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UTA NURS 3481 Exam 2

UTA NURS 3481 Psych Exam 2

QuestionAnswer
Action of gamma-aminobutyric acid (GABA) Works as an inhibitory neurotransmitter, reducing agression, excitation, and anxiety. [GABA is the mom that calms down the child Serotonin]
Antianxiety/anxiolytic medications Benzodiazepines and Non-Benzodiazepines (azapirones [buspirone])
Benzodiazepine Mechanism of Action potentiate and intensify the actions of gamma-aminobutyric acid (GABA)
Librium classification long-acting benzodiazepine antianxiety agent
clorazepate (Tranxene) classification long-acting benzodiazepine antianxiety agent
Valium classification long-acting benzodiazepine antianxiety agent
prazepam (Centrex) classification long-acting benzodiazepine antianxiety agent
Xanax classification short-acting benzodiazepine antianxiety agent
Ativan classification short-acting benzodiazepine antianxiety agent
oxazepam [Serax] classification short-acting benzodiazepine antianxiety agent
Clonazepam (Klonopin) classification long-acting benzodiazepine antianxiety agent
Concern for short-acting benzodiazepines have the potential for serious withdrawal reactions (e.g., anxiety, insomnia, headache, muscle irritability, blurred vision, dizziness, delirium, paranoia, psychosis)
Benzodiazepine Adverse Effects Psychomotor impairment, drowsiness, cognitive impairment, sedative effects, profound hypotention/cardiac arrest (taken IV), potential for abuse
Benzodiazepine reversal agent Flumazenil (Mazicon)
Buspirone (BuSpar) classification Azapirone used as a non-benzodiazepine antianxiety agents
Disadvantage of Buspirone (BuSpar) anxiolytic effects can take several weeks to become effective. Therefore, it cannot be used as an as needed (PRN) medication. (Varcarolis 2011, p. 573)
Buspirone (BuSpar) Adverse Effects dizziness, drowsiness, headache, lightheadedness, excitability, nausea, dry mouth, diarrhea, constipation, vomiting
Buspirone (BuSpar) Cautions pregnant/breastfeeding, elderly/debilitated, hepatic/renal dysfunction
Propranolol (Inderal) classification β-Blocker used as a non-benzodiazepine antianxiety agent
Hydroxyzine pamoate (Vistaril) classification Antihistamine used as a non-benzodiazepine antianxiety agent
Piper methysticum (kava kava) classification herbal sedative with antianxiety effects
Kava Kava concerns Inhibits liver enzyme (P450); use can result in liver failure, especially when taken along with alcohol or other medications such as central nervous system depressants
Antidepressant Drugs of Choice for High suicide risk Avoid Tricyclics and MAOIs
Antidepressant Drugs of Choice for Concurrent depression and panic attacks or OCD Venlafaxine, SSRIs
Antidepressant Drugs of Choice for Chronic pain with or without depression Amitriptyline, doxepin, venlafaxine, duloxetine
Antidepressant Drugs of Choice for Weight gain on other antidepressants Bupropion, SSRIs, avoid mirtazapine
Antidepressant Drugs of Choice for Sensitivity to anticholinergic side effects Avoid tricyclics and paroxetine
Antidepressant Drugs of Choice for Orthostatic hypotension Nortriptyline, bupropion, sertraline
Antidepressant Drugs of Choice for Sexual dysfunction Bupropion, nefazodone
First-line Antidepressant agents SSRIs, Novel (atypical) new antidepressants, TCAs
Second-line Antidepressant agents MAOIs
SSRI Mechanism of Action SSRIs specifically block the reuptake of 5-HT
SSRI Adverse Effects agitation, anxiety, sleep disturbance, tremor, sexual dysfunction (anorgasmia), headache, dry mouth, sweating, weight change, mild nausea, loose bowel movements
SSRI Withdrawal Syndrome symptoms dizziness, headache, nausea, sensory disturbances, tremors, anxiety, and dysphoria
SSRI Drug Interactions MAOIs, Alcohol, Oral anticoagulants, St. John's wort, TCAs, Lithium
Citalopram (Celexa) classification SSRI
Escitalopram (Lexapro) classification SSRI
