The bipolar patient becomes overwhelmed with emotional stimulation with no way of understanding it, which can trigger mania and exacerbate the effects of depression. Signs and symptoms
Bipolar disorder is characterized by marked swings in mood, activity, and behavior. BP-II is characterized by periods of hypomania, which may occur before, after, or independently of a depressive episode. Hypomania
Hypomania is the signature characteristic of BP-II, defined by an experience of elevated mood. A patients mood is typically cheerful, enthusiastic, euphoric, or irritable. In addition, they can present with symptoms of inflated self-esteem or grandiosity, decreased need for sleep, talkativeness or pressured speech, flight of ideas or rapid cycling of thoughts, distractibility, increased goal-directed activity, psychomotor agitation, and/or excessive involvement in activities that have a high potential for painful consequences (engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments. )Hypomania is distinct from mania. During a typical hypomanic episode, patients may present as upbeat, may show signs of poor judgment or display signs of increased energy despite lack of sleep, but do not meet the full criteria for an acute manic episode. Patients may display elevated confidence, but do not express delusional thoughts as in mania. They can experience increase in goal-directed activity and creativity, but do not reach the severity of aimlessness and disorganization. Speech may be rapid, but interruptible. Patients with hypomania never present with psychotic symptoms and do not reach the severity to require psychiatric hospitalization.For these reasons, hypomania commonly goes unnoticed.
A circulatory collapse is defined as a general or specific failure of the circulation, either cardiac or peripheral in nature. Although the mechanisms, causes and clinical syndromes are different, the pathogenesis is the same—the circulatory system fails to maintain the supply of oxygen and other nutrients to the tissues and to remove the carbon dioxide and other metabolites from them. The failure may be hypovolemic or distributive. A common cause of this could be shock or trauma from injury or surgery. Types
A general failure is one that occurs across a wide range of locations in the body, such as systemic shock after the loss of a large amount of blood collapsing all the circulatory systems in the legs. A specific failure can be traced to a particular point, such as a clot. Cardiac circulatory collapse affects the vessels of the heart such as the aorta and is almost always fatal. It is sometimes referred to as "acute" circulatory failure. Peripheral circulatory collapse involves outlying arteries and veins in the body and can result in gangrene, organ failure or other serious complications. This form is sometimes called peripheral vascular failure, shock or peripheral vascular shutdown. A milder or preliminary form of circulatory collapse is circulatory insufficiency. Causes
A very large range of medical conditions can cause circulatory collapse. These include, but are not limited to:
Hypovolemic shock
Trauma, especially those with massive hemorrhage
Surgery, particularly on patients who have lost blood
Hemorrhagic conditions, e.g. upper gastrointestinal bleeding (esophageal varices, Mallory–Weiss syndrome, aortoenteric fistula, etc.