Causes, symptoms and treatments for manic depression. What is dangerous about manic-depressive psychosis and how to cure it Manic fear

Manic depression (bipolar depression or bipolar affective disorder) is a psychogenic illness that is accompanied by frequent and sudden mood swings. Patients with this form of depression should be protected in every possible way from all kinds of stressful and conflict situations. The family environment should be as comfortable as possible. It is worth noting that it is quite different from ordinary depression.

In this article we will tell you what manic depression is, look at its causes and symptoms, tell you how to diagnose it, and also outline treatment methods.

The name of the disease itself consists of two definitions: depression is a depressed state, mania is an excessive, extreme degree of excitability. Those who suffer from this disease behave inappropriately, like the waves of the sea - sometimes calm, sometimes stormy.

It has been proven that manic-depressive illness is a genetic predisposition that can be passed on through generations. Often, it is not even the disease itself that is transmitted, but only the predisposition to it. It all depends on the environment of a growing person. Thus, the main reason is heredity. Another reason can be called a hormonal imbalance due to anything in life.

Not everyone knows how the disease manifests itself. As a rule, this happens after the child reaches 13 years of age. But its development is sluggish, at this age an acute form is not yet observed, moreover, it is similar to, but has a number of differences. The patient himself is unaware of the disease. However, parents can notice the underlying prerequisites.

You should pay attention to the child’s emotions - with this disease, the mood changes sharply from depressed to excited and vice versa.
If you leave everything to chance and do not provide medical assistance to the patient in time, then after some time the initial stage will turn into a serious illness -

Diagnostics

Recognizing and diagnosing manic-depressive syndrome is quite difficult and only an experienced psychotherapist can do it. The nature of the disease occurs in spurts, depression is replaced by excitability, lethargy is replaced by excessive activity, which makes it difficult to recognize. Even with a pronounced manic stage, the patient may experience noticeable mental retardation and intellectual capabilities.

Psychotherapists sometimes recognize mild forms of the disease, called cyclothymia, in 80% of seemingly healthy people.

As a rule, the depressive phase proceeds clearly and clearly, but the manic phase is relatively calm and can only be recognized by an experienced neurologist.

This condition cannot be left to chance; it must be treated.

In advanced cases, speech may deteriorate and motor retardation may appear. In extreme, severe form, the patient will fall into a stupor and become silent. Important functions will turn off: he will stop drinking, eating, independently fulfilling natural needs, and subsequently, generally reacting to the world around him.
Sometimes the patient has delusional ideas; he can evaluate reality in overly bright colors that have nothing to do with reality.

An experienced specialist will immediately distinguish this disease from ordinary melancholy. Strong nervous tension will be expressed in a tense face and unblinking eyes. It is difficult to call such a person for dialogue; he will be laconic and may generally become withdrawn.

The main symptoms of a manic state:

euphoria combined with irritability;
inflated self-esteem and sense of self-importance;
thoughts are expressed in a pathetic form, he often jumps from one topic to another;
imposition of communication, excessive talkativeness;
insomnia, the need for sleep decreases;
constant distraction by unimportant points that do not relate to the essence of the matter;
too much activity at work and in communication with loved ones;
promiscuity;
the desire to spend money and generally take risks;
sudden outbursts of aggression and severe irritation;
at stronger stages - all sorts of illusions about life.

Depressive symptoms:

feelings of inferiority and zero self-esteem;
constant crying, incoherence in thoughts;
incessant melancholy, a feeling of uselessness and hopelessness - the patient constantly feels guilty;
apathy, lack of vital energy;
chaotic movements, difficulty speaking, detached consciousness;
thoughts of suicide and death in general;
strong appetite or loss of appetite;
shifty gaze, hands constantly out of place - always fiddling with something;
tendency to take drugs;
loss of interest in life, loss of strength, apathy.

In severe cases, the patient's manic depression is manifested by numbness and loss of self-control - these factors are an alarming symptom.

Treatment

It is necessary to treat manic depression; therapy is carried out under the supervision of a specialist.

Treatment of the disease takes place in several stages. First, the doctor analyzes the symptoms, then prescribes a course of medications, which are selected purely individually. If there is emotional inhibition, apathy, the patient is prescribed medications that, when excited, must be taken

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.

Manic depression, or bipolar affective disorder (BD), is a severe mental illness in which a wave-like change in affective states (phases) occurs - from depressive (anxiety, melancholy, lethargy) to manic (involvement, hyperactivity, euphoria).

According to statistics, about 3% of the world's population suffers from bipolar disorder, and the disease most often begins in youth or adolescence, usually before the age of 25. Manic-depressive psychosis affects men and women equally, however, it has been noted that depressive syndromes often predominate in women, and manic syndromes in men.

