Manic Depressive Disorder
Bipolar Disorder or Manic Depression
Bipolar disorder is one of the mood disorders. In bipolar patients, their emotion fluctuates within an abnormal range. It alternates from periods of euthymia (normal a normal, tranquil mental state or mood) to periods of mania, hypomania, or depression. Depending on the type (more depressive, manic or mixed episodes), bipolar disorder is further divided into subcategories (type I, II, III, IV).
Conversely, when bipolar patients are in a “hypomanic” or “manic” state, they do not understand the seriousness of their condition. During that time period, they feel full of energy, they have the sense they do not need any sleep, they can talk incessantly and faster than usual, experience racing thoughts, they may be sexually aroused or spend huge amounts of money on things they do not need.
Notable personalities from the present and past such as Vincent Van Gogh, Ernest Hemingway, Francis Ford Copolla, Mariah Carey, Catherine Zeta-Jones, Stephen Fry, Richard Dreyfuss, Mel Gibson, Frank Sinatra and many other celebrities have reported or are believed to be suffering or suffering from bipolar disorder (click here to see a full list of notable people with bipolar).
Depression is a common and serious medical illness that negatively affects the way one feels, the way they think and how the depressed patient acts. Fortunately, it’s also treatable. Depression causes feelings of sadness and / or loss of interest in activities that they once enjoyed. It can lead to a variety of emotional and physical problems and may reduce one’s ability to work at work and at home.
Symptoms of depression can range from mild to severe and may include:
- Feeling sad
- Loss of interest or pleasure in activities that previously gave him/her pleasure
- Appetite changes – loss or weight gain that is unrelated to diet
- Sleep problems (insomnia or need for more sleep).
- Loss of energy or increased fatigue
- Increased unnecessary physical activity (eg, hand strokes or gait) or slowing movements and speech (actions that can be observed by others)
- Feeling worthless or guilt
- Difficulty in clear thinking, concentration or decision making
- Thoughts of death or suicide In more serious situations, strange thoughts or behaviors may occur
Symptoms should last at least two weeks to diagnose depression.
The manic phase of bipolar disorder involves an unusually high level of energy and activity. It is common for people at this stage to experience multiple ‘galloping’ thoughts, less need for sleep, and difficulty concentrating or being over-observing. Their speech rate may be increased. Also, during the manic episodes they may display brazen, aggressive or weird behavior that they did not have before.
It is the state of over-functioning of my brain and body that looks like mania but with less clinical presentation. These episodes may be the most difficult to diagnose, since the patient is functional and over-productive for long periods, without reaching the levels of intensity and severity of the mania.
More rarely, there are patients with mixed symptoms. Thus, they could be depressed or have some of the symptoms of depression, but have increased sexual appetite or have galling thoughts or spend excessive amounts on products they would not buy.
The treatment that follows is based on the agreement the therapist will make with the patient. Depending on the symptoms, the patient is usually prescribed corresponding preparations. Thus, in depressive episodes, administration of a new generation of antidepressants or antipsychotics, combining or selecting one of the two with a mood stabilizer is desirable. Findings on the combination of olanzapine-fluoxetine, aripiprazole, quetiapine are encouraging for severe depressive episodes of bipolar disorder. In more severe cases a combination of carbamazepine or lithium is necessary.
For manic episodes, antipsychotic drugs are more effective than mood stabilizers (or antiepileptic). Risperidone, olanzapine, aripiprazole or quetiapine are considered as one of the best options available for the treatment of manic episodes. In these patients, mood stabilizers reduce relapses when they return to the normal phase.
In normal (mood) periods, prescribing only one mood stabilizer is in accordance with the guidelines. Thus, preservation of valproic acid or lithium prescription in people suffering from multiple episodes of mania and carbamazepine or lithium in cases suffering from multiple episodes of depression is legitimate.
According to international literature, the combination of medication and psychoeducation has the best therapeutic effect. The treatment, although long-lasting, is successfully treated with the appropriate support and cooperation with the therapist.