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Understanding Bipolar Disorder

Executive Summary

1. Mental health professionals have tended to assume that once someone experiences problems with unstable mood severe enough to bring them into contact with services, the problems are likely to recur, but, this actually appears to be the case for fewer than half of those people.

A. True

B. False


Executive Summary: Understanding the Bipolar Disorders

2. Which of the following is NOT an accurate statement about bipolar disorder?

A. Each person’s experience is unique and there is a continuum between extreme mood states and the normal mood swings that everyone experiences

B. Many people with a diagnosis of bipolar disorder have huge amounts of energy and are extremely creative and productive

C. Bipolar experiences are quite common, and about 3 to 5 percent of individuals are likely to receive a diagnosis of bipolar disorder at some point in their life

D. Bipolar symptoms and problems often start in late adolescence or early adulthood, and can affect a person’s development


Help and Treatment: Risk and Bipolar Experience

3. People with a diagnosis of bipolar disorder are at higher risk of suicide, and it is estimated that ____________ of people admitted to hospital with the diagnosis will eventually die by suicide.

A. 5 to 10 percent

B. 10 to 15 percent

C. 15 to 20 percent

D. 20 to 25 percent


Part One: What is Bipolar Disorder-Diagnosis

4. Some people experience so-called _______________ during which they experience some of the aspects of mania along with some of the symptoms of depression.

A. Mixed episodes

B. Alternating episodes

C. Combination episodes

D. None of the above


Continuum

5. Bipolar disorder is considered a discrete disorder that is clearly distinguishable from ‘normal’ aspects of human life and from other kinds of psychological problems.

A. True

B. False


How Common are These Experiences?-Prevalence

6. While people usually receive the diagnosis of bipolar disorder in their early 20’s, there is some evidence that younger people, even a very few children, may experience these kinds of problems.

A. True

B. False


Mood Swings Becoming a Problem

7. Several studies have investigated the experiences reported by people in mania, and found the most common symptom pattern to be:

A. Euphoria

B. Sleep disturbances

C. High mood

D. Dysphoria


Section Three: Development Impact and Course of Bipolar

8. Each of the following is a correct statement about the developmental impact and course of bipolar disorder EXCEPT:

A. Research tends to focus on people who have ongoing problems and are in contact with services, and this may lead to on overly negative view of how problems affect people with the bipolar illness

B. Problems often start in late adolescence or early adulthood, and can affect an individual's development

C. Despite the negative bias, research still shows that overall, 50 percent of people who have problems do not experience "relapse", and over 40 percent are able to return to able to their previous lifestyle within a 12 month period

D. There are positive as well as negative aspects to bipolar experiences, and many people with this diagnosis have huge amounts of energy and are extremely creative and productive


Section Four: Problems with 'Diagnosis' in Mental Health

9. Among people with a diagnosis of bipolar disorder, there are great similarities in how frequently they experience problems and in what treatments are helpful, which makes diagnosis very reliable and straight forward.

A. True

B. False


Validity of Psychiatric Diagnoses

10. The category Bipolar Disorder Not Otherwise Specified was created to account for individuals whose experiences seem to sit between bipolar illness and schizophrenia.

A. True

B. False


Part Two: Causes

11. Overly protective and/or critical patterns of family communication is known as:

A. High expressed emotion

B. Hypercritical articulation

C. Penetrating expression

D. Disturbed transmission


Section Six: Psychological Factors in Bipolar Experiences

12. Generally people with a diagnosis of bipolar disorder show extreme thinking styles only when they are experiencing very high or low moods.

A. True

B. False


Psychological Benefits

13. Bipolar experiences involve a mix of positive and negative psychological factors, and the extent to which these factors dominate or can be harnessed depends on:

A. Social factors

B. Coping styles

C. Biological predispositions

D. Problem solving skills


Section Seven: Biological Factors in Bipolar Disorders

14. Someone with a sibling or parent with a diagnosis of bipolar disorder is over ______ times more likely to receive the diagnosis themselves compared to someone from an unaffected family.

