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Bipolar Disorder and Substance Use Disorders

Learn about Bipolar I Disorder, its episodes, symptoms, and impacts. Explore effects of substance use disorders such as Cocaine Intoxication and Alcohol Withdrawal. Understand Depressive Episodes and seek help for those in need.

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Bipolar Disorder and Substance Use Disorders

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  1. Bipolar DisorderandSubstance Use Disorders

  2. Bipolar I Disorder Includes one or more Manic Episodes or Mixed Episodes, sometimes with Major Depressive Episodes as well • Single Manic Episode • Most Recent Episode Hypomanic • Most Recent Episode Manic • Most Recent Episode Mixed • Most Recent Episode Depressed

  3. Manic Episode • A period of unusual and ongoing elevated, expansive, or irritable mood, of at least 1 week duration

  4. Manic Episode • Three (3) or more of the following occur: • Inflated self-esteem or grandiosity; • Decreased sleep needs; • More talkative than usual; • Racing thoughts; • Distractibility; • Increase in activity or psychomotor agitation; • Excessive involvement in pleasurable activities with high potential for painful consequences (ex. spending, sex).

  5. Manic Episode • The mood disturbance is severe enough: • to significantly impair occupational functioning, or • to significantly impair usual social activities or relationships, or • to require hospitalization to prevent harm to self or others

  6. Manic Episode • Symptoms are NOT due to the direct effects of a substance (including prescribed medication and/or intoxication or withdrawal syndromes of substances of abuse), or a general medical condition

  7. Hypomanic Episode • A period of unusual and ongoing elevated, expansive, or irritable mood, lasting through at least 4 days, that is clearly different from the usual non-depressed mood • Manic symptoms (see) • Significant functional impairment • Symptoms are NOT due to substances of abuse

  8. Cocaine Intoxication • Euphoria (elevated, expansive mood) • Changes in sociability (more talkative) • Hypervigilance • Interpersonal sensitivity(irritability) • Anxiety, tension or anger • Impaired judgment • Impaired social or occupational functioning • Psychomotor agitation

  9. Alcohol Withdrawal • Insomnia • Psychomotor agitation • Anxiety • Hand tremor • Temporary hallucinations • Nausea, vomiting • Seizures • Impaired social or occupational functioning

  10. Depressive Episode • Five or more of the following are present during the same 2-week period, and represent a change from previous functioning, and at least one of the symptoms is either (1) depressed mood, or (2) loss of interest . . .

  11. Depressive Episode • Depressed mood most of the day, every day • Loss of interest or pleasure in most all activities, every day • Significant weight loss w/o dieting • Insomnia / hypersomnia every day • Psychomotor agitation / retardation every day • Fatigue or energy loss every day • Worthlessness or inappropriate guilt feelings nearly every day • Decreased ability to think, concentrate or make decisions nearly every day • Recurrent thoughts of death, or suicidal ideation, with or without plan &/or attempt

  12. Depressive Episode • Symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning

  13. Depressive Episode • Symptoms are NOT due to the effects of a substance(e.g., drug of abuse, or medication) or a general medical condition (e.g., hyperthyroidism)

  14. Depressive Episode • Symptoms are not better accounted for by Bereavement (i.e. lasting longer than 2 months after a significant loss, or characterized by severe degree of functional impairment, preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation)

  15. Sedative Intoxication • Inappropriate sexual or aggressive behavior • Slurred speech • Stupor • Impaired attention or memory • Mood lability • Impaired judgment • Psychomotor retardation or agitation • Impaired social, occupational, or other functioning

  16. Cocaine Withdrawal • Depressed mood • Fatigue • Vivid, unpleasant dreams • Insomnia or hypersomnia • Increased appetite • Psychomotor retardation or agitation • Symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning

  17. Mixed Episode • Criteria are met for both a Manic Episode, and for a Major Depressive Episode (except for duration) for at least a 1-week period

  18. Bipolar II Disorder • Presence (or history) of one or more Major Depressive Episodes • Presence (or history) of at least one Hypomanic Episode • There has never been a Manic Episode, or a Mixed Episode • Symptoms are NOT better accounted for by another disorder (including Substance Use disorders) • Symptoms impairment in social, occupational, or other important areas of functioning

  19. Comments or Questions? Thanks for coming!

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