The causes of manic-depressive syndrome are not fully understood, however, the main factor in the development of the disease is considered to be a genetic (hereditary) predisposition. In addition, brain injuries and diseases, significant neuropsychic stress and character traits can play a role.

Manic depression: symptoms and phases ^

Manic-depressive psychosis has many varieties. In some patients, it occurs in the form of an attack of depression, which after a few light years is replaced by manic symptoms. Alternatively, multiple depressive episodes may occur followed by a manic episode.

In some cases, only manic symptoms may occur, or the simultaneous presence of manic and depressive symptoms, which quickly replace each other, literally within a few hours. If bipolar disorder is not treated, the disease will continuously progress, and the intervals between individual phases will shorten. Moreover, the shorter the intervals, the harder and longer the healing process will take.

The main symptoms of the depression phase:

melancholy, anxiety, sadness, emptiness;
loss of interest in activities that previously aroused interest;
irritability and excessive anxiety;
feelings of helplessness, hopelessness, guilt;
inability to concentrate on anything and lack of vital energy;
physical, speech and intellectual inhibition;
lack of appetite, insomnia;
thoughts of suicide.

In addition to psychological problems, problems may arise in the functioning of the cardiovascular system (arrhythmia, tachycardia, bradycardia) and the gastrointestinal tract (spastic constipation). In especially severe cases, the patient may fall into a stupor - he stops eating, drinking, going to the toilet, does not respond to speech addressed to him and is completely immobile and silent.

Symptoms of the manic phase:

heightened self-esteem;
irritability and aggressive, often provocative behavior;
pathological increase in mood and causeless euphoria;
excessive talkativeness and motor agitation.

A patient who is in a manic phase loses the reality of perception of what is happening, endlessly generates completely delusional ideas, does not sit still and can talk almost incessantly for a long period of time.

Manic depression: treatment and diagnosis ^

A doctor makes a diagnosis of bipolar disorder after at least two episodes of affective mood swings. If an attack of depression is replaced by a mild manic state, or, conversely, after a manic attack a state of mild depression sets in, then a single depressive or manic episode is diagnosed.

Due to the seriousness of the disease, treatment of manic depression should only be carried out by a qualified psychotherapist. Self-medication is unacceptable, as it can be very dangerous and lead to dire consequences, including intellectual impairment, loss of productivity and suicide.

The treatment regimen is selected after a thorough examination and depends on what phase of the disease the patient is currently in. Doctors have a large selection of sedatives and antipsychotic drugs, antidepressants, neuroleptics and mood stabilizers in their arsenal.

When prescribing treatment, it is very important to avoid the development of phase inversion, that is, a sudden transition from mania to depression, and vice versa. For this purpose, patients, in addition to relief therapy, are prescribed mood stabilizers - drugs that stabilize mood. This effect is achieved due to the content of lithium salts in mood stabilizers, which reduce the tendency to mood swings in 70% of patients with bipolar disorder.

It is important to consider that excessive lithium concentration can have many side effects:

diarrhea,
nausea,
vomit,
excessive thirst,
frequent urination,
weight gain,
tremors and muscle twitching,
drowsiness,
heart rhythm disturbances,
decrease in thyroid hormones,
headache.

Therefore, treatment should be carried out with mandatory regular monitoring of lithium levels in the blood.

Side effects most often occur when treating elderly patients with lithium. Pregnant women and women planning pregnancy should not take lithium salts, as they can cause heart defects in the fetus.

In such cases, modern anticonvulsants are widely used as an alternative replacement, treatment of which should be carried out under constant monitoring of the number of leukocytes and erytrophytes in the blood (since there is a possible tendency for them to decrease) and liver function.

After relief of acute symptoms of the disease, in order to complete the main treatment, patients with manic depression are recommended to undergo a course of psychotherapy - this will help to better understand their illness and learn to cope with it. There is no need to think that the diagnosis of manic depression is a death sentence and consider yourself “abnormal.”

Conclusions ^

The results of a major study that analyzed the lives of a large number of brilliant people showed that many outstanding people (poets, composers, scientists, prominent political figures) suffered from manic-depressive psychosis.

It was in a state of hypomania, when the level of energy sharply increases, and thinking becomes clear and clear, that they were able to direct strength and energy in the right direction, as a result of which brilliant works were born.

Pushkin, Freud, Hemingway, Van Gogh, Churchill, Schopenhauer, Roosevelt, Gogol, Goethe, Dickens and many other greatest minds of mankind suffered from bipolar disorder. However, a heavy price to pay for their talent was an equally pronounced phase of depression, which replaced euphoria, when the meaning of life was lost and thoughts of suicide came.

