Manic depression, or bipolar affective disorder. Manic-depressive psychosis: symptoms and signs What is manic depression

Manic-depressive psychosis (MDP) refers to severe mental illnesses that occur with a sequential change of two phases of the disease - manic and depressive. Between them there is a period of mental “normality” (a bright interval).

Causes of manic-depressive psychosis

The onset of the disease is most often observed at the age of 25-30 years. Relative to common mental illnesses, the rate of MDP is about 10-15%. There are from 0.7 to 0.86 cases of the disease per 1000 population. Among women, pathology occurs 2-3 times more often than in men.

Note:The causes of manic-depressive psychosis are still under study. A clear pattern of inheritance transmission of the disease has been noted.

The period of pronounced clinical manifestations of pathology is preceded by personality characteristics - cyclothymic accentuations. Suspiciousness, anxiety, stress and a number of diseases (infectious, internal) can serve as a trigger for the development of symptoms and complaints of manic-depressive psychosis.

The mechanism of development of the disease is explained by the result of neuropsychic breakdowns with the formation of foci in the cerebral cortex, as well as problems in the structures of the thalamic formations of the brain. Dysregulation of norepinephrine-serotonin reactions caused by a deficiency of these substances plays a role.

Disorders of the nervous system in MDP were dealt with by V.P. Protopopov.

How does manic-depressive psychosis manifest?

Symptoms of manic-depressive psychosis depend on the phase of the disease. The disease can manifest itself in manic and depressive forms.

The manic phase can occur in the classic version and with some peculiarities.

In the most typical cases, it is accompanied by the following symptoms:

• inappropriately joyful, exalted and improved mood;
• sharply accelerated, unproductive thinking;
• inappropriate behavior, activity, mobility, manifestations of motor agitation.

The beginning of this phase in manic-depressive psychosis looks like a normal burst of energy. Patients are active, talk a lot, try to take on many things at the same time. Their mood is high, overly optimistic. Memory sharpens. Patients talk and remember a lot. They see exceptional positiveness in all events that take place, even where there is none.

Excitement gradually increases. The time allocated for sleep is reduced, patients do not feel tired.

Gradually, thinking becomes superficial; people suffering from psychosis cannot focus their attention on the main thing, they are constantly distracted, jumping from topic to topic. In their conversation, unfinished sentences and phrases are noted - “language is ahead of thoughts.” Patients have to constantly return to the unsaid topic.

The patients' faces turn pink, their facial expressions are excessively animated, and active hand gestures are observed. There is laughter, increased and inadequate playfulness; those suffering from manic-depressive psychosis talk loudly, scream, and breathe noisily.

Activity is unproductive. Patients simultaneously “grab at” a large number of things, but do not bring any of them to a logical end, and are constantly distracted. Hypermobility is often combined with singing, dance movements, and jumping.

In this phase of manic-depressive psychosis, patients seek active communication, interfere in all matters, give advice and teach others, and criticize. They exhibit a pronounced overestimation of their skills, knowledge and capabilities, which are sometimes completely absent. At the same time, self-criticism is sharply reduced.

Sexual and food instincts are enhanced. Patients constantly want to eat, sexual motives clearly appear in their behavior. Against this background, they easily and naturally make a lot of acquaintances. Women begin to use a lot of cosmetics to attract attention.

In some atypical cases, the manic phase of psychosis occurs with:

• unproductive mania– in which there are no active actions and thinking does not accelerate;
• solar mania– behavior is dominated by an over-cheerful mood;
• angry mania– anger, irritability, dissatisfaction with others come to the fore;
• manic stupor– manifestation of fun, accelerated thinking is combined with motor passivity.

There are three main symptoms in the depressive phase:

• painfully depressed mood;
• sharply slow pace of thinking;
• motor retardation up to complete immobilization.

The initial symptoms of this phase of manic-depressive psychosis are accompanied by sleep disturbances, frequent awakenings at night, and inability to sleep. Appetite gradually decreases, a state of weakness develops, constipation and pain in the chest appear. The mood is constantly depressed, the patients' faces are apathetic and sad. Depression increases. Everything present, past and future is presented in black and hopeless colors. Some patients with manic-depressive psychosis have ideas of self-blame, patients try to hide in inaccessible places, and experience painful experiences. The pace of thinking slows down sharply, the range of interests narrows, symptoms of “mental chewing gum” appear, patients repeat the same ideas, in which self-deprecating thoughts stand out. Those suffering from manic-depressive psychosis begin to remember all their actions and attach ideas of inferiority to them. Some consider themselves unworthy of food, sleep, respect. They feel that doctors are wasting their time and unreasonably prescribing medications for them, as if they are unworthy of treatment.

