Bipolar Disorder &

Catherine Zeta Jones

Presented by Autumn Placek

What is Bipolar Disorder?

• It is often referred to as Manic Depressive• It is characterized by two poles– One being manic – One being depressive

• Labeled as the 6th most disabling illness in the U.S.

• Chronic and not curable but can be controlled

Types of Bipolar Disorder

• Bipolar I-manic or mixed episodes that last seven

days requiring hospitalization• Bipolar II

-pattern of depressive episodes with hypomanic episodes• Bipolar NOS ( Not Otherwise Specified)

-symptoms that do not last long enough or too few symptoms

• Cyclothymic Disorder (Cyclothymia)-a mild form with episodes of hypomania with shifts to

mild depression

Catherine Zeta Jones BIO

• Born September 25th, 1969 in Wales, UK

• Married to Michael Douglas- separated in May of 2013

• Has One son, Dylan• One Daughter, Carys

The Symptoms and Struggle

• Was diagnosed in her twenties for depression• Traumatic event of husbands struggle with throat

cancer triggers voluntary commitment• Bipolar Disorder II diagnosis was in 2011• Hospitalized in June 2013 for stabilization• Simple things became overwhelming• Bolted from one idea to another and was “hard to

stay focused”

Bipolar Condition

http://www.youtube.com/watch?v=ZHlyUpMewHI

Nursing Process- Assessment

Assess client for bipolar disorder and periods of mania or depression by observing behavior and

actions

CharacteristicsSymptoms of mania or a manic episode include: Symptoms of depression or a depressive episode

include:

•Mood ChangesA long period of feeling "high," or an overly happy or outgoing mood•Extremely irritable mood, agitation, feeling "jumpy" or "wired."•Behavioral ChangesTalking very fast, jumping from one idea to another, having racing thoughts•Being easily distracted•Increasing goal-directed activities, such as taking on new projects•Being restless•Sleeping little•Having an unrealistic belief in one's abilities•Behaving impulsively and taking part in a lot of pleasurable,high-risk behaviors, such as spending sprees, impulsive sex, and impulsive business investments.

•Mood ChangesA long period of feeling worried or empty•Loss of interest in activities once enjoyed, including sex.•Behavioral ChangesFeeling tired or "slowed down"•Having problems concentrating, remembering, and making decisions•Being restless or irritable•Changing eating, sleeping, or other habits•Thinking of death or suicide, or attempting suicide.

(Kessler, 2008)

Nursing Process- Diagnosis

• Determine the patients nursing diagnosis Such as : Impaired Social, Impaired Self Care,

Defensive Coping, Ineffective coping, & Disturbed Thought Processes

Nursing Process- Plan

• Set out a plan of action to treat with drug therapy, individual therapy (talk therapy) and in some cases when drug therapy fails, ECT

• Allow client to set goals for mood stabilization, self care activities, impulse control,

Nursing Process-Implement

• Implement goals and treatment

Treatment

• Mood stabilizers such as Lithium, Depakene, Depakote, Tegretol, & Lamictal

• Antipsychotics such as Zyprexa, Risperdal, Seroquel, Abilify, Geodon, Saphris

• Antidepressants such as Paxil and Remeron

Treatment

• ECT• Individual Therapy• Family Therapy

Side Effects

• Weight Gain• Suicidal Ideations• Insomnia• Hypotension• Dry Mouth• Fatigue• Blurred Vision• Memory Loss

Nursing Process- Evaluate

• Evaluate the goals and compliance of the treatment and change or adjust as needed

NCLEX Question 1During family support group, a family member asks: “How is bipolar disorder different from depression?” Which of the following is the best response? A. Often, individuals with bipolar disorder can feel elated, are productive, and do not think there is anything wrong when they have manic feelings.” B. “Individuals with bipolar disorder start out happy enough, but they eventually develop irritability.”C. “Sleep patterns, self-care, and intake are affected only in depression.”D. “People with bipolar disorder do not seek help. People with depression readily seek treatment from health care providers.”