A. Six

B. Eight

C. Ten

D. Twelve


Neurological Changes

15. Which of the following in NOT one of the neurotransmitters targeted by medications prescribed to people diagnosed with bipolar disorder?

A. Serotonin

B. Norepinephrine

C. Dopamine

D. Acetylcholine


Part Three: Help and Treatment-Assessment

16. During the assessment of bipolar disorder, it is common for people to be given various diagnoses and therapies before an agreed diagnosis is made, and on average this process lasts two years.

A. True

B. False


Diagnosis

17. Which of the following is an accurate statement about the diagnosis of bipolar disorder?

A. The aim of assessment should be to help build a coherent understanding of experiences and to devise effective strategies to reduce distress or risk

B. Although assessment may involve making a clinical diagnosis, this should not be the sole purpose of the assessment

C. There is no definitive objective test for whether or not someone has bipolar disorder.

D. All of the above


Difficulties in Assessment

18. The assessment of bipolar disorder may be complicated because many people don't seek treatment for the initial mood episode, which is most commonly hypomania.

A. True

B. False


Section Nine: Beliefs about Health Problems and Self Management

19. The ways in which people think about their bipolar experiences can have a substantial impact on how they engage in self management of the disorder.

A. True

B. False


Section Ten: Psychological Therapies-Types of Therapy

20. A primary focus of cognitive behaviour therapy (CBT) is around understanding the links between ______________, thoughts, behavior and mood.

A. A client's history

B. Current experiences

C. External events

D. Interpersonal relationships


The Future of Therapy

21. Although it is typically not possible to maintain the standard structure of therapy when the bipolar client experiences a relapse requiring a hospital admission, it is usually helpful for the clinician to maintain regular contact through this period.

A. True

B. False


22. Bipolar disorder is characterized by ___________, so people’s treatment needs often do not fit well within traditional services.

A. Variability

B. Instability

C. Inconsistency

D. None of the above


Section Eleven: Medications

23. The three categories of medications offered to people with a diagnosis of bipolar disorder include each of the following EXCEPT:

A. Mood stabilizers

B. Anti-depressants

C. Neuroleptics

D. Anti-anxiety medications


Making Decisions About Medication

24. One of the advantages of taking medications to treat bipolar disorders is that it ensures that the client has regular health appointments to monitor dosing and and side effects.

A. True

B. False


Mood Stabilizers

25. Side effects of major tranquilizers used to treat bipolar illness include:

A. Slurred speech, confusion, and sleep problems

B. Liver damage, extreme tiredness, and jaundice

C. Unsteadiness, low red and white blood cell counts, and a severe skin rash

D. Heart arrhythmia, diabetes, and neurolptic malignant syndrome


Section Twelve: Risk and Bipolar Experience

26. A promising new approach called mindfulness based cognitive therapy (MBCT) is being used to treat bipolar patients who also have:

A. Substance abuse issues

B. Trauma histories

C. Suicidal thoughts

D. All of the above


Risk Through Drugs and Alcohol

27. Risks associated with bipolar disorder and drug and alcohol use indicate that:

A. 30–40 percent of people with experience of bipolar disorder will be dependent on or use significant amounts of drugs or alcohol in their lifetime

B. Although these rates are higher than those in the general population, it important to note that when alcohol use is included, potentially harmful levels of substance use are apparent in up to 15% of all adults

C. Use of alcohol and drugs tends to increase much more during periods of mania than during periods of depression

D. Individuals who have problems with drugs and/or alcohol along with bipolar disorder tend to have more severe mood problems and benefit less well from available treatments than individuals who do not use substances in this way


RIsks from Other People

28. A significant proportion of individuals with experiences of psychosis or bipolar disorder experience violence from others, and a recent study of these individuals found that over 23 percent were victims of violence over a 12-month period.

A. True

B. False


Part Four: Recovery

29. Each of the following accurately describes recovery from bipolar disorder EXCEPT:

A. The most common stages of recovery from bipolar disorders involve eliminating symptoms of distress and learning to manage without medication

B. Recovery is an ongoing journey that is unique to each individual

C. Recovery associated with a mental health problem can only be determined by the person with the problem, and it does not necessarily involve a complete elimination of distress

D. Part of this process may involve working out what features of the ‘illness’ can now be regarded as acceptable and manageable and how to engage with services in ways that feel constructive for the individual


30. While some individuals find that a diagnosis of bipolar disorder is helpful, others can find it to be disempowering, particularly if they do not make sense of their experiences within an illness framework.