Note:Sometimes it is necessary to transfer such patients to forced feeding.

Most patients experience muscle weakness, heaviness throughout the body, and they move with great difficulty.

With a more compensated form of manic-depressive psychosis, patients independently look for the dirtiest work for themselves. Gradually, ideas of self-blame lead some patients to thoughts of suicide, which they may well turn into reality.

It is most pronounced in the morning hours, before dawn. By evening, the intensity of her symptoms decreases. Patients mostly sit in inconspicuous places, lie on beds, and like to lie under the bed, as they consider themselves unworthy to be in a normal position. They are reluctant to make contact; they respond monotonously, slowly, without unnecessary words.

The faces bear the imprint of deep sorrow with a characteristic wrinkle on the forehead. The corners of the mouth are downturned, the eyes are dull and inactive.

Options for the depressive phase:

• asthenic depression– in patients with this type of manic-depressive psychosis, ideas of their own callousness in relation to loved ones dominate, they consider themselves unworthy parents, husbands, wives, etc.
• anxious depression– occurs with the manifestation of extreme degrees of anxiety, fears, leading patients to... In this state, patients can fall into a stupor.

Almost all patients in the depressive phase experience Protopopov’s triad – rapid heartbeat, dilated pupils.

Symptoms of disordersmanic-depressive psychosisfrom the internal organs:

• dry skin and mucous membranes;
• lack of appetite;
• in women, disorders of the menstrual cycle.

In some cases, MDP is manifested by dominant complaints of persistent pain and discomfort in the body. Patients describe the most varied complaints from almost all organs and parts of the body.

Note:Some patients try to resort to alcohol to alleviate complaints.

The depressive phase can last 5-6 months. Patients are unable to work during this period.

Cyclothymia is a mild form of manic-depressive psychosis

There are both a separate form of the disease and a milder version of TIR.

Cyclotomy occurs in phases:

How does TIR proceed?

There are three forms of the disease:

• circular– periodic alternation of phases of mania and depression with a light interval (intermission);
• alternating– one phase is immediately replaced by another without a light interval;
• single-pole– identical phases of depression or mania occur in a row.

Note:Usually the phases last for 3-5 months, and light intervals can last several months or years.

Manic-depressive psychosis at different periods of life

In children, the onset of the disease may go unnoticed, especially if the manic phase is dominant. Young patients look hyperactive, cheerful, playful, which does not immediately make it possible to note unhealthy traits in their behavior compared to their peers.

In the case of the depressive phase, children are passive and constantly tired, complaining about their health. With these problems they get to the doctor faster.

In adolescence, the manic phase is dominated by symptoms of swagger, rudeness in relationships, and there is a disinhibition of instincts.

One of the features of manic-depressive psychosis in childhood and adolescence is the short duration of the phases (on average 10-15 days). With age, their duration increases.

Treatment of manic-depressive psychosis

Treatment measures are based on the phase of the disease. Severe clinical symptoms and the presence of complaints require treatment of manic-depressive psychosis in a hospital. Because, being depressed, patients can harm their health or commit suicide.

The difficulty of psychotherapeutic work lies in the fact that patients in the depression phase practically do not make contact. An important point in treatment during this period is the correct selection antidepressants. The group of these drugs is diverse and the doctor prescribes them based on his own experience. Usually we are talking about tricyclic antidepressants.

If the state of lethargy is dominant, antidepressants with analeptic properties are selected. Anxious depression requires the use of drugs with a pronounced calming effect.

In the absence of appetite, treatment of manic-depressive psychosis is supplemented with restorative medications

During the manic phase, antipsychotics with pronounced sedative properties are prescribed.

In case of cyclothymia, it is preferable to use milder tranquilizers and antipsychotics in small dosages.

Note:quite recently, lithium salts were prescribed in all phases of treatment for MDP; at present, this method is not used by all doctors.

After exiting the pathological phases, patients must be included in various types of activities as early as possible; this is very important for maintaining socialization.

