Mental
Disorders
Psychiatric Disorders:
Bipolar Disorder
Bipolar disorder is also known as Manic-Depressive Disorder. Patient suffer from
alternating, prolonged episodes of extreme elation and depression.
Periods of mania are characterized by hyperactivity involving excessive participation
in multiple activities (sexual, occupational, political, religious, etc.) which is
unrecognized by the patient. Speech is often pressured, loud, rapid, theatrical, dramatic,
difficult to interpret, with abrupt changes in topic. The most common complications of
manic episodes are substance abuse and the consequences of actions resulting from impaired
judgement
Persons with bipolar disorder:
- are easily distracted
- display grandiose delusions in which they claim a special relationship to well known
person
- may go days with little or no sleep and not appear tired
- may have very labile mood with rapid shifts to anger or depression
Periods of depression are characterized by a loss of interest in almost all daily
activities
Oral problems manifested during mania are abrasion of mucosa and teeth from vigorous
brushing. During depression; poor oral hygiene, rampant caries, periodontal disease, and
oro-facial pain.
Lithium carbonate is effective in treating the manic phase while depressive episodes
are treated by temporary administration of antidepressants. Long term lithium therapy may
result in complaints of generalized stomatitis and xerostomia; artificial saliva may make
the patient more comfortable and better able to tolerate the medication. NSAIDs may affect
renal flow and increase blood levels of lithium; consult with patint's physician.
