercises include:

walking, swimming
T-Treatment
Treatment is best guided by a medical doctor who specializes in diagnosing and treating mental health
conditions (psychiatrist) who is skilled in treating bipolar and related disorders. Bipolar disorder is a
lifelong condition. Treatment is directed at managing symptoms. Depending on your needs, treatment
may include:

● Medications. Often, you'll need to start taking medications to balance your moods right away.
● Continued treatment. Bipolar disorder requires lifelong treatment with medications, even during
periods when you feel better. People who skip maintenance treatment are at high risk of a relapse
of symptoms or having minor mood changes turn into full-blown mania or depression.
● Day treatment programs. Your doctor may recommend a day treatment program. These
programs provide the support and counseling you need while you get symptoms under control.
● Substance abuse treatment. If you have problems with alcohol or drugs, you'll also need
substance abuse treatment. Otherwise, it can be very difficult to manage bipolar disorder.
● Hospitalization. Your doctor may recommend hospitalization if you're behaving dangerously, you
feel suicidal or you become detached from reality (psychotic). Getting psychiatric treatment at a
hospital can help keep you calm and safe and stabilize your mood, whether you're having a manic
or major depressive episode.
H-Health Teaching
Patient and Family Education
● Treatment plan needs to be discussed with both patient and family members
● They need to understand that long-term treatment is necessary
● Educate patient and family about prodromal symptoms. Teach them to recognize early signs and
symptoms of manic and depressive episodes and how to prevent
● Specific strategies such as enhancing coping skills through improvements in self-esteem,
empowerment and help-seeking behavior can help reduce stigma and can improve outcomes

Treatment Compliance
● Encourage treatment compliance because noncompliance may lead to relapse

Manage Functional Impairment

● Patients may suffer emotional, family, social, occupational, financial or academic problems during
an episode
● Full functional recovery rarely occurs within 12 weeks following the remission of mood symptoms

Psychosocial Stressors
● Enhance coping strategy and problem solving skills in managing psychosocial stressors
● Disruption in sleep cycles or social rhythm can trigger manic episodes
O-Observation/Out-patient
4 Major goal of outpatient treatment for bipolar.

1. LOOK AT AREAS OF STRESS AND FIND WAYS TO HANDLE THEM

2. MONITOR AND SUPPORT MEDICATION
3. DEVELOP AND MAINTAIN THERAPEUTIC alliance
4. Provide education (see Patient Education)
D-Diet
It's essential to maintain a good diet and nutrition. Patients with bipolar disorders should consume foods high in omega 3
fatty acids and selenium since these nutrients appear to be important for brain development and cell signaling and
contribute to the fluidity of the brain's cell membrane.

others:

Whole grains - This feel-good brain chemical helps to ease anxiety

and may leave you feeling more in control

Nuts - Almonds, cashews, and peanuts are also high in magnesium.

In addition to research that suggests it’s positive effect on mania,
magnesium helps to calm an overactive nervous system and plays a
role in regulating the body’s stress response by keeping cortisol levels
in check.

What Foods and Drinks Should People With Bipolar Disorder Avoid?

1. Caffeine
2. Alcohol
3. Sugar
4. Salt
5. Fat
 Thank
you for
listening
!
MEMBERS:
 REFERENCES:
https://go.drugbank.com/drugs/DB00810
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