Bipolar Disorder [Depression] Nursing Diagnosis, Interventions & Care Plan

Mental health issues are rising, and many struggle to understand bipolar disorder.

Bipolar disorder can be challenging to diagnose due to its complexity and wide range of symptoms. It is often misdiagnosed or overlooked altogether, leaving individuals feeling misunderstood and unsupported in their journey toward recovery.

Concepts of bipolar disorder provide an accessible guide for understanding this mental illness. With clear explanations of the different types of bipolar disorders, helpful tips for managing symptoms, and resources for finding support, this book offers a comprehensive overview that will help you better understand yourself or someone close to you who has been diagnosed with bipolar disorder.

What Are Bipolar Disorders?

Bipolar disorders, also known as manic-depressive illnesses, are a group of mental health conditions characterized by intense highs and lows in mood. Individuals with these disorders experience mania episodes involving excessive excitement, energy, and a decreased need for sleep. In contrast, they also experience periods of depression, which entail sadness, hopelessness, and lethargy.

These mood swings can occur in cycles, with periods of stability in between. Bipolar disorders can affect anyone, and their causes are not well understood. However, with proper diagnosis and treatment, including medication, therapy, and lifestyle changes, individuals with bipolar disorders can manage their symptoms and live fulfilling lives.

Vital Terms

• Major Depressive Episode: For two or more weeks, the individual experiences at least five symptoms of depression, such as increased sleeping time, difficulty concentrating, lack of interest in activities they previously enjoyed, and recurrent ideas of death or suicide.
• Manic Episode: Lasting for at least seven days, an individual experiences feelings of euphoria or irritability for most of the day each day, increased energy, and at least three characteristics of mania, such as augmented activity, reduced need for sleep, and racing thoughts.
• Hypomanic Episode: This is a milder version of a manic episode, typically lasting four days. It does not disrupt one’s everyday life as much as mania does.

Pathophysiology

Bipolar disorder is thought to have a neurological basis and likely involves an imbalance of certain chemicals in the brain called neurotransmitters. These imbalances can change mood, energy levels, sleep patterns, and behavior. Individuals with bipolar disorder may also have other psychiatric or physical health conditions that further complicate their diagnosis and treatment.

Causes

Various factors, including genetics, environmental effects, and brain chemistry, can cause bipolar disorder. While the exact causes are unclear, it is thought that a combination of genetic and environmental factors can lead to the development of this disorder.

Signs and Symptoms of Bipolar Disorder

The signs and symptoms of bipolar disorder can vary from person to person. Generally, the signs of mania include:

• Increased energy levels
• Substantial changes in sleep habits
• Dramatically increased self-confidence and excessive irritability
• Increased talkativeness
• Difficulty focusing
• Racing thoughts and ideas
• Reckless behavior or poor judgment.

Types of Bi-Polar Disorder

Bipolar disorder can be divided into three main types:

• Bipolar I disorder – This type is characterized by episodes of mania and depression that can last for months or even years. 
• Bipolar II disorder – Bipolar II disorder involves episodes of depression and hypomania (a milder form of mania).
• Cyclothymic disorder – This type involves shorter and less severe periods of mania and depression that last for at least two years.

Each type of disorder has its distinct symptoms, and it is essential to understand the differences between them so that individuals can get an accurate diagnosis and receive appropriate treatment.

Complications

Bipolar disorder can lead to severe complications if left untreated. These include an increased risk of suicide, substance abuse, and legal or financial problems. It can also lead to relationship issues, difficulties in school or work, and medical problems caused by manic or depressive episodes.

Treatment

The most helpful treatment for bipolar disorder is a combination of therapy and medication. Medication can help regulate mood swings, while talk therapy can identify and address the underlying factors contributing to bipolar disorder. Additionally, lifestyle changes such as getting adequate sleep, eating a healthy diet, and finding ways to reduce stress can help individuals manage their symptoms.

Living with Bipolar Disorder

Living with bipolar disorder can be challenging, but finding success and satisfaction in life is possible. It’s essential to establish a support system of friends, family, and medical professionals who can help you cope with the effects of the disorder.

Additionally, finding healthy outlets such as exercise, creative activities, and relaxation techniques can be beneficial in managing symptoms.

By understanding the concepts of bipolar disorder and learning how to manage its effects, individuals can live a fulfilling life with this condition.