Fluoxetine (Prozac, Sarafem, Selfemra) classification SSRI
Fluvoxamine (Luvox) classification SSRI
Paroxetine (Paxil, Pexeva, Sandoz) classification SSRI
Setraline (Zoloft) classification SSRI
St. John’s Wort classification SSRI
Trazadone (Oleptro) classification SSRI
SNRI Mechanism of Action Blocks the reuptake of serotonin and norepinephrine
SNRI Side Effects Hypertension (venlafaxine), nausea, insomnia, dry mouth, sweating, agitation, headache, sexual dysfunction
Venlafaxine (Effexor) classification SNRI (atypical antidepressant)
Pristiq classification SNRI (atypical antidepressant)
Duloxetine (Cymbalta) classification SNRI (atypical antidepressant)
NDRI Mechanism of Action Blocks the reuptake of norepinephrine and dopamine
NDRI Side Effects Agitation, insomnia, headache, nausea and vomiting, seizures (0.4%)
Bupropion (Wellbutrin, Zyban) classification NDRI (atypical antidepressant)
SNDI Mechanism of Action Blocks α1- adrenergic receptors that normally inhibit norepinephrine and serotonin
SNDI Side Effects Weight gain, sedation, dizziness, headache; sexual dysfunction is rare
Mirtazapine (Remeron) classification SNDI (atypical antidepressant)
Tricyclic Antidepressant (TCA) Adverse Effects sedating, cause orthostatic hypertension, and have anticholinergic effects (e.g., dry mouth, blurred vision, photophobia, constipation, urinary hesitancy, and tachycardia). The most hazardous effect is cardiac toxicity.
TCA Mechanism of Action block NE and serotonin reuptake
TCA Major Concern Cardiac toxicity – can be lethal with 1 weeks supply
Elavil (amitriptyline) classification Tricyclic Antidepressant
Anafranil (clomipramine) classification Tricyclic Antidepressant
Norpramin (desipramine) classification Tricyclic Antidepressant
Tofranil (imipramine) classification Tricyclic Antidepressant
Pamelor (nortriptyline) classification Tricyclic Antidepressant
Sinequan (doxepin) classification Tricyclic Antidepressant
Vivactil (protriptyline) classification Tricyclic Antidepressant
MAOI Mechanism of Action inhibit the action of the monoamine oxidase (MAO) enzyme system at the CNS storage sites. There are two types of MAO in the body: MAO-A and MAO-B. In the brain, MAO-A inactivates NE and serotonin, whereas MAO-B inactivates dopamine.
MAOI Adverse Effects Hypertensive Crisis from Dietary Tyramine, Hypotension, sedation/weakness/fatigue, Insomnia, Changes in cardiac rhythm, Muscle cramps, Anorgasmia or sexual impotence, Urinary hesitancy or constipation, Weight gain
Effect of MAOIs and Tyramine Hypertensive Crisis
Foods that contain tyramine Overripe avocados; sauerkraut; Fava beans; Overripe Figs; bananas; Fermented bean curd, soybean, or meats; smoked/aged meats; cheese; red wine, beer, ale, liquers; protein dietary supplements; soups (might contain protein extract); shrimp paste; soy sauce
phenelzine (Nardil) classification MAOI
Marplan classification MAOI
tranylcypromine (Parnate) classification MAOI
selegiline (EMSAM) classification MAOI
lithium (Eskalith, Lithobid) classification mood stabilizer
Valproate (Depakote, Depakene) classification anticonvulsant used as a mood stabilizer
Lamictal (lamotrigine) classification anticonvulsant used as a mood stabilizer
Carbamazepine (Tegretol) classification anticonvulsant used as a mood stabilizer
oxcarbazepine (Trileptal) classification anticonvulsant used as a mood stabilizer
Lamictal (lamotrigine) concern Stevens-Johnson syndrome
Stevens-Johnson syndrome sign Rash
Anticonvulsant (mood stabilizer) concern Monitor LFTs
Lithium concerns Low therapeutic index (requires blood level monitoring); maintain salt intake
Lithium Adverse/Toxic Effects Tremor, ataxia, confusion, convulsions, Nausea, vomiting, diarrhea, Arrhythmias, Polyuria, polydipsia, edema, Goiter and hypothyroidism
Neurotransmitters associated with anxiety epinephrine, norepinephrine (increased), dopamine, serotonin (increased), and GABA (decreased).
