Association of Advanced Practice Psychiatric Nurses
Advancing your practice, your career, and our community.

2018 Spring Conference

Under the Umbrella:
Framework and Treatment Considerations for Bipolar and Conversion Disorders

Join your colleagues for an in-depth workshop exploring the full spectrum of diagnostic and treatment modalities available to Advanced Practice Psychiatric Nurses.

The morning session addresses a conundrum you face in practice every day: “Is this unipolar depression, PTSD, or bipolar disorder?” Examine all aspects involved in reaching a diagnosis and selecting treatment of bipolar spectrum disorder.

The afternoon session will take a lifespan approach to conversion disorder. Using case studies—including an adolescent with complex symptoms—you will learn the newest information available while gaining a richer historical perspective.

Sessions will offer new information, research support, methods, and treatment tools—including medication—to utilize in your practice.

The conference will also feature poster presentations, exhibitors, and a reception for AAPPN members following the conference from 4:45-5:30 p.m.

Morning session: “Difficult Depressions: A Spectrum Approach to Diagnosis and Treatment of Bipolarity” presented by James Phelps, MD

A spectrum approach to mood disorder diagnosis has been advocated by the DSM-5 chairman and the NIMH, among others. This is complementary to the DSM system, allowing you to find patients in the cracks between labels. As you know, there are lots of them! 

Let’s consider how to identify subtle and subthreshold hypomania, and even more subtle bipolarity; how to finesse patients’ hesitation at the word “bipolar”; and how to do this efficiently in a busy practice.

Among these patients are many who experience severe anxiety as well as depression. We’ll examine how these may be presentations of a “mixed state” (per the new DSM-5 characterization; and per a recent review by the International Society for Bipolar Disorders).  This complicates diagnosis of PTSD and Generalized Anxiety Disorder when depression is also present.

But there is a simple solution…

For mid-spectrum depression treatment: First, consider the latest research in bipolar-specific psychotherapies. If you can’t do the therapy per se, you can incorporate some of the tricks—like management of light and darkness (we’ll look at some new data on “virtual darkness” as an anti-manic intervention; a tantalizing option at $9 with no risks or side effects!).

Then we’ll look at how to avoid atypical antipsychotics with their metabolic risks, and antidepressants with their risks of inducing cycling and mixed states. Mood stabilizers, namely good old lamotrigine, and low-dose lithium (a different strategy than the full-dose approach needed for Bipolar I) must be routine in your toolbox. 

A further strategy, rather than adding another medication, is removing mood destabilizers.  We’ll talk about using long antidepressant tapers—and how to cope with depression emerging during that time. 

Throughout this program there will be time built in to invite questions, clarify confusing ideas, and consider relevant cases briefly presented.

Read the Session Objectives

About the Presenter

James Phelps, MD, Staff Psychiatrist, Samaritan Mental Health, has specialized in bipolar spectrum variations for more than 15 years. He has authored multiple peer-reviewed articles on mood disorders, and serves as Bipolar section editor for Psychiatric Times. His no-profit website, PsychEducation.org, focusing on complex bipolar variations, has received more than two million visitors.

He accepts no honoraria from pharmaceutical companies, but does receive royalties from McGraw-Hill and W.W. Norton for books on the bipolar spectrum: A Spectrum Approach to Mood Disorders, 2016, is for professionals; Bipolar, Not So Much, 2016, is for patients and families. 

Dr. Phelps received his MD from Case Western Reserve University, and completed his residency in psychiatry and a fellowship in medical education at the University of New Mexico. Current work focuses on primary care psychiatric consultation. 

Afternoon session – Across the Lifespan Presentation: “Navigating the Complexities of Conversion Disorder” presented by Dana Dean Doering, ARNP, and Melanie Kristoferson, RN, Seattle University ARNP Student

This presentation will differentiate Conversion Disorder (Functional Neurological Symptom Disorder), Somatic Symptom Disorder, and Delusional Disorder.

We will start by providing an overview of Conversion Disorder and how its conceptualization in the DSM has changed over time with each new DSM revision. We will discuss prevalence, theoretical models, cultural perspectives and difficulties in differential diagnosis. This will demonstrate how taking a historical view in psychiatry and drawing on psychoanalytic case formulation aids in a more thorough and effective understanding of conversion disorder.

The second part of the presentation will center on case studies. We will outline a complex case study of an adolescent displaying somatic and delusional symptoms in the context of rapidly evolving mental and physical symptoms of conversion, all of which began with a stressful event of a TBI.

We will also present case studies and profiles of young adults and older adults experiencing conversion symptoms.

The presentation will conclude with a review of evidence-based treatment, including medication options being debated for conversion symptoms and medication recommendations for treating companion diagnoses.

Read the Session Objectives

About the Presenters

Dana Dean Doering, ARNP, is a leading national educational consultant and child and adolescent psychiatric mental health specialist who has dedicated a 35-year career to helping children, adolescents, young adults and families improve their lives. She serves as President of Dean Doering & Associates/ Dean Doering Educational Consultants, and as Executive Director and Head of School of Child & Family Psychiatric Mental Health Associates/Child & Family Guidance Center Canterbury Academy.

Dana has distinguished herself as an international child advocate, parenting coordinator, and children’s book photo illustrator. She helps children, adolescents, young adults and parents explore creative options for educational planning.

Dana has worked in academic and research positions, as well as in private practice. She is also involved in volunteer work, community development, and community philanthropy. She currently serves as the President of AAPPN. She has also served on the Governor’s Task Force—Washington State Suicide Prevention Plan for Youth Committee.

Melanie Kristoferson, RN, is delighted to be presenting at this year’s conference. She has worked for two years as a primary care nurse in a community health clinic, where she helped patients learn about and manage chronic illnesses. Before finding her way to nursing, she wrote grants for a federally-qualified health center for six years.

Melanie is currently enrolled in the Psychiatric Mental Health Nurse Practitioner program at Seattle University. She will graduate in June 2018 and hopes to work with youth and young adults. For her MSN project, she designed and implemented a process to coordinate care for youth at risk of harming themselves or others while they were at school. She received Seattle University’s Dr. Eileen Ridgway Nursing Outreach Scholarship for this project and presented results at the Advancing School-Based Mental Health conference in 2015. In 2017, she received the Lois Price Spratlen Foundation scholarship for academic performance, school involvement, and community service.

Melanie is proud to be a member of AAPPN and serves on the Education Committee.

Register Now!

This activity has been submitted to Oregon Nurses Association for approval to award contact hours. Oregon Nurses Association is accredited as an approver of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. Upon approval, attendees may earn 6 contact hours, of which 5 can be applied toward the pharmacotherapeutic continuing education requirement for advanced practice nurses with prescriptive authority. Participants must be present for all of the educational activity to receive contact hours.

Early Bird Registration

Take advantage of early-bird pricing. Register before January 31 and save $25 off the regular registration rate. Register online or download a registration form.

Registration Info

Early Bird Registration Fees
AAPPN Member – $175
Student Member – $95
Nonmember – $225
Student Nonmember – $145

February 1-28, 2018
AAPPN Member – $200
Student Member – $120
Nonmember – $250
Student Nonmember – $170

March 1-17, 2018
AAPPN Member – $220
Student Member – $140
Nonmember – $270
Student Nonmember – $190

Refund Policy
Balance minus $25 processing fee refundable until March 1. Requests for refunds made after March 1 will be calculated minus conference costs incurred.

Exhibitor Information

Exhibit spaces are available! Reach out to Advanced Practice Psychiatric Nurses with a display table. Download a reservation form or email Kirk Roberts at kirk@aappn.org to find out more.