A nurse is discussing treatment approaches for bipolar disorder with a client. Which class of medications is considered the gold standard for bipolar disorder treatment due to its efficacy in both acute and maintenance phases?

Choice A rationale:

While mood stabilizers are often used in combination with antidepressants for individuals with bipolar disorder, it's not an absolute requirement that antidepressants always be used alongside mood stabilizers. The choice to combine these medications depends on the individual's specific presentation and needs.

Choice B rationale:

Antidepressants can induce or worsen manic or hypomanic symptoms in individuals with bipolar disorder. This phenomenon is known as "switching" and can lead to a rapid shift from a depressive state to a manic or hypomanic state. Therefore, careful consideration is needed when prescribing antidepressants to individuals with bipolar disorder to avoid triggering manic episodes.

Choice C rationale:

Antidepressants are not the primary treatment for acute manic episodes in bipolar disorder. Antipsychotic medications and mood stabilizers are more commonly used to address the manic symptoms and stabilize the individual's mood during such episodes.

Choice D rationale:

Antidepressants, like all medications, have the potential for causing side effects. They can lead to a range of adverse effects, including gastrointestinal symptoms, changes in sleep patterns, and sexual dysfunction, among others. Monitoring for and managing these potential side effects is important in providing comprehensive care to individuals taking antidepressants.

Choice A rationale:

Increased sleep duration is not a characteristic of manic episodes in bipolar disorder. In fact, decreased need for sleep is a common symptom of manic episodes. Individuals experiencing a manic episode often report feeling restless and having a decreased need for sleep.

Choice B rationale:

Reduced goal-directed activity is not typical of manic episodes. During manic episodes, individuals often exhibit heightened goal-directed activity, excessive energy, and increased involvement in various activities. This can lead to a decreased ability to focus on one task at a time.

Choice C rationale:

Correct Choice In a manic episode, individuals may display a decreased need for social interaction. They might engage in excessive socializing, seek out new social interactions, and exhibit a heightened level of confidence in their ability to engage with others. This increased sociability can sometimes be characterized by rapid speech and impulsiveness in social situations.

Choice D rationale:

Feelings of sadness and hopelessness are not indicative of manic episodes. These emotions are more aligned with depressive episodes in bipolar disorder rather than manic ones. Manic episodes are characterized by elevated mood, increased energy, and a sense of euphoria or grandiosity.