Explanatory work is carried out with patients' relatives about the need to create a normal psychological climate at home; a patient with symptoms of manic-depressive psychosis should not feel like an unhealthy person during light periods.

It should be noted that in comparison with other mental illnesses, patients with manic-depressive psychosis retain their intelligence and performance without degradation.

Interesting! From a legal point of view, a crime committed during the aggravation phase of TIR is considered not subject to criminal liability, and in the intermission phase it is considered criminally punishable. Naturally, in any condition, those suffering from psychosis are not subject to military service. In severe cases, disability is assigned.

Manic-depressive psychosis (the modern name is bipolar affective disorder, bipolar disorder) is a fairly common disease that affects 5-7 people per thousand of the population. This disorder was first described in 1854, but over the past centuries it has remained a big mystery not only for patients, but even for doctors.

And the point here is not that bipolar disorder is somehow difficult to treat or its development is impossible to predict, but that this psychosis is too “many-sided,” which seriously complicates diagnosis. In fact, each doctor has his own idea of ​​what the clinical picture of a given disease should look like, so patients are forced to deal with the “subjectivity of diagnosis” over and over again (as it is written about bipolar disorder on Wikipedia).

Manic-depressive psychosis is an endogenous disease, that is, based on a hereditary predisposition. The mechanism of inheritance has not been sufficiently studied, research continues, but human chromosomes are definitely to blame for the occurrence of symptoms of bipolar disorder. If there are already patients with manic-depressive psychosis in the family, then the same disease may appear in subsequent generations (although not necessarily).

There are other factors that can provoke the onset of the disease (but only if there is a hereditary predisposition - if there is none, then the person will not face manic-depressive psychosis). These include:

1. Endocrine changes (adolescence, pregnancy and childbirth in women, etc.).
2. Psychogenic factors (stress, severe fatigue, working “extremely” for a long time, etc.).
3. Somatogenic factors (some diseases, especially those accompanied by hormonal changes).

Since manic-depressive psychosis often occurs against the background of serious psycho-emotional shocks, it can be confused with neurotic conditions, for example, reactive depression. In the future, the diagnosis is most often adjusted if the patient exhibits symptoms and signs that are not characteristic of neuroses, but typical of manic-depressive psychosis.

A useful video about how important it is to distinguish bipolar affective disorder from other mental disorders and diseases, what manifestations characterize manic-depressive psychosis and why this diagnosis is difficult for a teenager or child

According to statistics, symptoms of manic psychosis occur more often in men. The onset of the disease usually occurs between the ages of 25 and 44 years (46.5% of all cases), but a person can get sick at any age. This diagnosis is made extremely rarely in children, since the diagnostic criteria used for adults can be used in childhood to an extremely limited extent. However, this does not mean that manic-depressive psychosis does not occur in children at all.

How it manifests itself

Manic-depressive psychosis is characterized by the presence of several phases, which are also called affective states. Each of them has its own manifestations; sometimes the phases can differ radically from each other, and sometimes proceed rather blurredly. On average, each phase lasts approximately 3-7 months, although this period can range from a few weeks to 2 years or more.

A patient in the manic phase of bipolar disorder experiences a great surge of energy, is in a great mood, motor agitation is also noted, appetite increases, and sleep duration decreases (up to 3-4 hours a day). The patient may be overwhelmed by some very important idea for him, it is difficult for him to concentrate, he is easily distracted, his speech is fast, his gestures are fussy. At the peak of manic frenzy, it can be very difficult to understand the patient, since his speech loses coherence, he speaks in fragments of phrases or even individual words, and cannot sit still due to overexcitation. After passing the “peak”, the symptoms gradually fade away, and the person himself may not even remember his strange behavior; he is overcome by loss of strength, asthenia and mild lethargy.

The depressive phase of bipolar affective disorder is manifested by reduced, depressed mood, inhibition of movements and thinking. The patient loses his appetite, food seems tasteless to him, and significant weight loss is also possible. Women sometimes lose their periods.

As with ordinary depression, patients feel worst in the morning, waking up in a state of anxiety and melancholy. By evening, the condition improves, the mood rises slightly. At night it is difficult for the patient to fall asleep; insomnia can last for a very long time.

In the stage of severe depression, a person can lie in one position for hours, he has delusional ideas about his own worthlessness or immorality. This phase of MDP is not characterized by hallucinations and “voices”, but the appearance of dangerous suicidal thoughts is possible, which can develop into attempts to commit suicide.

