Week 4

Bipolar & Related Disorders

 BIPOLAR AND OTHER RELATED DISORDERS

1. Define and discuss the following mental

health disorders and common signs and
symptoms and treatment plans:

Weekly Mental disorders Treatments Plans

Learning
• Bipolar Disorder • Psychotherapy
• Depressive Disorder • Drug Therapy

Outcomes
• Seasonal Affective • Electronic Therapy
Disorders
• Bipolar Disorder
• Depressive Disorder
• Seasonal Affective
Disorders
What is
Bipolar?
 Bipolar is a mental illness that
brings severe high and low
moods and changes in sleep,
energy, thinking, and
behavior.

Bipolar is…
 Also known as manic-depressive illness

A group of related brain disorders that cause unusual shifts in a person’s

mood, energy, and ability to function

Considered a long-term illness

A client with bipolar will have emotional highs ( Mania) to emotional lows(
Bipolar depression)

Disorder Thoughts moods and behaviors will swing from normal to grandiose (
manic state) to depression

Symptoms can result in:

• damage relationships
• Poor job or school performance
• Suicide
Manic episode diagnosed if elevated mood occurs with three or more other
symptoms of mania most of the day, nearly every day, for 1 week or
longer.
Bipolar Affective Disorder
 A depressive disorder is not a passing blue
mood but rather persistent feelings of sadness
and worthlessness and a lack of desire to
engage in formerly pleasurable activities

Depressive The client has sad, empty, or irritable moods

Disorder accompanied by physical changes and thought
changes that are severe enough to affect ability
to function

Complete opposite from the manic state

 Signs and Symptoms of Depression

Inability to Feeling of Decrease in

Fatigue and uselessness, Increase Anxiety
experience sexual
lack of interest
pleasure
hopelessness and dependency
helplessness interest

Slow or Thoughts of Difficulty

Focus on the
unreliable Paranoia Agitation death / completing
memory past
suicide ADLS

Changes in Muscle aches,

Poor Withdrawal Nausea and
sleeping abdominal Headaches
patterns grooming from people vomiting
pain

Loss of
Dry mouth Weight loss
appetite
 Supporting clients with Bipolar
Disorder

The support worker can

assist in keeping a chart Phases of Treatment and
of daily mood symptoms, the Role of the Support
treatments, sleep Worker
patterns, and life events
 Occurs in Three
Symptoms Phases:
of Bipolar
Disorder Continuation
phase:
Maintenance
phase:
Acute phase:
when when the
when the
symptoms are symptoms are
client’s acute
escalating visible, and the
symptoms
client is usually
have subsided
being treated
 Phase Period Goal of Treatment Your Role
Acute Treatment: 6 to 12 months To reduce symptoms ❑ Observe for changes
Symptoms are and inappropriate in behaviour
beginning to behaviours ❑ Report these changes
escalate to your supervisor
❑ Provide safe, secure
consistent
Phases of environment for the
client
Treatment
and the Continuation: 4-9 months To prevent relapses into ❑ Observe the client for
Roles of Symptoms are still distressing emotional any signs or
the PSW evident , but
decreasing
state symptoms of
depression or mania
❑ Report to your
supervisor

Maintenance: Indefinite To prevent recurrences ❑ Same as above

The client does not as some clients think
have acute they are “ cured” and
symptoms stop taking their
medication
Treatment
for Bipolar Psychotherapy Drug therapy
Electroconvulsive

Disorder
therapy (ECT)
 Electroconvulsive
Psychotherapy: Drug Therapy:
therapy (ECT)

Treatment
for Bipolar During psychotherapy, a
person with depression
talks to a licensed and Also called psychopharmacology,
Electroconvulsive therapy
(ECT) is a medical
Disorder trained mental health
care professional who
helps him or her identify
is the treatment of a mental
disorder with the use of
prescription drugs. These drugs
treatment most
commonly used in
patients with severe
and work through the are prescribed by a doctor or major depression or
factors that may be licensed mental health bipolar disorder that has
causing their depression. professional and are often used not responded to other
in conjunction with talk therapy treatments
to treat mental disorders
Seasonal Depressive
Disorder
(SAD)
What is
SAD?
SAD
• Type of depression that
occurs at the same time each
year, usually in fall or winter,
and ending in spring or early
summer
• Common in colder regions
• Signs and symptoms may be
mild to severe, and the
condition is often mistaken
for major depression
• SAD is usually treated with
phototherapy
Treatment

• SAD is usually
treated with
phototherapy
 Treatments for Depressive Disorder
• Psychotherapy—a form of therapy in which a person
explores thoughts, feelings, and behaviours with the help
and guidance from a mental health specialist.

• Drug therapy—medications prescribed by a doctor. Street

drugs, abuse of over-the-counter (OTC) medication, and
alcohol interfere with the helping action of many medicines
and, therefore, will usually be discouraged.

