Causes, phases and methods of treatment of manic-depressive psychosis. Manic depression? There is a solution

Manic-depressive psychosis (modern name - bipolar affective disorder, BAD) 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 physicians.

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

Manic-depressive psychosis is an endogenous disease, that is, based on hereditary predisposition. The mechanism of inheritance has not been studied enough, research is ongoing, but human chromosomes are definitely “to blame” for the onset of symptoms of BAD. If there are already patients with manic-depressive psychosis in the family, then the same disease may manifest itself in the next 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 it is not there, then manic-depressive psychosis does not threaten a person). These include:

1. Endocrine changes (transitional age, pregnancy and childbirth in women, etc.).
2. Psychogenic factors (stress, serious overwork, work "for wear and tear" 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 states, for example, with reactive depression. In the future, the diagnosis is most often subject to adjustment if the patient shows symptoms and signs that are not characteristic of neuroses, but typical of manic-depressive psychosis.

Useful video on the importance of distinguishing 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, more often the symptoms of manic psychosis occur in men. The debut of the disease usually occurs between the ages of 25 and 44 (46.5% of all cases), but a person can get sick at any age. This diagnosis is extremely rare in children, since the diagnostic criteria used for adults can be used extremely limitedly in childhood. However, this does not mean that manic-depressive psychosis does not occur at all in children.

How does it manifest

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 be radically different from each other, and sometimes they can proceed quite blurry. On average, each phase lasts approximately 3-7 months, although this period can vary from a few weeks to 2 years or more.

A patient in the manic phase of bipolar disorder experiences a great burst of energy, is in a great mood, motor excitation is also noted, appetite increases, sleep duration decreases (up to 3-4 hours a day). The patient may be obsessed with 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, as his speech loses coherence, he speaks in fragments of phrases or even single words, 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 covered by a breakdown, asthenia and slight lethargy.

The depressive phase of bipolar affective disorder is manifested by a 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 miss 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. It is difficult for the patient to fall asleep at night, 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. Hallucinations and “voices” are not typical for this phase of MDP, but dangerous suicidal thoughts may appear, which can develop into attempts to commit suicide.

As in the case of the manic stage, after the most acute period has passed, depressive symptoms gradually disappear. For some time, the patient may remain rather lethargic and asthenic, or vice versa - becomes 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 within the framework of one article. For example, the depressive and manic phases do not have to go strictly one after the other - they can alternate in any sequence. Also, in manic-depressive disorder, the manic phase can be expressed quite weakly, which sometimes leads to misdiagnosis. Another common variant is rapid-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.

What is dangerous manic psychosis

We have already mentioned the possibility of suicide during the depressive phase of the disease. But this is not the only thing that can harm both the patient himself and his environment.

The fact is that at the moment of the highest euphoria, a person suffering from BAD is not aware of his own actions, he seems to be in an altered state of consciousness. In some way, this state is similar to drug intoxication, when it seems to the patient that nothing is impossible for him, and this can lead to dangerous impulsive actions. Delusional ideas of dominance also affect a person's perception of reality, and during such delusions, he can cause serious harm to his loved ones, who will refuse to "obey" him or do something with which he strongly disagrees.

In the depressive phase, anorexia may develop due to loss of appetite, and this disorder itself is very difficult to cure. In some cases, the patient may inflict bodily harm on himself during an attack of hatred for his body.

And both phases are extremely exhausting for the body itself and the human psyche. Constant throwing from one extreme to another exhausts moral strength, and physical symptoms and constant anxiety negatively affect the body of the patient. Therefore, it is very important to start the right 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 made 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 the usual children's behavior, which in itself is not very stable.

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

The manic phase is characterized by increased motor activity, a desire for new entertainment and a constant search for them. It is literally impossible to calm a child, while he practically does not support the rules of the game, his actions are spontaneous and largely devoid of logic. Unfortunately, such a state is quite difficult to distinguish from normal childhood behavior, especially if the symptoms of mania do not reach full 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 adults.

In the clinical picture of manic-depressive psychosis in adolescents, all the symptoms characteristic of this disease are usually present, especially in the depressive phase. The emerging suicidal thoughts are of great danger to adolescents, since in 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 meet its manifestations with joy, especially if before that the child was in a state of anxiety and melancholy. A teenager in the phase of mania literally “gushes” with energy and new ideas, can stay awake at night, make grandiose plans, and endlessly look for entertainment and new companies during the day.

In order to correctly diagnose a teenager, parents and a doctor need to carefully observe the behavior of a potential patient. In bipolar disorder, the symptoms of mania or depression most often occur at certain times of the year. Another important point is a quick change of mood, which is not typical for a healthy person: yesterday the teenager was in high spirits, and today he is sluggish, apathetic, and so on. All this can lead to the idea that the child suffers from a mental disorder, and not from the hormonal fluctuations typical of adolescence.