As with the manic stage, after the most acute period has passed, depressive symptoms gradually subside. For some time, the patient may remain rather lethargic and asthenic, or vice versa - become overly talkative and active.

The signs of manic-depressive psychosis can be very diverse; it is very difficult to talk about all the variants of the course of the disease in one article. For example, the depressive and manic phases do not necessarily have to follow each other strictly - they can alternate in any order. Also, with manic-depressive disorder, the manic phase can be expressed quite weakly, which sometimes leads to incorrect diagnosis. Another common option is rapidly cycling bipolar disorder, when episodes of mania or depression recur more than 4 times a year. And these are only the most common forms of bipolar disorder; in fact, the clinical picture of the disease can be even more diverse and atypical.

Why is manic psychosis dangerous?

The possibility of suicide during the depressive phase of the disease has already been mentioned above. But this is not the only thing that can cause harm to both the patient himself and those around him.

The fact is that at the moment of highest euphoria, a person suffering from bipolar disorder is not aware of his own actions; he seems to be in an altered state of consciousness. In some ways, this state is similar to drug intoxication, when the patient feels that nothing is impossible for him, and this can lead to dangerous impulsive actions. Delusions of dominance also affect a person's perception of reality, and during such delusions, he can cause serious harm to his loved ones who refuse to “submit” to him or do something with which he categorically disagrees.

In the depressive phase, anorexia may develop due to loss of appetite, and this disorder in itself is very difficult to cure. In some cases, the patient may self-harm during an attack of hatred towards his body.

And both phases are extremely exhausting for the human body and psyche. Constantly going from one extreme to another depletes moral strength, and physical symptoms and constant anxiety negatively affect the patient’s body. Therefore, it is very important to start proper treatment on time, always with the use of medications.

Manic psychosis in children and adolescents

It is believed that such a diagnosis is practically not given to children under 10 years of age. This is due to the difficulties of diagnosis and the atypical manifestation of the phases, which is very different from the “adult” course of the disease.

In children, manic-depressive psychosis is blurred, the symptoms are difficult to separate from ordinary childhood behavior, which in itself is not very stable.

The depressive phase of the disease in a child may manifest itself as slowness, passivity, and lack of interest in toys and books. The student’s academic performance decreases, it is difficult for him to communicate with peers, and his appetite and sleep also worsen. The child also complains of physical ailments, pain in different parts of the body, and weakness. This condition must be differentiated from endogenous depression, which requires long-term and careful monitoring of the child’s mood and physical condition.

The manic phase is characterized by increased motor activity, a desire for new entertainment and a constant search for it. It is literally impossible to calm a child down; at the same time, he practically does not support the rules of the game; his actions are spontaneous and largely devoid of logic. Unfortunately, this condition is quite difficult to distinguish from normal childhood behavior, especially if the symptoms of mania do not reach the point of complete frenzy.

The older the child and the closer he is to adolescence, the clearer the differences between the depressive and manic phases become. It is during this period that diagnosis becomes possible, including with the help of tests that are used to diagnose adult patients.

The clinical picture of manic-depressive psychosis in adolescents usually contains all the symptoms characteristic of this disease, especially the depressive phase. Suicidal thoughts that arise are a great danger for adolescents, since during puberty the understanding of the value of life is not yet sufficiently developed, therefore the risk of “successful” attempts to commit suicide is higher.

The manic phase at this age may not be so clear; some parents may even greet its manifestations with joy, especially if the child was previously in a state of anxiety and melancholy. A teenager in a manic phase is literally “gushing” with energy and new ideas, can stay awake at night, make grandiose plans, and during the day endlessly search for entertainment and new company.

To correctly diagnose a teenager, parents and doctors need to carefully observe the behavior of a potential patient. In bipolar disorder, symptoms of mania or depression are most likely to occur during certain times of the year. Another important point is the rapid change of mood, which is not typical for a healthy person: just yesterday the teenager was in an elevated state of mind, but today he is inhibited, apathetic, etc. All this may lead to the idea that the child is suffering from a mental disorder, and not from hormonal changes typical of adolescence.

Diagnosis and treatment

On the Internet you can find tests that you can take yourself and determine the symptoms of manic-depressive psychosis. However, you should not rely entirely on their results; this disease cannot be diagnosed using only one test.

