Anti manics

2.  Problems do not go away. They must be worked
through or else they remain, forever a barrier…
M. Scott Peck

3. “But I don’t want to go among mad people,” Alice
remarked.
“Oh, you can’t help that,” said the Cat. “We’re all mad
here. I’m mad. You’re mad.”
“How do you know I’m mad?” said Alice.
“You must be,” said the Cat, “or you wouldn’t have come
here.”
Lewis Carrol, Alice in Wonderland

4. ADULT DIAGNOSES
 Depression
 Schizophrenia
 Bipolar Disorder (Manic Depressive Illness)
 Personality Disorders
 Substance Abuse

5. Depression
 DSM IV TR Criteria
 Course of illness
 Effect on caregiving
 Comorbidities

6. Schizophrenia
 DSM IV TR Criteria
 Course of illness
 Effects on caregiving
 Comorbidities

7. Bipolar Disorder
 DSM IV TR Criteria
 Course of illness
 Effect on caregiving
 Comorbidities

8. Personality Disorders
 DSM IV TR Criteria
 Course of illness
 Effect on caregiving
 Comorbidities

9. Substance Abuse:
Drugs, Alcohol & Polysubstance
 DSM IV TR Criteria
 Abuse v. dependence
 Course of illness
 Effects on caregiving
 Comorbidities

10. Kids’ Diagnoses
 Depression
 Bipolar (controversial, especially before 13 years old)
 ADD
 Behavioral consequences in kids whose parent has an
unstable mental illness

11. Working with parents with
unstable mental illnesses
 Compliance v. noncompliance
 Drug addiction
 Assessment

12. Long-term prognosis
 Depression
 Good prognosis if compliant with medication and
supportive therapy
 Schizophrenia
 Fair prognosis if compliant with medication , therapy
and social supports
 Poor prognosis with marked deterioration if
noncompliant
 Bipolar Disorder
 Good prognosis if compliant with medication
 Unfortunately, often prefer to be unmedicated

13. Long-term prognosis
 Personality Disorder
 Generally difficult to treat
 Problems arise because of co-occurring substance abuse
&/or poor judgment, impulsivity and disrupted
interpersonal relationships
 Substance Abuse
 Fair prognosis if complies with medication & supportive
therapy. However, relapse is anticipated.
 Poor prognosis with marked deterioration if untreated.

14. Medications
 Antidepressants
 Antipsychotics
 Antimanics
 Anxiolytics
 Drugs that treat cravings

15. Antidepressants
 SSRIs Prozac, Zoloft Paxil
 Available as pills, liquids
 Actions: thought to block reuptake of serotonin
 Duration: varies. Takes 4-6 weeks for full effect.

16. Antidepressants
 NSRIs Effexor, Cymbalta
 Available in pill form
 Actions: thought to act by blocking reputake of
serotonin & norepinephrine
 Duration: varies. Can take 1-4 weeks for full effect

17. Antipsychotics
 Haldol
 Available in pill, liquid and short-acting or long-acting
shot (get every 4 weeks)
 Actions: blocks dopamine receptors. Treats short-
term psychotic symptoms
 Duration: pill form lasts 6-10 hours;
 Long-acting shot lasts 28 days

18. Antipsychotics
 Risperdal
 Available in pill or long-acting shot form
 Actions:
 blocks serotonin, dopamine & histamine receptors
 For short-term treatment of psychotic symptoms or for
irritability associated with manic behavior
 Duration:
 pill form lasts 6-7 hours
 Long-acting shot lasts 7 weeks but can take 3 weeks to
start working

19. Antipsychotics
 Geodon
 Available in pill and short-acting shot form
 Actions: dopamine & serotonin antagonist
 Treats positive and negative symptoms of schizophrenia
with minimal EPS side effects
 Rapid control of agitation and psychotic symptoms
 Rapid short-term treatment of manic or mixed
symptoms
 Pill form lasts 12 hours but IM best for acute symptoms

20. Antimanics
 Lithium
 Available as pill or liquid
 Action: alters chemical transmissions in neurons
 Duration: 1-3 weeks for full effect
 Use additional alternate medication for short term
treatment of symptoms
 Maintain adequate fluid intake, scheduled blood tests

21. Antimanics
 Depakote/Depakene
 Antiepileptic/mood stabilizer
 Often used as an alternative to Lithium
 Available as pills, syrup sprinkles
 Actions: May inhibit nerve transmission in CNS and
may increase brain level of GABA

22. Mood Stabilizers
 Lamictal
 Available in pill form
 Action: inhibits certain neurotransmitters
 Important info: can cause life-threatening
complications if given with depakote

23. Mood Stabilizers
 Topamax
 Available as pill or sprinkles
 Action: unknown

24. Resources
 Directory of Health & Human Services in Metropolitan
Chicago
 312-491-7800
 www.communityresourcenetwork.org
 Haymarket House
 Hull House
 Thresholds