Neurotransmitters associated with depression serotonin (decreased) and norepinephrine (decreased)
Neurotransmitters associated with bipolar norepinephrine (increased), dopamine (increased), and serotonin (increased)
Overt suicidal statements “I can't take it anymore.”;“Life isn't worth living anymore.”
Covert suicidal statements “It's okay now. Soon everything will be fine.”; "I won't be a problem munch longer."
Suicide risk factors for youth alcohol or other drug use disorders, aggressive or disruptive behaviors and depression or social isolation
Suicide risk factors for adults depression, alcohol abuse, cocaine use, and separation or divorce
Suicide risk factors for elderly recent visit to PCP, social isolation, solitary living arrangements, widowhood, lack of financial resources, and poor health.
High-risk suicide methods (hard methods) Using a gun, Jumping off a high place, Hanging, Poisoning with carbon monoxide, Staging a car crash
Low-risk suicide methods (soft methods) Slashing one's wrists, Inhaling natural gas, Ingesting pills
SAD PERSONS scale a simple and practical guide for triaging potentially suicidal patients, particularly in an emergency department environment.
Cognitive restructuring a process in which the therapist helps the patient (1) identify automatic negative beliefs that cause anxiety, (2) explore the basis for these thoughts, (3) reevaluate the situation realistically, and (4) replace negative self-talk with supportive ideas.
progressive muscle relaxation (PMR) A method of decreasing anxiety in which the individual tenses groups of muscles as tightly as possible for 8 seconds and then suddenly releases them.
Benson's relaxation techniques Techniques that allow a patient to switch from the sympathetic mode of the autonomic nervous system to a state of relaxation by focusing on a pleasant mental image in a calm and peaceful environment.
meditation A discipline for training the mind to develop greater calm and then using that calm to bring penetrative insight into one's experience.
guided imagery A process whereby a person is led to envision images that are both calming and health enhancing.
biofeedback A technique for gaining conscious control over unconscious body functions, such as blood pressure and heartbeat, to achieve relaxation or the relief of stress-related physical symptoms; involves the use of self-monitoring equipment.
cognitive reframing A process of changing the individual's perceptions of stress by reassessing a situation and replacing irrational beliefs.
mindfulness A centuries-old form of meditation that emphasizes awareness of ourselves and our mental activity from moment to moment.
journaling Keeping a diary which may be informal or part of a treatment plan of daily events, activities, and feelings.
fight-or-flight response The body's physiological response to fear or rage that triggers the sympathetic branch of the autonomic nervous system as well as the endocrine system.
Anxiety sympathetic signs and symptoms tachycardia, rapid breathing, palpitations, muscle tension, diaphoresis, increased blood pressure
Anxiety Parasympathetic signs and symptoms fatigue, nausea, urinary frequency, urgency
Compensation used to make up for perceived deficiencies and cover up shortcomings related to these deficiencies to protect the conscious mind from recognizing them.
Conversion the unconscious transformation of anxiety into a physical symptom with no organic cause. Often the symptom functions to gain attention or as an excuse.
Denial escaping unpleasant, anxiety-causing thoughts, feelings, wishes, or needs by ignoring their existence.
Displacement the transference of emotions associated with a particular person, object, or situation to another nonthreatening person, object, or situation.
Dissociation a disruption in the usually integrated functions of consciousness, memory, identity, or perception of the environment. It may result in a separation between feeling and thought.
Identification attributing to oneself the characteristics of another person or group. This may be done consciously or unconsciously.
Intellectualization a process in which events are analyzed based on remote, cold facts and without passion, rather than incorporating feeling and emotion into the processing.
Introjection the process by which the outside world is incorporated or absorbed into a person's view of the self.
Projection the unconscious rejection of emotionally unacceptable features and attributing them to other people, objects, or situations. You can remember this defense through the childhood retort of “What you say is what you are.”
Rationalization justifying illogical or unreasonable ideas, actions, or feelings by developing acceptable explanations that satisfy the teller as well as the listener.
Reaction formation when unacceptable feelings or behaviors are controlled and kept out of awareness by developing the opposite behavior or emotion.
Regression reverting to an earlier, more primitive and childlike pattern of behavior that may or may not have been previously exhibited.
Repression a first-line psychological defense against anxiety. It is the temporary or long-term exclusion of unpleasant or unwanted experiences, emotions, or ideas from conscious awareness. This happens at an unconscious level.
Splitting the inability to integrate the positive and negative qualities of oneself or others into a cohesive image. Aspects of the self and of others tend to alternate between opposite poles.
