|
BIPOLAR DISORDER Part 1 Charles Hodges MD |
 |
| I. Introduction |
|
|
A. John 8, Knowing the truth and finding freedom. |
|
|
1. Light, Truth, and freedom. Vs 12-32 2. Sin, ignorance and bondage. Vs. 32-44. 3. Refusing the truth leads to bondage. |
|
B. The truth about Bipolar Disorder. |
|
1. Absolute truth in BPD is hard to find. 2. In search of truth treating patients. 3. Medically treating patients is not required in order to help. 4. Romans 14 and Judgment. |
|
C. Sorting out the reality of disease and sin. |
|
1. We will hold to the common definitions of disease, syndrome and disorder. The dictionary definition of disease is “a pathological condition of a part, organ, or system of an organism resulting from various causes, such as infection, genetic defect, or environmental stress, and characterized by an identifiable group of signs or symptoms 2. We will never call anything a disease that the Bible calls sin. 3. We will never call anything sin unless the Bible clearly does. 4. Diminished capacity may result in diminished responsibility. |
|
D. Definitions of BPD. Looking for truth in a world of opinion. |
|
1. Medicine is an art and science. 2. Definition: Bipolar disorder is a “condition” in which the patient has periods in life, which swing from major depression to mania. Mania is defined as times when the patient has increased motor activity, a pressure to keep talking, a reduced need for sleep, and a “flight of ideas.” These times may be marked by grandiose thinking, impaired or poor judgment, impulsiveness, aggressiveness, and hostility. They may spend large amounts of money they do not have and make personally destructive decisions in business and in sexual/moral matters. May also include thoughts of suicide, and hallucinations. 3. You gotta know the categories. |
|
Categories: DSM IV classification a. Bipolar 1: Both mania and major depression b. Bipolar 2: Major depression and hypomania c. Major Depression and no Mania. Some blood relatives have had mania d. Hypomanic Episode e. Mixed Episode: Both the criteria for major depression (except for time) and Mania are met on every day for seven days. f. Mania and no depression g. Cyclothymia: Mild depression and hypomania |
| 4. The Problem: No pathology. |
|
a. No blood test, MRI, CAT, PET, or physical findings can identify BPD from the general population. b. Only a hint. CSF difference in first time psychosis patients. |
| 5. Without pathology our definition sets us free. |
|
a. This freedom lets us look at BPD for exactly what it is, behavior. b. It requires us to use Discernment. “The quality of being able to grasp and comprehend what is obscure” c. Discernment as a tool requires mercy and the ability to say I do not know when I don’t. d. It also requires the willingness to say what the scriptures say about behavior. |
| 6. Medical treatment. For BPD 1. |
|
a. The medicines. Lithium. Still the best for BP1. The least suicide. Antiepileptic Valproate Carbamazine Lamictal Atypical Antipsychotic Zyprexa Seroquel Risperidone SSRI Antidepressants: Perhaps more trouble than they are worth? Only In combination. b. All the same medicines except lithium are used in BPD and a blizzard of other behavior disorders. c. Counseling for the most part is aimed at getting patients to take their medicine and believe that they need it. |