• Electroconvulsive therapy (ECT)—a short-term treatment

that alters brain chemicals. Before ECT, clients are
administered anaesthesia to put them in a dreamlike state
and medications to relax their muscles. An electrical current
is then briefly sent to the brain through electrodes placed on
the client’s temples, which causes a seizure. It is not known
exactly how ECT works, but it is believed that it alters brain
chemicals, serotonin, endorphins, and adrenalin.
 CLIENTS WITH BIPOLAR AND OTHER
Weekly RELATED DISORDERS SUPPORT
Learning
Outcomes 3. Explore how the PSW can support clients
with bipolar and related disorders.
 Supporting Clients With
Bipolar and Related
Disorders
The support worker can assist in keeping a
chart of daily mood symptoms, treatments,
sleep patterns, and life events to help the
client and their family better understand
and cope with the illness. See TABLE 37.1
for a description of phases of treatment of
bipolar and related disorders and the role
of the Personal Support Worker.
 DISRUPTIVE, IMPULSE-CONTROL, AND
CONDUCT DISORDERS
4. Explain the symptoms associated with
disruptive, impulse-control, and conduct
Weekly disorders.
Learning
Outcomes CLIENTS WITH DISRUPTIVE, IMPULSE
CONTROL, AND CONDUCT DISORDERS
SUPPORT
5. List ways to support clients with disruptive,
impulse-control, and conduct disorders.
 Disruptive, Are disorders in which clients display:
difficult, disruptive, aggressive, or antisocial
Impulse- behaviours; these disorders are often
associated with physical or verbal injury to
Control, and self, others, or objects or with violating the
rights of others.
Conduct Behaviours can appear in several forms and
Disorders can be defensive, premeditated, or
impulsive. They are grouped into three
types: (1) angry/irritable mood, (2)
argumentative/defiant behaviour, and (3)
vindictiveness. Clients with dementia may
display aggressive behaviours but those
behaviours are not premeditated and are
merely responses to the environment.
 How the PSW can
• You must accept clients in a caring,
support clients
nonjudgmental way. Clients may lack insight into
their feelings and not be able to deal with them in with bipolar and
the moment. related disorders
• Maintain a safe distance between the two of you.
• Ensure that you keep an open pathway to an exit.
• Avoid doing anything that might escalate the
situation.
• If clients are verbally aggressive try to determine:
if they are cold, hungry, in pain, or frightened about
something.
• Try to understand the client’s anger in the cultural
context. Some men, for example, would rather yell
and scream than admit that they are frightened or
in pain.
How the PSW can
•Do not yell back, but remain calm and
support clients professional yourself.
with bipolar and • Courses such as “Managing Disruptive
related disorders Behaviours”
• If the client is verbally aggressive, your main
concern is your safety and the safety of
others. Leave the situation and immediately
call your supervisor. If the client is threatening
to harm you physically, call the police
immediately.
• For some clients, remaining angry can simply
be the easiest way out.
• Remind the client that making oneself happy
requires skillful effort and mental control.
SCHIZOPHRENIA
6. Define schizophrenia and the following
characterized symptoms:
• Psychosis
• Delusions
•
•
Delusions of Grandeur
Delusions of Persecution
Weekly
• Hallucinations Learning
• Paranoia Outcomes
CLIENTS WITH SCHIZOPHRENIA
SPECTRUM DISORDERS SUPPORT
7. List ways to support clients with schizophrenia
spectrum disorders.
 • Psychosis—a mental state in which a person’s perception of
Schizophrenia reality is impaired
and • Delusions—false beliefs that are not based on reality
Characterized • Delusions of grandeur—false and exaggerated beliefs about
Symptoms the importance, talent, or wealth of oneself. For example, a
woman believes she is a goddess or the prime minister.

• Delusions of persecution—false beliefs about being mistreated,

abused, or harassed. For example, a man believes that his
neighbour wants to kill him.

• Hallucination—seeing, hearing, tasting, smelling, or feeling

things that are not real. For example, the person may see faces
and hear voices that are not really there.

• Paranoia—extreme suspicion about a person or a situation. For

example, a person may imagine being watched, followed, or
controlled by someone else and may have delusions of
persecution.
 Supporting Clients With
Schizophrenia Spectrum Disorders
• Focus on one task or activity at a time so as to help the
client to focus.
• Be aware of your nonverbal communication. Avoid
body language and facial expressions that could be
considered threatening.
• Do not argue with the client about a delusion or
hallucination not being real; it is real to the client. You
can suggest gently to the client that the delusion is not
real.
• Do not pretend that the delusion or hallucination is
real. Comfort the client, and show empathy. Tell your
supervisor if your client is having a delusion or
hallucination.
• Use distractions to avoid disturbing the client. For
example, play music, or take the client for a walk.
 Text Book:
Wilk, M.J. Sorrentino, S.A., &
Remmert, L.(2022). Mosby Canadian
textbook for the support worker, (5th
Canadian ed.). Toronto: Elsevier.
eferences
Web Pages:
• Canadian Mental Health Association
• Images: http://www.light-
therapy.net/