A. True

B. False


Mood Related Coping Strategies

31. Learning to grow from, rather than feeling crushed by criticism, rejection, or disagreement falls into which category of mood related coping strategies?

A. Psychological

B. Mood management and self awareness

C. Identity

D. Interpersonal


32. Having the freedom to make choices and mistakes, while also experiencing success are all important "self care" coping strategies.

A. True

B. False


Part Five: Wider Implications

33. Professionals and other mental health workers should recognize that all service users do not want to be treated as a collection of symptoms to be managed, but rather as:

A. A partner in the treatment process

B. A whole person

C. A competent and self-sufficient indicidual

D. None of the above


Services As a Choice, Not a Requirement

34. It is important to remember that providing services should be a choice rather than a requirement, as some individuals with bipolar disorder may not be distressed by their symptoms or experiences.

A. True

B. False


Talking Treatments

35. Large-scale trials have indicated that talking treatments can be very helpful, and because of their effectiveness and their popularity they are now widely available for people with a diagnosis of bipolar disorder.

A. True

B. False


Information and Choice

36. Services such as massage, exercise therapy, meditation, and acupuncture may be effective in reducing the high levels of stress and arousal that are often associated with bipolar disorder, and they are referred to as:

A. Hollistic approaches

B. Alternative treatments

C. Complementary therapies

D. Self-management techniques


Information and Choice: Practical Help

37. Work and/or education are often particularly important to those with bipolar disorder, as people who are under-occupied are much more likely than others to experience recurring problems with extreme mood.

A. True

B. False


Information and Choice: Mental Health Legislation

38. The use of the powers under mental health legislation has led to experiences with mental health services that have been:

A. Punitive and authoritative

B. Coercive and restrictive

C. Hostile and non-collaborative

D. None of the above


39. A trusting and collaborative relationship between clinicians and service users should be a prerequisite to any specific treatment, although some service providers do not operate as if this were the case.

A. True

B. False


Service Users as Trainers

40. Service users, ex-users and relatives are experts by experience, so it is often helpful to include their valuable insights as part of mental health professional training.

A. True

B. False


How Professional Training Needs to Change

41. A fundamental message for training professionals working with bipolar disorder is that extreme mood states are not understandable in the same ways as ‘normal' mood states, and therefore cannot be approached in the same way.

A. True

B. False


Section Fourteen: Social Inclusion-Overview

42. Studies suggest that people diagnosed with ‘severe’ mental health difficulties are amongst the most socially and financially excluded groups in society, and change in mental health needs to occur:

A. On an emotional and physical level

B. Within the family and community

C. In a personal and group-oriented way

D. Individually and on a societal level


Work and Employers

43. Which of the following is NOT a true statement about how individuals with bipolar disorders should disclose their illness to potential or existing employers?

A. There is an obligation to respond truthfully to direct questions from potential employers concerning any existing conditions

B. Those with a history of struggling to maintain consistent control over their moods may opt to inform employers, so that they can recieve the support they need

C. Those in the workforce who disclose their bipolar disorder are legally protected under the Disability Discrimination Act, so it is unlikely that they will ever be passed up for an appointment or promotion

D. It is important that the individual seeking work, or needing to return to work after a period of time off, gives full consideration to the option to disclose or not, and seek out support and counseling


Relationships

44. Both manic and depressive episodes can be triggered by difficulties in close relationships, and social stressors and losses are commonly cited as a precipitating factor of mood instability.

A. True

B. False


Changing Attitudes: The Role of the Media

45. A grassroots anti-discrimination project called ___________,  run by the charity MIND, works on the principle that talking about mental health is the best way to confront stereotypes and tackle prejudice.

A. Talk is Cheap

B. Time for Discussion

C. Be Real

D. Open Up


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