Manic-Depressive Illness
Definition
Mental health professionals refer to manic-depressive illness as bipolar disorder. It is characterized by recurring periods of mental illness in which episodes of excitement and hyperactivity (mania) either occur alone or alternate with periods of depression.
Everyone has moods, but extreme and unpredictable mood swings from highly excited euphoria to the darkest depths of despair and depression characterize bipolar disorder. In most people, mood changes are a response to events in the environment, but when elation or depression occurs without relation to the circumstances, this is manic-depressive illness.
Your feelings may become so intense that they take over completely, and you lose contact with the real world. The manic phase usually is the episode that may require the person to be hospitalized. During the manic episode, you may feel very "high" or irritable. Euphoria may not be obvious to those who do not know you well, but friends and loved ones will come to recognize it as unusual or as typical of the manic phase. Your speech and thoughts seem to run at high speed, so fast that it is difficult to understand them. Your speech may become so laden with puns, jokes, and plays on words that, after a while, it makes little sense.
The self-esteem of an individual with manic-depressive illness may soar, often to the point of delusions of grandeur. In fact, you are likely to be hyperactive, eager to take on far more activities than you can reasonably handle. Should such activities be thwarted, however, irritability may result. You may have an inability to judge the consequences of your actions, manifested in shopping sprees, self-destructive sexual activity, unwise business decisions, or reckless driving. You may change moods frequently, alternately laughing and crying, and there may be fleeting delusions or hallucinations.
If untreated, the manic episode may last for weeks, during which you are physically restless, highly talkative, likely to sleep less, and easily distracted.
During the depressed phase (which is the more frequent form of the illness), you appear depressed for most of the day, nearly every day. You lose interest and pleasure in nearly all activities, may lose or gain a great deal of weight, and usually have a change in sleeping patterns. You may be fatigued, suffer from feelings of worthlessness, and have trouble concentrating. You may withdraw completely, speaking only rarely. Often, there are recurrent thoughts of death and suicide. If untreated, the depressive phase may last for months.
Often, two or more complete cycles (a manic episode and a major depression that follow each other with no period of remission) will occur within a year. This situation may be called rapid cycling and seems to be more chronic than other types of bipolar disorder. Although major depression is more common in women, bipolar disorder is equally common in men and women. About 1 percent of the adult population have had this disease.
The disorder usually appears between the ages of 15 and 25. It occurs much more often in immediate relatives of people with bipolar disorder than in the general population.
Symptoms
- Alternating pattern of emotional highs (characterized by high-spirited behavior) and emotional lows or depressions.
- The manic and major depression episodes may alternate rapidly every few days.
- Symptoms of depression are prominent and last for a full day or more.
Conventional Treatment
Tranquilizing drugs help control the manic phase. Antidepressant drugs can treat the depression episodes. Lithium carbonate is the standard treatment for manic episodes, and the regular use of this drug may prevent uncontrolled mood swings. Certain anticonvulsant drugs such as carbamazepine (Tegretol) can be helpful in those persons who cannot tolerate lithium carbonate.
In severe cases, electroconvulsive therapy may be necessary. It is always important to be aware that the danger of suicide is present. When you appear to have suicidal tendencies, it is important for those closest to you to express a caring attitude. In these cases, however, you will probably need to be hospitalized.
Hospitalization also is necessary if you are in a depressed phase and regress so much that you are unable to take care of personal needs at home. Likewise, if your doctor prescribes electroconvulsive therapy or expects the antidepressant medication to have severe side effects, it may be appropriate to admit you to the hospital. On the other hand, considering how severe the depressed phase often is in bipolar disorder, it is surprising how frequently outpatient treatment is successful.
During the depressed phase, psychotherapy usually serves only as a means of emotional support. The therapist will explain the illness to those closest to you, establish a rapport with you, and foster a sense of hope and planning for the future. You may receive a structured daily program and the therapist will determine the risk of suicide and intervene when necessary.
Other Types of Depression
Depression
Major Depressive Disorder
Seasonal Affective Disorder
Situational Depression
Suicide (Potential)