Question 1

Answer:A. “Often, individuals with bipolar disorder can feel elated, are productive, and do not think there is anything wrong when they have manic feelings.”

NCLEX Question 2

2. At 10:00 P.M., the nurse offers trazodone (Desyrel) 150 milligrams to a newly admitted client experiencing mania. The client responds, “I feel great, and I don’t need to sleep.” The nurse’s most therapeutic response is: A. “You and your family stated you did not sleep at all last night. That can be tough on your system.”B. “The medication will potentiate your mood stabilizer so that you’ll be discharged sooner.”C. “Remember that unit rules are to be quiet with lights out by

11:00 P.M.”D. “The medication should help you get to sleep so that you’re at

your best tomorrow.”

Question 2

Answer: A. “You and your family stated you did not sleep

at all last night. That can be tough on your system.”

NCLEX Question 33. .” Your client states, “I’m going to participate in an experimental brain imaging study. My primary health care provider thinks I have bipolar I disorder. Are there lab tests that can help diagnose mood disorders?” Your first response is:

A. “You should probably ask your primary health care provider.”B. “Although some abnormal results are found in individuals with mood disorders, there are no diagnostic lab tests specific to mood disorders at this time.”C. “There’s the dexamethasone suppression test, but we don’t know whether mood disorder causes the non-suppression or whether the non-suppression causes the disorder.” D. “Are you hoping for diagnosis based on the imaging study?”

Question 3

AnswerB. “Although some abnormal results are found in individuals with mood disorders, there are no diagnostic lab tests specific to mood disorders at this time.”

NCLEX Question 4 4. Based on your knowledge of circadian rhythms, discharge teaching for clients with mood disorders should include which of the following? A. Disruption of the client’s usual diurnal pattern does not influence the course of illness.B. Antidepressants and mood stabilizers can help restore circadian rhythms.C. Particularly during times of decreased stress, the client should do everything possible to maintain similar routines.D. Nonprescription medications and dietary supplements do not alter activity and rest cycles.

Question 4

Answer:B. Antidepressants and mood stabilizers can help restore circadian rhythms.

NCLEX Question 5

5. A colleague expresses frustration with a client with bipolar disorder on his seventh admission within 2 years. “I wish he would try taking his medication. Instead he keeps stopping the medicine and coming back here.” Your best initial response is:

A. “Maybe you would rather work in the NICU, where all of your clients adhere to the prescribed treatment regimen.” B. “He stays on his meds. He is a rapid cycler and he has more episodes anyway.” C. “It can be frustrating to care for chronically ill clients.” D. “Get control of your anger so that you do not take it out on the client.”

Question 5

Answer : C. “It can be frustrating to care for chronically ill

clients.”

Conclusion

• Bipolar Disorder is chronic and hard to manage

• Many clients do not remain medication or treatment compliant

• It disrupts not only ones life but social interactions and relationships

References

Columbia Pictures. (Photographer). Still Photos of Catherine Zeta

Jones[Print Photo]. Retrieved from http://

www.imdb.com/media/index/rg1176148480?refine=nm0000 120

Kessler, R. National Institute of Health,(2008). Nimh: Bipolar disorder.

Retrieved from National Institute of Mental Health website:

http://www.nimh.nih.gov/health/publications/bipolar-disorder/index.shtml

References

Perth, E. (2013, April). Catherine Zeta-Jones - famous bipolar actress.

Retrieved from

http://www.famousbipolarpeople.com/Catherinezetajones.html

Ren Kneisl , C., & Trigoboff, E. (2010). Contemporary psychiatric-mental

health nursing. (2nd ed.). New York, NY: Pearson Prentiss Hall.

Varcarolis, E. (2013). Essentials of psychiatric mental health nursing. (2nd ed.).

St. Louis, MO: Elsevier.