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Covers the complexities of Bipolar I and II, as well as the symptoms and causes of Schizophrenia.
Imagine your brain's 'volume' knob is broken: one day the world is so loud and bright you feel like a god, and the next, the sound cuts out entirely. But what happens when the radio starts playing stations that no one else can hear?
Bipolar Disorder is characterized by extreme fluctuations in mood, energy, and activity levels. The primary distinction lies in the severity of the 'highs.' Bipolar I Disorder requires at least one Manic Episode, which lasts at least seven days or is so severe that immediate hospital care is needed. During mania, individuals may experience euphoria, decreased need for sleep, and 'grandiosity.' In contrast, Bipolar II Disorder is defined by a pattern of Depressive Episodes shifting back and forth with Hypomanic Episodes. Hypomania is a less severe version of mania; it does not cause significant functional impairment or require hospitalization, but the depressive crashes in Bipolar II are often longer and more frequent.
Consider two patients: 1. Patient A hasn't slept in 4 days, spent their entire savings on a fleet of racehorses they can't afford, and believes they have discovered a secret language. This is a Manic Episode (Bipolar I). 2. Patient B feels unusually productive and energetic for 4 days, talking faster than usual but still attending work and finishing tasks, followed by 3 weeks of intense sadness. This is a Hypomanic Episode (Bipolar II).
Quick Check
What is the core requirement for a Bipolar I diagnosis that is NOT required for Bipolar II?
Answer
A full-blown Manic Episode (lasting at least 7 days or requiring hospitalization).
Schizophrenia is a chronic brain disorder involving a breakdown in the relation between thought, emotion, and behavior. Symptoms are categorized into two main groups. Positive Symptoms are 'additions' to normal behavior, such as hallucinations (sensory experiences without stimuli, usually auditory) and delusions (fixed false beliefs). Negative Symptoms are 'subtractions' or deficits in normal functioning. These include alogia (reduced speech), avolition (lack of motivation), and flat affect (diminished emotional expression). While positive symptoms are more 'dramatic,' negative symptoms are often more debilitating for long-term daily living.
A clinician observes a patient who reports hearing voices telling him he is a secret agent (Positive: Hallucination/Delusion). However, the clinician also notices the patient sits for hours without moving or speaking and shows no facial reaction when told a joke (Negative: Avolition/Flat Affect).
Quick Check
If a patient experiences 'Alogia' (poverty of speech), is this a positive or negative symptom?
Answer
It is a negative symptom because it represents a deficit or 'subtraction' of normal speech function.
If we look at the probability of developing Schizophrenia based on genetic relatedness: 1. General Population: 2. Fraternal Twin (50% DNA): 3. Identical Twin (100% DNA): This shows that while genetics are the strongest predictor, they are not 100% deterministic, implying the 'Diathesis-Stress' model where environment also matters.
Which disorder requires at least one episode of full mania?
A patient believes the FBI is tracking them through their toaster. This is an example of:
The Dopamine Hypothesis suggests that Schizophrenia is caused solely by a lack of serotonin.
Review Tomorrow
In 24 hours, try to explain the difference between a hallucination and a delusion to a friend, and list three negative symptoms of schizophrenia.
Practice Activity
Create a Venn Diagram comparing Bipolar I and Bipolar II, focusing on the duration and severity of the 'up' moods.