The main diagnostic method is to collect anamnesis, that is, information about the patient’s behavior over a fairly long period of time. The manifestations of bipolar disorder resemble the symptoms of many other mental illnesses, including those from the group of psychoses, so a thorough analysis of all the information received is necessary to make a diagnosis.

Doctors also use special tests for diagnosis, but usually these are several different questionnaires, the results of which are processed by a computer to make it easier for the doctor to formulate an overall picture of the disease.

In addition to tests, the patient is offered to undergo examinations by specialized specialists and undergo tests. Sometimes the cause of manic-depressive psychosis can be, for example, endocrine disorders, and in this case it is necessary to treat the underlying disease first.

As for the treatment of manic psychosis, it does not always take place in a hospital. Urgent hospitalization is required for:

• severe suicidal thoughts or suicide attempts;
• hypertrophied sense of guilt and moral inferiority (due to the danger of suicide);
• tendency to conceal one’s condition and symptoms of the disease;
• a state of mania with pronounced psychopathic behavior, when the patient can be dangerous to people around him;
• severe depression;
• multiple somatic symptoms.

In other cases, treatment of manic-depressive psychosis is possible at home, but under the constant supervision of a psychiatrist.

For treatment, mood stabilizers (mood stabilizers), neuroleptics (antipsychotic drugs), and antidepressants are used.

It has been proven that lithium drugs are guaranteed to reduce the possibility of suicide by reducing the patient’s aggressiveness and impulsivity.

The doctor decides how to treat manic-depressive psychosis in each specific case; the choice of medications depends on the phase of the disease and the severity of the symptoms. In total, the patient can receive 3-6 different drugs during the day. When the condition stabilizes, the dosage of medications is reduced, selecting the most effective maintenance combination, which the patient must take for a long time (sometimes for life) in order to remain in remission. If the patient strictly follows the doctor’s recommendations, then the prognosis for the course of the disease is favorable, although sometimes the doses of drugs will need to be adjusted to avoid exacerbations.

Manic psychosis is also treated with psychotherapy, but in this case this method should not be considered the main one. It is completely unrealistic to cure a genetically determined disease only by working with a psychotherapist, but this work will help the patient to perceive himself and his illness more adequately.

Summarize

Manic psychosis is a disorder that affects people regardless of their gender, age, social status and living conditions. The causes of this condition have yet to be discovered, and the features of the development of bipolar disorder are so varied that doctors sometimes find it difficult to make a correct diagnosis.

Can this disease be cured? There is no definite answer, but if the patient conscientiously follows all his doctor’s prescriptions, then the prognosis will be very optimistic, and the remission will be stable and long-lasting.

Manic depression is a mental disorder manifested by two affective states: manic and depressive, replacing each other.

This condition is characterized by constant mood swings.

Characteristics of the disease

Manic depression is a disease based on genetic predisposition. It is represented by the following phases:

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• manic;
• depressed;
• mixed.

Bipolar depression is characterized by a sharp change in phases. In the mixed phase, there is a combination of manic and depressive symptoms, which can manifest themselves in different variations. It can also manifest itself in only manic or only depressive phases.

The duration of the phase can range from several weeks to several years, the average duration is from 3 to 7 months. As a rule, manic phases are 3 times shorter in duration than depressive phases.

After this period, a quiet period begins, which can last from 3 to 7 years, but may be completely absent.

Manic depression can take severe forms and requires serious psycho-emotional correction.

It is difficult to accurately estimate the prevalence of the disease. This is due to the variety of assessment criteria and inevitable subjectivity in diagnosis. In almost half of the patients, the first signs of the disease were detected at the age of 25-44 years.

In most cases (75%), manic depression occurs against the background of other mental disorders. Unlike schizophrenia, manic depression does not cause personality degradation.

Bipolar manic depression is more common in men than in women. Women who experience a mental disorder during the postpartum period are significantly more likely to develop it. For example, if an attack occurs within 2 weeks after birth, this risk increases 4 times.

According to ICD-10, this disorder corresponds to code F.30 - Manic episode, F.30.8 - Other manic episodes, F.30.9 - Unspecified manic episode.

Causes

The main reason is the genetic predisposition and psychotype of a person. More often among patients there are people of a psychasthenic and cycloid type.

Provoking factors that can cause the onset of the disease include:

• psychological trauma;
• prolonged stress;
• somatic pathologies;
• brain damage of traumatic and infectious nature.