Nursing Care Plan For Bipolar Disorder

Assessment

• Assess the patient’s understanding of the disorder, including their triggers and symptoms.
• Ask about current and past treatments for bipolar disorder.
• Review the patient’s medication history and evaluate adherence to the treatment plan.
• Assess any co-occurring mental health conditions, such as anxiety or substance abuse.
• Ask about the patient’s support system and access to resources.

Bipolar Disorder Nursing Diagnosis

 Impaired Social Interaction

• Help the patient identify and describe their feelings.
• Encourage positive self-talk and provide support for any negative emotions.
• Offer strategies for managing anxiety or irritability, such as deep breathing, relaxation techniques, or mindfulness practice.
• Provide psychoeducation on the importance of sleep hygiene and healthy lifestyle habits.
• Encourage the patient to engage in activities that promote social interaction, such as joining a support group or participating in recreational activities.

Activity Intolerance 

The patient’s manic state, caused by biochemical and neurological imbalances, poses a risk of self-directed or other-directed violence. This is evidenced by their aggressive speech and actions and threats of hurting others and themselves.

Risk for Suicide Ideation 

• Assess the patient’s risk factors for suicide ideation, such as feelings of hopelessness and difficulty managing stress.
• Encourage patients to express their feelings in a safe, non-judgmental environment.
• Refer the patient to appropriate mental health professionals for further assessment and treatment.
• Provide education on signs and symptoms of suicide ideation and how to recognize them in oneself or others.
• Suggest activities that can help reduce stress, such as yoga, art therapy, or journaling.
• Remind the patient they are not alone, and help is available.

Nursing Interventions for Bipolar Disorder

• Provide education on bipolar disorder and its treatments.
• Monitor the patient for signs of mania or depression and intervene accordingly.
• Encourage the patient to engage in activities that promote physical and mental health, such as exercise, relaxation techniques, and healthy nutrition.
• Offer support with medication management, lifestyle habits, and coping strategies.
• Encourage family and friends to provide emotional support for the patient.
• Refer the patient to appropriate mental health professionals if needed.
• Provide resources for additional support, such as 12-step programs or support groups.
• Monitor the patient’s progress and adjust the treatment plan as needed.
• Emphasize the importance of continuing treatment even when symptoms are in remission.
• Help the patient identify potential triggers for episodes and develop a plan to manage them.
• Encourage the patient to seek help early if symptoms worsen or appear.

Important Note) Bipolar disorder is frequently misdiagnosed!

Misdiagnosis of Bipolar Disorder is expected, as it can be mistaken for conditions like depression, cyclothymic disorder, or borderline personality disorder due to the similarities in symptoms. This can lead to an unfortunate delay in beginning proper treatment. Recognizing particular key distinctions between these conditions is essential to assess them accurately.

• BD vs. Depression – Due to many individuals with BD initially experiencing a depressive episode, there is a high risk of misdiagnosis. Those with BD eventually have manic or hypomanic episodes, whereas those with depression do not.
• BD vs. Cyclothymic Disorder – People with cyclothymic disorder experience temperamental swings in mood that are neither hypomanic nor severe enough to be classified as major depressive episodes.
• BD vs. Borderline Personality Disorder – Compared to individuals with BPD, people with BD endure longer bouts of depression and elation or mania, while those suffering from BPD experience shorter but more intense shifts in mood between depression and rage. (hours to days).

At what age does bipolar start?

Bipolar disorder, a mental health condition characterized by extreme mood swings, can occur at any age. However, it tends to manifest more frequently between the ages of 15 and 19, with fewer cases emerging after the age of 40. It is important to recognize the early signs and symptoms of bipolar disorder and seek appropriate support and treatment to manage this condition effectively.

Final Words

Bipolar disorder is a complex mental health condition that requires an accurate and timely diagnosis for successful treatment. It’s important to note the differences between bipolar disorder and similar conditions like depression, cyclothymic disorder, or borderline personality disorder to ensure proper treatment is prescribed. With the right support system and interventions, individuals living with bipolar disorder can lead fulfilling lives.

Ultimately, the most essential factor for successfully managing bipolar disorder is early recognition and diagnosis. Primary care providers and mental health professionals should closely monitor symptoms to provide proper treatment that addresses the unique needs of each individual.

In this way, people with bipolar disorder can receive effective interventions and support that help them live more rewarding, stable lives.

References

• https://en.wikipedia.org/wiki/Bipolar_disorder
• https://www.ncbi.nlm.nih.gov/books/NBK590048/