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Thursday, October 16, 2014


Manic-Depressive Disorder

Bipolar Disorder or Bipolar Affective Disorder is a psychiatric diagnosis for a mood disorder 
(Historically known as Manic-Depressive Disorder or Manic-Depression)

A healthy person has mood swings that shift from moderate liveliness to moderate lethargy, depending largely on circumstances. A person who has the disorder called manic-depression has extreme mood swings, and the relationship between the moods and what is actually happening is not direct.

Manic-depressive illness tends to be cyclical, with periods of unexplainable elation and overactivity (mania) irregularly alternating with deep depression. Periods of normality, sandwiched between the extremes, may last for a short time or for years.

Extreme stress or a death may trigger a sudden episode of mania or depression. Often, however, there is no single direct cause, but a gradual accumulation of setbacks. Very rarely manic-depression is caused by a severe infection, a stroke, or a brain injury.

What are the symptoms?
  • Associates of a person with this disorder are likely to be first to recognize the beginning of a manic phase, which starts out gradually with hypo-mania  and output of accelerated energy. People in this phase begin to wake up earlier and earlier in the morning, until they find themselves getting out of bed before sunrise. At the same time, their work output often falls because they are easily distracted and restless. They may be promiscuous sexually, go on spending sprees, and enthusiastically start but rarely finish new projects. They are often irritable and may have sudden attacks of rage.
  • The object of a spending spree is usually to try to feel better by spending money on oneself. Some psychotherapists think that this type of short-term lift just masks the underlying depression. In other words, the manic phase is probably a defense against the real problem of depression. Often people with manic-depression demonstrate exaggerated thinking (grandiosity) and have a very high opinion of their abilities.
  • If mania develops, total elation may result in wider speech, full of rhyming, punning, and illogical word associations. Some people sing and dance or laugh uproariously for no reason. At times anger or underlying sadness may break through in fleeting moments of withdrawal or a total break with reality.
  • Because they lack concentration, manic people often forget to eat, so they tend to lose weight and become exhausted. Eventually, they may have delusions of grandeur or intense anger at their inability to carry out wild schemes.
  • The depressive phase is like depression, but the symptoms are more severe. The onset may be gradual or very sudden, with the person becoming increasingly withdrawal. Sleep is frequently disturbed. Although there may be early morning wakefulness, late rising becomes habitual. Sex drive decreases, speech and movement slow down, and imagined problems multiply. Some people with manic-depression become unable to face the world, and simply stay in their rooms. This may in turn lead to a break with reality, delusions, and psychosis.

What are the risks? 
  • Manic-depressive illness is rarer than depression. It is thought to occur in about 3% of the population. More than one family member may be afflicted, and men and women are equally susceptible to it.
  • Although someone with this disorder may threaten suicide during depressions, he or she may lack the energy to carry it out. The danger increases with emergence from deep depression, when renewed energy may accompany a continuing death wish. In the manic phase, outrageous behavior may ruin social and professional relationships, and lack of judgment can become serious enough to lead to financial disaster.

What is the treatment options?
  • Mild cases often can treated by medication. The person should also be treated by a psychiatrist or other qualified mental health professional. In severe cases, especially when there is a risk of suicide or if irrational behavior gets out of hand, treatment in a hospital may be necessary.
  • As the treatment in the hospital begins to show results, occupational therapy is added to the treatment to prepare the person for a return to everyday life. If someone in your family has been in the hospital for this disorder, you will probably be told both how to recognize signs of an impending episode and how to reduce the strain on the patient as to lesson the risk of further episodes. After release from the hospital, many people with manic-depression must continue to take medications to prevent recurrent episodes of illness. 
  • Many people with severe manic-depression have been restored to near-normal health by long-term treatment with the medication lithium carbonate. This reduces the frequency and severity of episodes. The dosage must be carefully controlled, and regular laboratory test and checkups to help prevent potential harmful side effects are an essential part of treatment with lithium.

What are the long-term prospects?
  • Not long ago most people who had one episode of manic depressive illness could expect to have many more, which might become increasingly severe. However this gloomy outlook can now often be brightened by long-term treatment combining both psychotherapy and medication.

What should be done? 

If you suspect someone you are close to has manic-depression, persuade him or her to see a psychiatrist or a mental health professional. You will need patience and persistence in most cases. If necessary, ask your physician for advice as a first step. If you think that you may be becoming manic-depressive, see your physician without delay. Manic-depression disorder can be treated with psychotherapy and medication.

Myths and Facts About Bipolar Disorder

Myth: People with bipolar disorder can not get better or lead a normal life.
Fact: Many people with bipolar disorder have successful careers, happy family lives, and satisfying relationships. Living with bipolar disorder is challenging. However with treatment, healthy coping skills, and a solid support system, you can live fully while managing your symptoms.

Myth: People with bipolar disorder swing back and forth between mania and depression.
Fact: Some people alternate between extreme episodes of mania and depression, but most are depressed more often than they are manic. Mania may also be so mild that it goes unrecognized. People with bipolar disorder can also go for long stretches without symptoms.

Myth: Bipolar disorder only affects mood.
Fact: Bipolar disorder also affects your energy level, judgment, memory, concentration, appetite, sleep patterns, sex drive, and self-esteem. Additionally, bipolar disorder has been linked to anxiety, substance abuse, and health problems such as diabetes, heart disease, migraines, and high blood pressure.

Myth: Aside from taking medication, there is nothing you can do to control bipolar disorder.
Fact: While medication is the foundation of bipolar disorder treatment, therapy and self-help strategies also play important roles. You can help control your symptoms by exercising regularly, getting enough sleep, eating right, monitoring your moods, keeping stress to a minimum, and surrounding yourself with supportive people.