But, fortunately, medical science has stepped far forward since then and we live in a time when modern technologies for treating mental illness have been improved to such an extent that they make it possible to completely remove the negative symptoms of manic disorders and restore health and mental balance.

Eastern horoscope for May 2019

Mental illnesses that are common nowadays leave an indelible mark on people. Many people believe that such problems will definitely bypass them. There are many people around us who have such diseases. These diseases can have a hidden form and the sick themselves do not always realize that they are sick. Timely treatment provided to such people helps them integrate into life and fully perceive it: work, get married, have a family and children.

Such patients need the most favorable environment of loved ones. Relatives of patients should know and constantly remember this. The microclimate in the family should be comfortable; stress and quarrels have no right to be present.

Causes

What is this disease? Let's consider this name as having two components: depression - depressed mood, mania - excessive excitability. The behavior of patients, sometimes in an inadequate state, resembles sea waves. Sometimes there is peace and quiet, sometimes there is a storm. Wave-like states of mood can disappear without affecting the patient’s personality.

Manic-depressive states are genetic diseases. Doctors confirm the fact that such a disease can pass through generations and be transmitted from grandparents. This does not mean that the disease is transmitted, but a predisposition to the disease is transmitted. Or it may not be transmitted; a lot will depend on the environment and development conditions. Parents must always know the heritage and remember it at the right moments in raising a child.

The disease begins to appear after the child reaches his thirteenth birthday. It does not develop immediately and in an acute form. The patient himself is also unaware of his illness. Those around you and relatives can, with sensitive attention, notice the prerequisites for this disease.

Initially, a person’s psyche and emotions may change slightly. The mood can change dramatically from depressed to excited. After a deep depressed state, your mood can sharply improve, and most importantly, the depressed state lasts much longer than the phase of a good mood.

Such conditions may occur in periods and ultimately last from 6 to 24 months. If you do not pay attention to this and do not notice such a person’s condition, and do not provide him with medical assistance in a timely manner, then an exacerbation will soon occur and the initial stage of the disease will turn into a real disease - depressive-manic psychosis.

Depression

This phase of the disease is characterized by depression and has three distinct signs:

Manifestation of bad mood. Constant depressed mood, accompanied by all sorts of real physical ailments: weakness, constant fatigue, lack of appetite.
Speech and physical retardation. Being in an inhibited state, a person has a reduced mental and physical reaction. The appearance of drowsiness and constant indifference is expressed on a person’s face like a mask; he is not interested in anything.
Intellectual inhibition. This condition is expressed in the inability to concentrate one’s attention on any object, be it TV, computer, reading or writing.

Constant negative thinking, feelings of guilt, it is not clear what and in front of whom, self-flagellation and self-destruction become a necessary activity for the patient. All this can be expressed in such great depression that the result can be suicide attempts.

Such depression can be of two types: physical and mental. Mental depression manifests itself in a depressed emotional and mental state. In the physical form of depression, problems in the functioning of the heart may be added to such a depressed state.

If such conditions are left to chance and not treated, they worsen to such an extent that speech may deteriorate, motor retardation will progress more and more, and ultimately the person may fall into a stupor - silent in a completely motionless state. A person sits motionless to such an extent that he stops eating, drinking, going to the toilet, and completely does not react to anything, no matter who turns to him.

In such patients, the pupils dilate greatly, and a disturbance in the heart rhythm occurs, which is expressed in the disease: arrhythmia, tachycardia or bradycardia. This may be accompanied by the development of spastic constipation, due to spasms of the muscles of the stomach and intestines.

Manic part of the disease

It has already been said above that in people with depressive-manic syndrome, each depressive state is replaced by a manic one. Disorders in the body included in the manic-depressive phase:

Manic mood enhancing effect.
Excessive strong motor and speech excitement, often for no reason.
Temporary increase in performance.

The depressive phase occurs quite pronounced, the manic phase, on the contrary, passes calmly, without any excesses. Only an experienced neuropathologist will be able to determine deviations in the behavior of such a patient. As the disease progresses, the manic part of the disease becomes more pronounced in its expression.

The patient's overly optimistic mood evaluates reality in very rosy colors that do not correspond to the present. Delusional ideas may arise, excessive movement activity may occur, and it is almost impossible to stop a person’s speech.

Symptoms

The features of the course of such a disease will differ from the previously listed neuropsychiatric diseases. We'll talk about this below. All these symptoms can be summed up in one definition: depression and anxiety.

A strong feeling of anxiety that does not leave the patient in this state, and even groundless, and if there is something to do with it, it is too depressed - a depressive-anxious state. A person experiences a feeling of anxiety for his loved ones, for their fate, the fear that something will happen to them: they will get hit by a car, lose their job, their home will burn down and many other worries do not leave the patient.