Symptoms of manic depression

The severity of symptoms may vary from patient to patient. There are both mild disorders and severe mania and depression.

The occurrence of anxiety states has no real basis. Patients avoid communication and try not to talk. People with this diagnosis do not like long pauses.

Additional symptoms may include: lack of appetite, bradycardia, gastrointestinal problems, insomnia, weight loss. Patients are haunted by thoughts of suicide and delusional ideas. The patient's hands are in constant motion, his eyes run around. He often changes his position and is constantly fiddling with something.

There are 2 stages in which it is necessary to urgently call an ambulance to hospitalize the patient:

Hidden forms of manic depression - cyclomythia - are common. It is believed that they affect about 80% of the population. Moreover, the symptoms are so vague that neither those around nor the person himself even suspect the disease. The person is active, able to work, the condition that has arisen does not cause obvious inconvenience or affect work.

Phases

Depressed

In most cases, manic depression is characterized by depressive rather than manic states.

During the depressive phase, the following signs are observed:

The depressive phase is characterized by constant negative thinking, unreasonable feelings of guilt, and self-flagellation. This condition can grow so strong that a person begins to be haunted by thoughts of suicide.

When these conditions are identified, they must be treated. If no action is taken, the disease can progress, ending in a state of complete stupor, in which the patient stops moving and speaking at all.

Visually, the disease can manifest itself as dilated pupils, interruptions in the heart rhythm (arrhythmias, tachycardia, bradycardia). Another possible symptom is the development of spastic constipation caused by spasms of the muscles of the stomach and intestines.

There are 4 stages of the phase:

Manic

After the depressive phase, the manic phase begins, which is manifested by the following symptoms:

• elevated mood;
• excessive motor and speech activity;
• temporary increase in working capacity.

During the depressive phase, the symptoms manifest themselves quite clearly, while the manic phase may pass more calmly. However, in the future, gradually progressing, the disease even in this phase becomes more pronounced.

The patient is characterized by an illusory perception of the world; he assesses any situation overly optimistically and does not take reality into account. Delusional ideas may arise, the person is overly active both in actions (makes unnecessary movements) and in conversations (it is almost impossible to stop the flow of words).

In this phase, the patient goes through 5 stages:

Mixed

In this phase, one of the components studied in the clinical picture (motor activity, mood, thinking) is contrasted with the others.

Such conditions are common and cause difficulties in diagnosis, and, consequently, in the selection of treatment methods.

In children

In childhood, it is diagnosed less frequently than other disorders, such as schizophrenia. As a rule, the clinical picture does not include all characteristic symptoms.

Cases are more common in children over 10 years of age, but medicine also records manifestations of manic depression in children 3-4 years old.

The course of the disease in children is characterized by a more frequent occurrence of attacks. Young children are characterized by a predominance of the manic rather than the depressive phase.

Diagnostics

To accurately diagnose the disease, constant monitoring of symptoms, behavioral changes, and the duration and frequency of attacks is necessary. The most common symptom is a sudden change in mood, but this can occur in different ways.

If you suspect this condition, you should seek advice from a psychiatrist. The doctor conducts an examination and inquires about the presence of mental illness in the family. If mood changes occur more than 4 times a year, then getting rid of the disorder will be more difficult.

Nowadays, mental illnesses are becoming more and more common. This is due to the fact that every day a person faces stress and other tensions that harm our psychological state. Sometimes a normal psychological disorder can develop into manic depression.

Causes and development of manic depression

Manic-depressive syndrome is a mental disorder that occurs against the background of wave-like psycho-emotional states: depressive and manic. Between these phases, mental disorders may disappear completely. Scientists have found that manic-depressive psychosis is a genetic disease. It can be inherited, but even if one of your relatives suffered from this disease, this does not mean that it will manifest itself in you. Everything will depend on external factors: the conditions in which you grew up, the environment, the level of mental stress, and so on.

Most often, the disease makes itself felt in adulthood. Moreover, the disease does not immediately manifest itself in acute form. After some time, family and friends begin to notice that the disease is progressing. First of all, the psycho-emotional background changes. A person may be too depressed, or, conversely, too cheerful. These phases replace each other, with depression lasting longer than joy.

