Prodromal signs of BAD (Quora Case Discussion)1/6

ebingo(71)

Published in

StemSocial

Words

1106

Reading

5 min

Listen

Play

BAD Tic quora 1-6.png
Inkscape.org
Depression vector created by pch.vector - www.freepik.com and

Can a bipolar episode come on very quickly when triggered by a highly stressful event, or do bipolar episodes always have a prodrome or build up with signs?
Source

In the last post, we saw how:

Mood disorders present with depression and mania. BAD had both while Major depression present with just depression.
Executive Functioning is a big problem especially in BAD.
Atypical anti depressant are very effective for managing mania.

BAD Tic tok 7-7.png

Inkscape.org
Depression vector created by pch.vector - www.freepik.com and

https://www.tiktok.com/@thebpspouse/video/7096158088465567022?is_from_webapp=1&sender_device=pc&web_id=7146615854787839493

Welcome to Medic Vibes, where we discuss mental health disorders and make sense of them. Dr Ebingo Kigigha is a medical doctor (aspiring psychiatrist) and creative person (illustration and music). This has been our routine for two consecutive months. This month will be dedicated to BAD or Bipolar Affective Disorder. In the first month, we discussed Depression, and in the subsequent month, anxiety. We are done looking at Twitter Posts and now we are moving to Tik Tok posts.

Announcement!!!

We are moving to our new account after this month's topic. Follow us here @medicvibes

In this post, we are looking at this tweet that talks about Executive Functioning in BAD. To learn more just keep scrolling down. You can also skip to the key point of the post if you which or go to the conclusion to get the summary.

Vibes dimacations.png

Patients who are bipolar have these major depressive episodes and manic episodes. Mood disorders are also called Prodromal Signs of BAD 2 months ago, we talked about depression, among the types of depression is Major Depressive Disorder which is otherwise known as unipolar depression.

Vibes dimacations.png

Bipolar Disorder use to be called manic depression. In BAD there are problems with mood, energy management, and concentration, and this usually makes following up with tasks and daily activities difficult.

There are 3 types of BAD, type I, Type II and Cyclothymia

In type I BAD, The symptoms affect the patient most of the day for 7 days almost every day or the symptoms are so severe that the patient may need to be admitted. The episode of depression can go on for 2 weeks. It is also possible that the mixed presentation can happen in type I. They may specifically have rapid cycling when they have up to or more than 4 episodes in one year.

Type II presents with episodes of depression and hypomania. These episodes are less severe when compared to type I.

In cyclothymia, there are recurrent episodes of hypomania and depression. It is the least severe form of BAD. But as a more stable course.

The diagnosis of this condition is usually made in adolescence or early adult life but in rare cases, it can present in childhood. When a diagnosis is made the patient will require treatment for the rest of their life. The symptom can be less intense but it comes with following an effective treatment plan closely while working with a doctor.

Vibes dimacations.png

Prodromal signs of BAD

Image by mamewmy on Freepik

Image by macrovector_official on Freepik
Chris Ridgeway's explanation was accepted by K Collins. What he explained (from experience) was that BAD should not be seen as an oscillation that can be predicted. He advised that it should be seen more as susceptibility to feeling lower lows and higher highs.

Bipolar has a higher risk to be affected by psychosis and stressful events can disrupt a cycle and bring trigger a depressive episode. The condition usually starts with a traumatic experience.

It is like having drugs internally that affect the body’s physiology. The manic episodes are a result of attempting to get out of depression.

Healthline explains the different types of Episodes as manic, hypomanic or depressive episodes although some episodes can be mixed mania and depression.

Episodes can be spontaneous and may not necessarily have any symptoms but some may have many symptoms of mania and depression and cause problems in the relationship.

When a patient is manic it comes with long periods of euphoria and they exhibit irrational behaviour and can do things that might hurt themselves or hurt others. They may be in this state for weeks and might need to be admitted to the hospital.

The euphoria can quickly change to anger and feeling down and they can get very irritated in a manic episode. This presentation can affect daily function, work and social life. If they have not been diagnosed, they usually will not know that something is wrong. Sometimes even doctors may not know the patient is in a manic phase, just those who know the patient very well have this conviction that something is wrong.

In Hypomania, the patient has a similar presentation to mania. The episodes last almost throughout the day on most days as they go through it. The episodes are not as detrimental to work and personal life. The patient can function normally while going through it,

The depressive episodes are similar to the depression in major depressive disorder. There is no difference in their presentation. The episodes come in the way of work and personal life. The symptoms are like depressive symptoms: loss of interest in previously pleasurable activities, weight loss, loss of appetite, sleep disturbance, ruminating thoughts and sometimes suicidal ideation.

Vibes dimacations.png

Tips for treatment

Treatment Of Acute Bipolar Depression: The drugs used to treat major depression are not so useful in Bipolar types, rapid cycling and in mixed states, in fact, they have a tendency to induce mania, hypomania and cycling.

To be effective a mood stabilizer must be used. They are typically prescribed as the first-line medication for first episodes of depression or isolated episodes.

Olanzapine and fluoxetine are used for the first few weeks of acute bipolar depression and it does not cause mania or hypomania.

Sometimes these patients are unresponsive to antidepressants and in these times, lamotrigine or ziprasidone are the drugs of choice.

Electroconvulsive therapy can be used for patients who are not responsive to mood stabilizers or lithium therapy especially when the patient has suicidal tendencies.

Vibes dimacations.png