Sublimation an unconscious process of substituting mature, constructive, and socially acceptable activity for immature, destructive, and unacceptable impulses. Often these impulses are sexual or aggressive.
Suppression the conscious denial of a disturbing situation or feeling. For example, Jessica has been studying for the state board examination for a week solid. She says, “I won't worry about paying my rent until after my exam tomorrow.”
Undoing most commonly seen in children. It is when a person makes up for an act or communication.
generalized anxiety disorder (GAD) Anxiety disorder characterized by excessive anxiety or worry about numerous things, lasting for 6 months or longer.
panic disorder (PD) An anxiety disorder in which panic attacks are the key feature.
posttraumatic stress disorder (PTSD) An anxiety disorder characterized by persistent reexperiencing of a highly traumatic event that involved actual or threatened death or serious injury to self or others, to which the individual responded with intense fear, helplessness, or horror.
seasonal affective disorder (SAD) A recently studied syndrome that appears to affect mostly women and is characterized by hypersomnia, fatigue, weight gain, irritability, and interpersonal difficulties during the winter months.
panic attack the sudden onset of extreme apprehension or fear, usually associated with feelings of impending doom.
Agoraphobia intense, excessive anxiety or fear about being in places or situations from which escape might be difficult or embarrassing or in which help might not be available if a panic attack occurred
phobia a persistent, irrational fear of a specific object, activity, or situation that leads to a desire for avoidance, or actual avoidance, of the object, activity, or situation
social phobia A phobia of an interpersonal nature, such as fear of public speaking, fear of eating in front of others, or fear of writing or performing in public.
Obsessions thoughts, impulses, or images that persist and recur, so that they cannot be dismissed from the mind.
Compulsions ritualistic behaviors an individual feels driven to perform in an attempt to reduce anxiety.
acute stress disorder Severe fear, helplessness, or horror that occurs within 1 month of exposure to extreme stress.
Substance-induced anxiety disorder symptoms of anxiety, panic attacks, obsessions, and compulsions that develop with the use of a substance or within a month of stopping use of the substance
mild anxiety Occurs in the normal experience of everyday living.
moderate anxiety selective inattention, some diminished thinking with ability to still learn/problem solve. Symptoms: tension, pounding heart, increased pulse and respiration rate, perspiration, gastric discomfort, headache, urinary urgency, voice tremors, and shaking.
severe anxiety difficulty noticing what is going on in the environment, Learning/problem solving not possible. Symptoms: headache, nausea, dizziness, insomnia; trembling and pounding heart, hyperventilation and a sense of impending doom or dread.
panic Sudden, overwhelming anxiety of such intensity that it produces disorganization of the personality, loss of rational thought, and inability to communicate, along with specific physiological changes.
Panic disorder treatment Meds: High-potency benzodiazepines, Antidepressants (TCAs and SSRIs), MAOIs; Cognitive-behavioral therapy (Relaxation and Breathing techniques, Cognitive restructuring, Systematic desensitization, In vivo exposure r/t eliminating avoidance behaviors)
Generalized anxiety disorder treatment Meds: Benzodiazepines, Busipirone (BuSpar), SSRIs and TCA antidepressants, Gabapentin; Cognitive therapy, behavioral therapy, stress management, relaxation training, aerobic level exercises
PTSD treatment Meds: MAOIs(panic), TCAs (imipramine and amitriptyline) and SSRIs, Low-dose antipsychotics, Anticonvulsants; Physchotherapy, Family therapy, vocational rehabilitation, group therapy, relaxation techniques
OCD treatment Meds: SSRIs (fluvoxamine [Luvox] and fluoxetine [Prozac]), TCA (Clomipramine [Anafranil]); Cognitive-behavioral therapy
acute anxiety Anxiety that is precipitated by an imminent loss or a change that threatens an individual's sense of security.
chronic anxiety Anxiety a person has lived with for a long time. Chronic anxiety may take the form of chronic fatigue, insomnia, discomfort in daily activities, or discomfort in personal relationships.