This condition can last for a very long time - from several months to several years. Therefore, if the ailment is not identified in a timely manner and medical assistance is not provided, then the harbingers of the disease will go directly into the disease itself - manic-depressive psychosis.

Depressive phase of the disease

As mentioned above, the disease mainly occurs in the depressive phase. This phase has three main features:

• Bad mood;
• The appearance of physical and speech inhibition;
• The appearance of pronounced intellectual inhibition.

The patient's thoughts are too negative. He develops a groundless sense of guilt, self-flagellation and self-destruction. In this state, people often decide to commit suicide.

Depression can be physical or mental. With mental depression, a person experiences a depressed psycho-emotional state. In the physical form of depression, problems with the cardiovascular system are added to the depressed psycho-emotional state.

If treatment is not started when these symptoms appear, the person may fall into a stupor. He can be absolutely motionless and silent. The person stops eating, going to the toilet, and responding to calls to him. In addition, the physiological state of the patient changes: the heart rhythm is disturbed, arrhythmia, bradycardia appears, the pupils dilate.

Manic phase of the disease

The depressive phase gives way to the manic phase. This phase includes:

• Pathological increase in mood - manic effect;
• Excessive motor and speech stimulation;
• Temporary increase in performance;

This phase has many specific features. It most often does not occur in a pronounced form, so only an experienced doctor can determine it. But as the disease progresses, the manic phase becomes more pronounced.

A person’s mood is too optimistic, and he begins to assess reality too positively. The patient may have delusional ideas. In addition, motor and speech activity increases.

Features of the course of manic depression

Most often, doctors are faced with the classic form of the disease, but there are exceptions. In such cases, it is very difficult to timely identify the disease and begin its treatment.

For example, there is a mixed form of manic depression - when psychosis makes itself felt differently. In the mixed form, some symptoms of one phase are replaced by certain symptoms of another phase. For example, a depressive state may be accompanied by excessive nervous excitability, while inhibition may be completely absent.

The manic stage can be expressed by emotional upsurge with pronounced intellectual and mental retardation. The patient’s behavior in this case is difficult to predict: it may be inadequate or completely normal.

Also, sometimes doctors encounter erased forms of manic-depressive syndrome. The most common form is cyclothymia. With this form, all the symptoms of the disease are very blurred. Therefore, a person can maintain full working capacity. And his friends and family may not even know about the presence of the disease.

Sometimes the disease, in its vague form, occurs with an open form of depression. But it is also almost impossible to detect, because even the patient may not be aware of the reasons for his bad mood. The danger with hidden forms of manic depression is that they can go unnoticed. As a result, a person may resort to suicide.

Symptoms of classic manic-depressive syndrome

The patient begins to experience a strong feeling of anxiety. Moreover, the anxiety is completely unfounded. Most often, patients worry about their future or about their relatives. As a rule, the doctor immediately distinguishes this condition from ordinary melancholy. After all, in such people, anxiety is reflected on the face: an unblinking gaze and a tense face. And in conversation such people are not too frank.

If there is improper contact with a patient, a person may simply withdraw into himself. Therefore, the patient’s relatives should know the basic rules of behavior and how to properly establish contact. It is very important to start the conversation correctly - you need to pause.

If a person is simply depressed, then after a pause he can remain silent for a very long time. A person suffering from manic depression will not tolerate a long pause and will start a conversation. During the conversation, it is worth observing the patient’s behavior. Such a person’s gaze will be shifty and restless, he will constantly fiddle with something in his hands: clothes, a button, a sheet. It is difficult for such people to remain in the same position for a long time, so they get up and walk around the room. In severe cases, patients lose control of themselves. The person may become completely stupefied or begin to pace frantically around the room, crying or screaming. The patient loses his appetite.

In especially severe forms of the disease, patients are placed in special medical institutions, where they receive the full necessary care. Without professional help, the condition will only get worse.

The patient is prescribed special medications, which are selected individually by the doctor. In cases of lethargy, medications are prescribed that stimulate activity. In case of increased excitability, sedatives are prescribed.

If correct and timely treatment is provided, the prognosis for recovery is favorable. After some time, the patient can return to a full-fledged lifestyle. Therefore, when the first symptoms of the disease appear, it is better to play it safe and consult a doctor to establish a diagnosis.

