City Vision College: Course 416 Key Study Guide Chapter 7: The Affective and Anxiety Disorders (pages 99 – 121) Clients with Bipolar Disorder 1. Bipolar disorder is the more recent term for _______________________________. 2. What are the distinctive features of bipolar disorder? 3. Define the term hypomania. 4. What is the first criterion for bipolar disorder? 5. What are the other symptoms a person may exhibit during the manic phase? o o o o o o o 6. What is the difference between Bipolar I and Bipolar II? o Bipolar I type: o Bipolar II type: 7. What are the three key treatment issues people suffering with bipolar disease encounter? o o o 8. What do mania and chemical dependency have in common? 9. In addition to Education about their illness and the need for medication, what other action can help those with bipolar disorder to maintain compliance? 10. When may hospitalization become necessary to stabilize behavior and ensure initial abstinence for someone with bipolar? 11. What is an option to attempting to stop the manic behavior while the person is in treatment? 12. What other treatment options would you use to redirect a person's manic behavior into something positive? 13. What type of treatment approach can help clients deal not only with their chemical dependency but also their bipolar illness? How will this approach help the clients with bipolar disorder? 14. What should the focus be for a person with bipolar disorder when planning for relapse? 15. What is a “think-through-it first” drill as mentioned in your text? Give examples. 16. True or false. There is little hope for people with bipolar disease to recover well and maintain abstinence from substance abuse. Clients with Attention-Deficit/Hyperactivity Disorder (ADHD) 17. True or false. Symptoms of ADHD can sometimes mimic the symptoms of mania. 18. In assessing ADHD in students, what are many school districts now requiring before completing that assessment? 19. True or false. Using stimulants to treat ADHD should be avoided if the client is also suffering from a disease of addiction. 20. What type of medication is an alternative to using stimulants to treat ADHD? Clients with Major Depression 21. What is the cardinal feature of major depression? 22. What are the other symptoms of major depression as indicated by the DSM-IV? o o o o o o o o o o 23. How many of the above symptoms must the person exhibit and for how long must those symptoms exist for person to be diagnosed with Major Depression? 24. What is dysthymia? 25. What are the symptoms of dysthymia? How long must they last? o o o o o o o o 26. How many people with a lifetime history of major depression also have a lifetime history of a substance use disorder? 27. For those with substance use disorders, what factors are likely to be causally linked to the development of major depression? o o o o o o 28. “Negative life events not only can trigger a major depression, but a major depression can create negative life events in a vicious cycle.” What does that statement mean to you? How will understanding that statement affect treatment for the dually diagnosed client with Major Depression? 29. About ________________ of persons with an episode of major depression will not fully recover, and those who have ________________ episodes are at higher risk for having additional episodes. 30. What type of treatment do the authors of your text suggest for the following types of depression: o Mild depression: o Moderate to severe depression: 31. When should the depressed dually diagnosed client be considered a candidate for antidepressant medication? 32. What should you do with the client who presents with serious suicidal ideation? 33. Who should you consult with regarding psychotropic medication issues? 34. People with Major Depression show significant cognitive impairments; and those in early addiction recovery also show cognitive impairments. What should you be prepared to do with your client? 35. How can you help those clients remember the solutions and tasks you agreed upon during your session? 36. True or false. Symptoms of anxiety very commonly accompany major depression and require attention. 37. What will happen to the patient's depression if their anxiety levels are diminished? 38. Why do you believe that helping a client to build or rebuild their social support system would help their levels of depression? 39. How can you effectively use the client's mild dysphoria they might experience as they grieve over the losses caused by their chemical use? 40. Why do you think that the hopelessness that accompanies major depression might lead to relapse? 41. “It's not always denial” is a useful saying to keep in mind when doing dual diagnosis work. What does that saying mean to you? How would that saying affect your counseling? 42. What is the purpose of frequently reviewing your client's progress? o o o o 43. What should the focus be for relapse prevention work? 44. Why might clients relapse if they fall into a sense of "what's the point" or "don't care?" o o 45. True or false. The chances of recovery for the clinically depressed dually diagnosed client with appropriate treatment are poor. 46. What can the pain associated with Major Depression provide while addressing the substance use and the grist for step work on unmanageability? 47. Abstinence alone will not remove the depression, and psychotherapy and antidepressant alone will not eliminate substance dependence. How can you use this information when treating a person who is truly diagnosed with depression and chemical dependency? Clients with Anxiety Disorders 48. What are the cardinal features of anxiety disorders? 49. List the 8 specific conditions that fall under the classification of anxiety disorders: o o o o o o o o 50. What happens when the trigger for one of the above anxiety disorders is very focused? What type of intervention is used when the trigger is focused? o o o 51. True or false. The anxiety disorders tend to be acute in half or more of individuals. 52. What are the diagnostic criteria for Generalized Anxiety Disorder? o o 53. PTSD involves exposure to a traumatic event and is characterized by what three symptoms? o o o 54. What other symptoms might a person with PTSD experience? o o o 55. What does the term Panic Attack refer to? o A discrete period of intense fear or discomfort in which four or more of the following symptoms develop abruptly and peak within 10 minutes: 56. Abstinence will resolve the anxiety of many substance abusers, but a significant minority appears to have co-existing anxiety disorders. What must be done to determine the existence of a co-existing anxiety disorder? 57. What types of chemicals do people with anxiety disorders often use? 58. “Taking a pill to fix things can become an easy way to avoid work necessary to lead to long-term recovery.” What does that statement mean to you? 59. What two therapeutic techniques are often used when treating an anxiety disorder? o o 60. The authors of your text state that letting clients “borrow the counselor’s brain” is also a helpful technique. What type of technique do you think this is? 61. The authors of your text suggest that there are high rates of codependency in people with anxiety. Why would the codependent person be anxious? 62. What has research on attachment theory indicated about those with long-term problems with anxiety? 63. What type of approach should be used to nudge clients with an anxiety disorder one step at a time, one day at a time, forward? 64. Why might recovering addicts and alcoholics need higher doses of antidepressants or other medications to treat anxiety? 65. True or false. People with anxiety disorders are at a high risk for relapse.