Etiologic Factors: -environmental factors: stress (financial problem) -low self-esteem -lack of support system -physically, emotionally stressed

BIPOLAR 1 DISORDER

Genetic Factors: Bipolar is greatest when the disorder is present in the first-degree family members.

Biological theories: -neurochemical and neuroendocrine factors: biogenic amine theorys about the imbalance or deficiency of neurotransmitters norepinephrine and serotonin leading to depression; mania resultsfrom inability to modulate neuronal excitation

Nueromatomical factors: appearance of specific abnromalitites, or lesions in the white matter of the brain of people with bipolar disorder.

Signs and symptoms: Manic: Elevated, expensive or irritable mood; loud and rapid, clanging speech, flight of ideas; grandiose speech, delusion and easily distracted cognitive function, hyperactive, vulgar and obscene psychomotor activity. Depression: dysphoric, depressive, despairing mood, pessism with poverty of ideas and suicidal preoccupation, psychomotor agitation or retardation with feeling of fatigue, restlessness, thought blocking, blunted affect. Cyclothymiais marked by manic and depressive states yet is of sufficient intensity nor duration to merit diagnosis of bipolar or major depressive disorders Complications/ Risk for: -suicidal -violence towards others -disorders of eating, sexual behavior, conduct disorder and anxiety disorder

Treatment: The most effective treatment is a combination of supportive psychotherapy, psycho education, and the use of mood-stabilizers (lithium carbamazepimne, or divalproex, ) in combination of anti-psychotic medications