All people experience fear sometimes. It can be caused by a number of different factors. Fear is the feeling we experience when we are in some dangerous situation, regardless of the real or imaginary danger. Fear is an illusion that creates its own reality and which we often perceive as real reality. When a person is overcome by fear, she unconsciously or consciously puts into action a whole series of defense mechanisms to avoid fear, to run away from it, instead of thinking it through thoroughly.

If this sounds like you, then you'll probably agree that you don't try to confront your fears at all because they scare you.

Fear destroys us in this way. He has the power to control your thoughts and convince you that you cannot resist him. I don’t want to turn the story into some kind of horror story about how “something” guides your actions and behavior, reminiscent of the plot of some Hollywood horror film, but this is exactly how fear acts on most people.

It can manifest itself in many things. It's not normal when your life is controlled by fear, this is not your path. You can manage your fears.

What fears affect me?

Fear is inherent

Innate fear

Acquired fear

Manic fear

Fear is inherent It's fear that makes you cautious. This is a healthy and completely normal fear. Imagine that you are riding a bicycle at very high speed. The wind is whistling in your ears, adrenaline is playing in your blood, you continue to pick up speed, but suddenly you accidentally hit some stone that was lying on the road, the steering wheel moved a little, you lost control of the bike a little - this caused a flash of fear that your brain perceives , as a signal that you need to slow down, because driving very fast can lead to a fall. Your actions are common sense.

Innate fear– a fear that has been there since your birth. For example, some people are afraid of snakes and birds. There is even a fear of scientific terms. Most people cannot explain the reasons for these fears; it is on a subconscious level. These fears can be eliminated, but an individual and careful approach is needed.

Acquired fear– fear that was acquired over some time of personality development. Let's take a situation. Suppose that in a physical education lesson you are ready to pass the standard - rope climbing, but you think that you will not succeed and in general you have never liked climbing a rope. “Why do I need it,” you think, “I don’t know how to climb and I don’t want to, but the girls will look, no, it’s better to tell the teacher that my hand hurts.” You may have fear of this situation because you are already focused on the fact that you are bad at rope climbing, you start thinking about what others will think, and come up with ways to “escape”. This is an acquired fear. In the future, it may manifest itself in other situations, but its nature will be the same, you will be afraid of what you cannot do. This fear will discourage even the idea that a little practice and self-belief can solve these problems. If you give yourself a chance and set a goal, then with practice you will get rid of this fear.

Manic fear- this is the strongest fear that keeps a person in its power, and is considered a clinical case. To get rid of this fear you need time and the right and competent help from professionals.

Remember, fears can be forgotten.

Fear makes you constantly think: what will happen if?

What happens if... I don’t pass the exams and don’t get into the University?
What happens if... I can't find a job?
What will happen... if I don't find a true friend?
What will happen if... I'm left alone?

It hurts. If we ask ourselves “What would happen if...?” in every single situation of our life, then we will receive so many incredible scenarios for the development of events that will only puzzle us. We would end up doing nothing with life. This is a negative spiral that moves in a downward circle and you should not give in to these negative and destructive thoughts.

Fear prevents us from developing our potential. Fear will tell you to put off what you planned to do today until tomorrow or next week or forever. Fear doesn't want you to succeed. Fear will find many reasons why you will not be able to do what you planned. Fear will tell you that you have failed.

But this is a lie! Don't believe it! Fear makes us hide from ourselves and from others; it hides reality from us. Fear is the first reason for our adverbs and excuses to ourselves. It prevents us from seeing clearly, it disorients, it paralyzes.

It hinders your growth as a person and negatively affects your self-esteem and the assessment of others. This is a senseless fear.

How can I overcome my fear?

You can conquer your fear!

The main thing is to understand the problem correctly. It lies in the fact that most people, when faced with fear, simply run away or try to avoid the situations they are afraid of. Like ostriches, they bury their heads in the sand and naively believe that if they run away or hide, the fear will disappear on its own.

But that's not true!

Fear is always within us. If you can look fear straight in the eye, it means you have the resources and strength to manage any situation. You enrich yourself with knowledge, beginning to understand yourself better.

Look fear in the eyes, and you will understand that the cause of fear is ignorance and faith in yourself and your own strengths. You can begin to overcome your fear by eliminating these shortcomings. Since you build a new base, you begin to know and understand the cause of your fears, they will begin to disappear, since they will not be able to paralyze your consciousness.

Do not run away! Confront and fight fear, it will make you stronger and change your outlook on life to a more positive one.