Nursing Diagnosis of Bipolar Disorder

Nurses will come in contact with patients who have bipolar disorder when they present to clinics, emergency rooms, on a medical floor of a hospital or a psychiatric ward. Bipolar disorder ranges from mild to severe forms. Nursing evaluations can help determine if patients are experiencing physical symptoms associated with bipolar disorder in addition to the emotional symptoms characteristic of the illness. Risky behavior, including high rates of suicide attempts, is characteristic of bipolar disorder; therefore, swift recognition of symptoms and referral to a specialist is imperative to ensuring a patient's safety.

Mania

• Mania is a condition identifiable by symptoms such as sleeping little or not at all over several days, high levels of agitation and irritability, increased energy, grandiosity or inflated self-esteem, excessive talking, racing thoughts and high risk behavior including hypersexual behavior, excessive gambling or spending excessive amounts of money.

Major Depression

• Major depression is a condition identifiable by chronic sadness or depressed mood, loss of pleasure, extreme lack of energy, weight, appetite and sleep changes in addition to thoughts of death and suicidal ideation, plans or attempts.

Types of Bipolar Disorder

• There are different types of bipolar disorder including Bipolar I Disorder and Bipolar II Disorder. Bipolar I Disorder is more severe than Bipolar II Disorder. A nursing evaluation will determine if a patient has experienced symptoms consistent with both mania and major depression, including the length of time each episode may last. Identifiers with the diagnosis of bipolar disorder include whether the most recent mood episode is manic, depressed or mixed (a combination of both).

Treatment Options

• Treatment options may include brief inpatient hospitalization if symptoms are acute and a person is at risk for safety. There are medications prescribed specifically for bipolar disorder such as Neurontin, Lamictal, Depakote or Lithium. Counseling can also be effective in helping the individual manage mood swings and encourage compliance with treatment protocol.

Other Assessment Features

• Nurses will need to evaluate whether a person has been treated in the past for bipolar disorder and if he is prescribed medication. Some of the mood stabilizers require laboratory blood tests to identify if the level of medication is in the therapeutic range in order to be effective. Additionally, due to the higher rates of suicide attempts among individuals with bipolar disorder, evaluating for an overdose or other self harm behaviors is important.