Agranulocytosis symptoms sore throat, fever, malaise, and mouth sores
Agranulocytosis interventions discontinue drug, initiate reverse isolation
Agranulocytosis medication implicated Clozapine (Clozaril)
Hypertensive crisis symptoms Severe headache, Tachycardia, palpitations, Hypertension, Nausea and vomiting
Hypertensive crisis interventions Antihypertensive meds: 5mg IV phentolamine [Regitine] or sublingual nifedipine
Hypertensive crisis medication implicated MAOIs combined with Tyramine
Serotonin Syndrome symptoms Hyperactivity/restlessness; Tachycardia→cardiovascular shock; Fever→hyperpyrexia; ↑ BP; Delirium; Irrationality/mood swings/hostility; Seizures→status epilepticus; Myoclonus/incoordination/tonic rigidity; Abdominal pain/diarrhea/bloating; Apnea→death
Serotonin Syndrome interventions discontinue drug; Serotonin-receptor blockade with cyproheptadine, methysergide, propranolol; Cooling blankets, chlorpromazine for hyperthermia; Dantrolene, diazepam for muscle rigidity or rigors; Anticonvulsants; Artificial ventilation; Paralysis
Serotonin Syndrome medication implicated SSRIs
Neuroleptic malignant syndrome (NMS) symptoms muscle rigidity, fever, and elevated white blood cell count.
Neuroleptic malignant syndrome (NMS) interventions early detection, discontinuation of the antipsychotic, management of fluid balance, temperature reduction, and monitoring for complication; Meds: bromocriptine (Parlodel) for mild cases, IV dantrolene (Dantrium) for severe cases; ECT for severe cases
Neuroleptic malignant syndrome (NMS) medication implicated Conventional antipsychotics (Haloperidol [Haldol])
Stevens-Johnson syndrome symptoms rash
Stevens-Johnson syndrome interventions slow titration to therapeutic doses
Stevens-Johnson syndrome medication implicated Lamotrigine (Lamictal)
Alcohol withdrawal symptoms occurs 24-48 hrs and ends promptly; hyperalert, manifest jerky movements and irritability, startle easily, and experience subjective distress often described as “shaking inside.”
Alcohol withdrawal delirium symptoms occurs 40-48 hrs & lasts 2-3 days; Autonomic hyperactivity (tachycardia, diaphoresis, elevated BP); disorientation, clouding of consciousness; Perceptual disturbances (hallucinations); Fluctuating LOC; Delusions (paranoid), agitated behaviors, & fever
Benzodiazepines used for alcohol withdrawal delirium Chlordiazepoxide; Diazepam (usually not recommended due to its short half-life and frequent dosing schedule); Lorazepam
Beta-adrenergic blockers used for alcohol withdrawal delirium Atenolol; Propranolol
Alpha-adrenergic blockers used for alcohol withdrawal delirium Clonidine
Antiepileptics used for alcohol withdrawal delirium Carbamazepine
predictable defensive style elements defense mechanisms (e.g., denial, projection, rationalization), as well as characteristic thought processes (e.g., all-or-none thinking, selective attention) and behaviors (e.g., conflict minimization and avoidance, passivity, and manipulation)
LSD intoxication symptoms Pupil dilation; Tachycardia; Diaphoresis; Palpitations; Tremors; Incoordination; Elevated temp, pulse, resp; Fear of going crazy; Paranoia; anxiety, depression; Synesthesia; Depersonalization; Hallucinations; Grandiosity
Date Rape Drugs GHB (gamma- hydroxybutyrate); Rohypnol (flunitrazepam); Ketamine
Stimulant OD symptoms Respiratory distress, ataxia, hyperpyrexia, convulsions, Coma/Stroke, MI
Cocain, crack intoxication symptoms tachycardia, dilate pupils, elevated BP, n/v, insomnia, assualtiveness, gradiosity, impaired judgment, impaired and occupational functioning, Euphoria
Amphetamine intoxication symptoms Increased energy, state resembling paranoid schizophrenia, paranoia with delusions, psychosis, hallucinations, severe-panic anxiety, potential for violence
crisis intervention A brief, active, and collaborative therapy that draws on an individual's personal coping abilities and resources within the family, health care setting, or community.
critical incident stress debriefing (CISD) A seven-phase group meeting that offers individuals who have experienced a crisis the opportunity to share their thoughts and feelings in a safe and controlled environment.
maturational crisis A normal state in growth and development in which a specific maturational task must be learned, but old coping mechanisms are no longer adequate or acceptable.
situational crisis A crisis arising from an external as opposed to an internal source. Most people experience situational crises to some extent during the course of their lives (e.g., the death of a loved one, marriage, divorce, or a change in health status).
