Bipolar Disorder

Bipolar disorder is an affective disorder characterized by the occurrence of alternating periods of euphoria (mania) and depression.

Signs and Symptoms Of Mania:

• Becomes angry quickly.
• Distracted by environmental stimuli.
• Extroverted personality
• Flights of idea
• Delusional self-confidence.
• Grandiose and persecutory delusions
• Inability to eat or sleep.
• High and unstable affect.
• Inappropriate dress.
• Inappropriate affect.
• Initiation of activity
• Restlessness
• Pressured speech
• Sexually promiscuous
• Unlimited energy
• Urgent motor activity
• Significant decrease in appetite

Signs and Symptoms Of Depression:

• Decreased emotion and physical activity
• Decrease in activities of daily living
• Easily fatigue
• Inability to make decisions
• Introverted personality
• Internalizing hostility
• Lack of initiative
• Lack of energy
• Lack of self-confidence
• Lack of sexual interest
• Withdrawn from groups

Interventions for maniac patients:

• Remove hazardous objects from the environment
• Assess the client closely for fatigue
• Promote sleep
• Provide rest periods
• Provide private room
• Hypnotic or sedative medication as prescribed
• Encourage the patient to ventilate feeling
• Calm and slow interaction
• Encourage patient to focus on one topic during conversation
• Ignore and distract patient from grandiose thinking
• Present reality to patient
• Do not argue with patient
• Provide high-calorie finger foods and fluids
• Reduce environmental stimuli
• Set limits on inappropriate behaviors
• Provide physical activities and outlets for tension
• Avoid competitive games
• Provide gross motor activities such as walking and writing
• Provide structured activities with nurse
• Provide simple and direct explanations for routine procedures
• Supervise the administration of medication

Deal With Aggressive Behavior Patients:

• Assist patient to identify feeling of frustration and aggression
• Encourage patient to talk out instead of acting out
• Assist patient in identifying precipitating events or situations lead to aggressive behavior
• Describe the consequences of the behavior on self and others
• Assist in identifying previous coping mechanism
• Assist in problem solving techniques.

Deal With De-escalation Techniques:

• Maintain safety for the patient, others and self
• Maintain a large personal space and use non-aggressive posture
• Calm in approaching and communicating
• Clear tone of voice, be assertive not aggressive
• Avoid verbal struggles
• Assist the patient with problem-solving and decision making
• Provide the patient with clear option

Deal With Manipulative Behaviors:

• Set clear, consistent, realistic and enforceable limits
• Communicate the expected behaviors
• Be clear with the consequences associated with exceeding limits
• Discuss the patient’s behavior in non-judgmental and non-threatening manner
• Avoid power struggles with the patients