Diagnosis and treatment

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

The main diagnostic method is the collection of 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, so that it is easier for a doctor to draw up a general picture of the disease.

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

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

• pronounced suicidal thoughts or suicide attempts;
• hypertrophied sense of guilt and moral inferiority (due to the risk of suicide);
• tendency to hush up their condition, symptoms of the disease;
• a state of mania with pronounced psychopathic behavior, when the patient can be dangerous to other people;
• severe depression;
• multiple somatic symptoms.

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

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

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

How to treat manic-depressive psychosis in each case is decided by the doctor, the choice of medication 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 doses of drugs are reduced, choosing 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 recommendations of the doctor, then the prognosis for the course of the disease is favorable, although sometimes the doses of the 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 known, and the features of the development of bipolar disorder are so diverse that doctors sometimes find it difficult to make a correct diagnosis.

Can this disease be cured? There is no single answer, but if the patient is conscientious about all the appointments of his doctor, then the prognosis will be very optimistic, and the remission will be stable and long.

Manic depression is one of the diseases of the human psyche that occurs quite often. This disorder is characterized by a frequent abrupt change from a depressed (depressive) state to an excited (manic) state.

This disease is very often found in a latent form, and then it is almost impossible to diagnose. Even a pronounced form of the disease does not always prompt the patient or his relatives to see a doctor, which is completely in vain: with proper treatment, the patient will be able to feel better, and staying at home can harm both himself and those around him.

Unfortunately, even at present, the reasons why manic depression develops are almost unknown. It has been proven that a tendency to this mental disorder can be inherited (for example, from grandmother to grandson), and, if there are factors favorable for the development of the disease, it can manifest itself at any time, but only after reaching the age of thirteen.

It is also known that manic depression most often develops on the basis of increased nervous excitability. From the foregoing, we can conclude that people who have a hereditary tendency to this disease should be especially jealous of their mental health.

This mental disorder is most easily treated in the initial stages, and therefore it is very important to be able to recognize its most As already mentioned, this disease begins to develop only from the age of 13, and just at this age the human psyche is already fully formed, which allows an observant person to notice the first deviations from the norm.

The first symptom is a slight change in emotional reactions to any events, and a sharp change in mood appears a little later. So, close to depression, can be abruptly replaced by high mood, joy, even euphoria. And, which is especially important in diagnosis, the period always lasts longer.

As you can understand by the name of the disease, manic depression is characterized by a frequent change of two states - depressive and manic.

A depressive state can be recognized by constant manifestations of bad mood, physical and mental lethargy, deterioration of well-being, and the development of heart disease. In especially severe cases, the patient may fall into a stupor - do not move, do not talk, do not react to anything.

The manic state is easily recognized by a sharp increase in mood, excessive cheerfulness, strong excitement (the patient is constantly moving and talking).

Both conditions are characterized by increased heart rate.

At the initial stage, this disease is characterized as causing significant inconvenience, but not carrying a real danger. But in the absence of treatment, after a couple of years, the syndrome turns into At this stage, the patient becomes truly dangerous, since in a depressive period he is capable of suicide, and in a manic period - of destruction and murder.

Treatment of this mental disorder is possible only in a psychiatric clinic, where the patient will be protected from society and pathogens. Treatment includes both work with a psychiatrist and medical procedures.

For the patient, conversations with a psychotherapist are very important, who should not only identify the causes of manic depression and eliminate them, but also reassure the patient. Also, a positive result will bring the observance of the correct daily routine and the support of relatives.

The human psyche is a complex system, and failures can sometimes occur in it. Sometimes they are minor and corrected by several visits to a psychologist, but sometimes the problems can be much more significant. One of the serious mental disorders that require specialist monitoring is manic-depressive psychosis.

A distinctive feature of this disease is the alternating manifestation in a person of certain affective states: manic and depressive. These states can be called opposite, because manic-depressive psychosis is also called bipolar affective disorder.

Why do people get bipolar disorder?

It is believed that manic-depressive psychosis (MDP) is due to heredity: this is due to some disturbances in the transmission of nerve impulses in the hypothalamus. But, of course, it is quite difficult to determine this in advance, especially if the disease was not transmitted from the previous generation, but from more distant relatives. Therefore, risk groups were identified, among which cases of the onset of the disease are especially frequent. Among them:

• Constant stress on the psyche. It can be a job associated with negative emotions, or a difficult situation in the family - in a word, everything that day by day puts a person out of balance.
• Hormonal disruptions.
• Adolescence.
• Experienced violence - moral or physical.
• Presence of other mental illnesses.