A psychiatrist can immediately distinguish such a disease from melancholy. A tense face and unblinking eyes indicate a feeling of intense nervous tension. It is not easy to call such people to be frank; they will remain silent and wait. And if one careless word slips through, the patient immediately closes down, and it will be impossible to get him to talk.

In order to alleviate the moral state of the patient and establish contact with him, it is necessary to remember the rules of behavior:

first: you need to be sure that this is a case of increased anxiety;
second: carefully monitor his behavior.

You can ask the person a question and take a short pause. If a person has a simple depressive state, the silence will be long. A person with anxiety symptoms cannot stand long pauses, and will be the first to continue the conversation.

The patient can be identified by his shifting gaze, restlessly moving hands: he is fiddling with something, correcting something, etc. A person's posture can change very often, he can stand up, sit down, walk and make unnecessary movements.

Severe cases of anxiety symptoms manifest in two stages: numbness and loss of control.

Numbness reaches the extreme - a person continuously looks at one point, is unable to react to others, and is not interested in anything.

When control is lost (less common), a person becomes suddenly agitated, begins to rush around the room, refuses to eat, sobs and screams non-stop. In such cases, an ambulance team and hospitalization in a special-purpose medical facility are necessary. Do not feel guilty about not being able to care for such a patient yourself, since it is necessary to protect yourself and those around you from such a person’s condition. In such a state, a person is capable of the most terrible acts.

Treatment

It is imperative to treat a manic-depressive state; such a disease cannot be ignored under any circumstances, and treatment should only be carried out by a doctor. A sleeping pill at night would be inappropriate here.

Treatment of such a disease is usually carried out in stages. First, the doctor prescribes treatment with pharmacological drugs; such drugs are selected on an individual basis. In case of physical and emotional inhibition, the patient will be prescribed medications to stimulate activity. And the patient’s excitation factors will be extinguished by sedative medications.

Prediction of the disease

Many people ask the question when faced with such situations: what is the result of treatment and what do doctors predict? There can be only one answer. Provided that the manic-depressive syndrome manifests itself independently and there are no concomitant diseases associated with it, the patient responds well to treatment and returns to his life and work.

One condition must be taken into account: treatment must begin after the first signs of the disease. An advanced form of the disease, with irreversible changes in the patient’s personality, may not give the desired result, and the treatment will be quite long.

Pay close attention to your moods, and be healthy!

Stories from our readers

The depressive phase is characterized by a triad of symptoms: depressed, melancholy mood, inhibition of thought processes, stiffness of movements. The person is sad, gloomy, barely moves, he experiences a feeling of melancholy, hopelessness, indifference to loved ones and to everything that previously gave him pleasure. A person who is in a depressive phase sits in one position or lies in bed and answers questions in monosyllables, with a delay. The future seems unpromising to him, life - meaningless. The past is viewed only in terms of failures and mistakes. A person can talk about his worthlessness, uselessness, insolvency. The feeling of oppressive melancholy sometimes leads to suicidal attempts.

In women during depression, menstruation often disappears. With mild depression, diurnal mood swings characteristic of MDP are observed: in the morning, the state of health is worse (they wake up early with a feeling of melancholy and anxiety, they are inactive), by the evening the mood improves somewhat, and activity increases. With age, anxiety (unmotivated restlessness, a premonition that “something is going to happen,” “internal agitation”) occupies an increasingly important place in the clinical picture of depression. Typically, patients with manic-depressive psychosis understand the changes happening to them, evaluate them critically, but cannot help themselves and suffer greatly from this.

Manic phase

The manic phase is manifested by increased mood, acceleration of thought processes, and psychomotor agitation. Everything around seems beautiful and joyful, the person laughs, sings, talks a lot, and gesticulates. This phase is characterized by disinhibition of instincts, which can result in promiscuity.

A person in a manic phase often overestimates his capabilities and proposes his own candidacy for various positions that do not correspond to his level of knowledge and qualifications. Often such people discover extraordinary abilities, pass themselves off as an actor, poet, writer, quit their job in order to engage in creativity or simply change their profession. A person in a manic phase has an excellent appetite, but may lose weight because he uses too much energy and sleeps little - only 3-4 hours.

The duration and frequency of depressive and manic states vary: from several days and weeks to several months. Depressive phases are usually longer than manic phases. Seasonality of relapses is characteristic, more often in autumn and spring. Sometimes the disease is characterized by the occurrence of only depression (less often only mania), then they speak of a monopolar course of the disease. Treatment of severe forms is carried out in a hospital; for mild manifestations of the disease, treatment is carried out on an outpatient basis.