adventitious crisis A crisis that is not part of everyday life but involves an event that is unplanned and accidental. Adventitious crises include natural disasters and crimes of violence such as rapes or muggings.
indicators of the patient progressing along the anger continuum Hyperactivity, Increasing anxiety & tension, Verbal abuse, Loud voice/change of pitch/very soft voice, Intense eye contact
milieu's conducive to violence overcrowding, staff inexperience, staff provocative/controlling, poor limit setting, arbitrarily taking away privileges
Anger and Violence Interventions minimize personal risks; set limits at the outset
Disulfiram (Antabuse) classification Substance Abuse Related (alcohol deterrant)
primary sources of hidden alcohol food, medicines, and preparations that are applied to the skin.
Naltrexone (Trexan, Revia) classification opiate antagonist used to treat alcoholism and opioid use
Acamprosate (Campral) classification amino acid derivative used to treat alcoholism
Topiramate (Topamax) classification Anticonvulsant used to decrease alcohol cravings
Methadone (Dolophine) classification opioid agonist used to block heroin cravings
Buprenorphine (Subutex) classification partial opiod agonist
Clonidine (Catapres) classification Anti-HTN used as Substance Abuse Related (nonopioid suppressor of opioid withdrawal symptoms)
INEFFECTIVE COPING Inability to form a valid appraisal of the stressors, inadequate choices of practiced responses, and/or inability to use available resources
INEFFECTIVE DENIAL Conscious or unconscious attempt to disavow the knowledge or meaning of an event to reduce anxiety/fear, but leading to the detriment of health
CHRONIC LOW SELF-ESTEEM Longstanding negative self-evaluation/feelings about self or self-capabilities
Cocain/crack classification CNS Stimulant
Amphetamine classification CNS Stimulant
Caffeine classification CNS Stimulant
Nicotine classification CNS Stimulant
Management of CNS Stimulant Overdose Ambient cooling (for hyperpyrexia), Diazepam (or convulsions)
Med given to treat CNS Stimulant Overdose Antipsychotics
1st Phase of Cocain/crack withdrawal crash phase, can last up to 4 days. Users report depression, anergia, and an acute onset of agitated depression. Craving for the drug peaks during this phase, along with anxiety and paranoia.
2nd Phase of Cocain/crack withdrawal prolonged sense of dysphoria, anhedonia, and a lack of motivation, along with intense cravings that can last up to 10 weeks.
3rd Phase of Cocain/crack withdrawal intermittent craving and can last indefinitely
Opium classification Opiate
Morphine classification Opiate
Heroin classification Opiate
Codeine classification Opiate
Fentanyl (methadone, meperidine) classification Opiate
Med given to treat Opiate Overdose naloxone (Narcan)
Marijuana classification depressant and hallucinogenic
Lysergic Acid Diethylamide (LSD) classification Hallucinogen
Mescaline (peyote) classification Hallucinogen
Psilocybin (mushrooms) classification Hallucinogen
Phencyclidine Piperidine (PCP, angel dust, hourse tranquilizer, peace pill) classification Hallucinogen
Inhalants volatile solvents such as spray paint, glue, cigarette lighter fluid, and propellant gases used in aerosols
Anesthetic (Gas, Liquid, Local) Overdose treament B12
Volatile nitrite (room deodorizers) Overdose treatment methylene blue and oxygen
Ecstasy classification (MDMA, Adam, yaba, and XTC) Club Drug
somatization The expression of psychological stress through physical symptoms.
gamma-aminobutyric acid (GABA) The major inhibitory neurotransmitter in the central nervous system; targeted by drugs that reduce anxiety.
TCA affect on elderly orthostatic hypotension and urinary retention
Teaching for antidepressants meds can increase suicidal ideation; can take a while to kick in; discontinuation syndrome
Clearance time needed between taking SSRIs and MAOIs Minimum of 2 weeks
bipolar I disorder A form of bipolar disorder in which at least one episode of mania alternates with major depression.
bipolar II disorder A form of bipolar disorder in which hypomanic episodes alternate with major depression.
cyclothymia Chronic mood disturbance (of a least 2 yrs duration) involving both hypomanic and dysthymic mood swings. No delusions and does not warrant hospitalization or grossly impair a person's social, occupational, or interpersonal functioning.
Created by: camellia