Bipolar and SUD-Recording

Video Transcription

Video Summary

In this comprehensive lecture, the focus is on understanding and managing bipolar disorder, particularly in the context of substance use disorders. The session begins with a case study of a 32-year-old woman, Sarah, who is experiencing a manic episode due to discontinuation of lithium, leading to erratic behavior and increased alcohol consumption. The lecture highlights bipolar disorder's impact and prevalence, affecting about 1% of the population, and discusses the 'kindling hypothesis' which suggests untreated bipolar disorder can lead to more frequent and intensified episodes.<br /><br />Key symptoms of bipolar disorder, such as mania and depression, are detailed. Mania involves periods of heightened activity and mood changes, often requiring a week or more for a diagnosis, and can lead to significant life disruptions. The discussion also covers the challenge of distinguishing bipolar disorder from similar conditions like ADHD, personality disorders, and substance use disorders, emphasizing the importance of accurate diagnosis due to treatment implications.<br /><br />The lecture covers treatment options, primarily focusing on mood stabilizers such as lithium, valproic acid, and lamotrigine, alongside antipsychotics approved for managing symptoms. The complexities of medication adherence are discussed, highlighting common barriers like side effects and the misconception of improved health without medication. Strategies for maintaining medication adherence include psychoeducation, family involvement, and considering long-acting injectables.<br /><br />The psychosocial aspect of managing bipolar disorder is addressed through interpersonal and social rhythm therapy, which emphasizes the importance of maintaining regular sleep and social routines to prevent episodes. The session concludes with a reminder of the importance of a supportive therapeutic alliance and specific considerations for managing alcohol use alongside bipolar disorder.

Keywords

bipolar disorder

substance use disorders

kindling hypothesis

mania

depression

mood stabilizers

medication adherence

psychoeducation

interpersonal therapy

social rhythm therapy

alcohol use