Another characteristic feature of the disease is that, despite the tendency to emotionality and nervousness prescribed for women, it occurs precisely in females.

Signs of bipolar affective disorder

As already mentioned, for such a disease as manic-depressive psychosis, two "poles" are characteristic, two states - manic and depressive. Therefore, the symptoms of each of the phases should be described separately.

Manic stage

During this phase of bipolar disorder, the patient feels a sense of elation, joy, memory improves, and a desire to interact with the outside world arises. It would seem, and where are the symptoms of the disease? But still, the manic phase of such a disease as manic-depressive psychosis has some signs that make it possible to distinguish a painful state of the psyche from ordinary cheerfulness.

• Increased desire for risk, getting adrenaline. This may include gambling, extreme sports, the use of alcohol, psychoactive substances, etc.
• Restlessness, agitation, impulsivity.
• Fast, slurred speech.
• A prolonged, unconditioned feeling of euphoria.
• There may be hallucinations - both visual and auditory, tactile.
• Not quite adequate (or completely inadequate) perception of reality.

One of the main disadvantages of this condition is the commission of rash acts, which in the future can aggravate another stage of the disease - the depressive phase. But it happens that a manic syndrome exists in a person by itself, without the onset of depression. This condition is called manic psychosis, and it is a special case of unipolar disorder (as opposed to bipolar, which combines two syndromes). Another name for this syndrome is hypomanic psychosis.

depressive phase

Depression follows the manic phase of psychosis, during which the patient is extremely active. The following symptoms are characteristic of the depressive stage of the disease:

• Apathy, slow response to environmental stimuli.
• Low mood, craving for self-flagellation and self-abasement.
• Inability to concentrate on anything.
• Refusal to eat, talk even with loved ones, unwillingness to continue treatment.
• Sleep disorders.
• Slow, incoherent speech. The person answers questions automatically.
• Headaches and other symptoms that indicate the impact of depression on physical health: nausea, dizziness, etc.
• Perception of the surrounding world in gray, boring colors.
• Weight loss associated with loss of appetite. Women may experience amenorrhea.

A depressive state is dangerous, first of all, with possible suicidal tendencies, a person closing in on himself and the inability to carry out further treatment.

How is TIR treated?

Manic-depressive psychosis is a disease that requires very competent and complex treatment. Special drugs are prescribed, in addition, psychotherapy is used, as well as conservative therapy.

Medical treatment

If we talk about the treatment of psychosis with drugs, then we should distinguish between drugs designed for a long course and drugs, the main purpose of which is to quickly relieve the symptoms of a painful mental state.

Strong antidepressants are used to relieve acute depressive states. However, treatment with antidepressants must be combined with mood stabilizers, because otherwise the patient's condition may destabilize. As for the manic phase, here you will need medications that will help normalize sleep, remove overexcitation. You will need antipsychotics, antipsychotics, and all the same mood stabilizers.

Long-term treatment is designed not only to remove the consequences of affective states, but also to stabilize the patient's condition during periods of "calm". And in the long term, and completely minimize the manifestations of the disease. These are, again, sedatives, antipsychotics, tranquilizers. The treatment of manic-depressive psychosis also often involves the use of lithium carbonate: it has a pronounced anti-manic effect, removes the excited state.

Psychotherapeutic methods of treatment

Although medications play a huge role in the recovery of a person with bipolar disorder, other therapies are needed. Including the need for a person and psychological help. The following are widely used in this regard:

• Cognitive therapy. At this stage, a person needs to find out what in his behavior aggravates his condition. This will help avoid similar patterns of thinking in the future.
• Family therapy. Helps in establishing contacts with other people, especially with relatives and friends.
• Social therapy. It involves, first of all, the creation of a clear daily routine, which will allow you to regulate the time of work and rest, not allowing you to overstrain unnecessarily or worsen the patient's condition in any other way.

General therapy

In the intervals between depressive and manic phases, conservative treatment methods are used that contribute to relaxation, mood stabilization and overall strengthening of mental and physical health. Electrosleep, physiotherapy, massage, hydromassage, etc.

In conclusion, it is worth noting that although manic-depressive psychosis is a rather dangerous disease for a person, if treatment is started in a hospital on time, the patient may well return to normal life. And of course, in addition to medicines and procedures, the support of loved ones is very important in this situation. The same applies to illnesses such as depression or hypomanic psychosis.

Manic-depressive psychosis (or bipolar personality disorder) is a pathology of the human mental sphere, in which affective disorders are observed in the form of alternating manic syndrome and depression. Interestingly, MDP in mild disease sometimes goes unnoticed, and its manifestations are often confused with other mental disorders. Isolated forms are less common, but if they are found, then with a pronounced depressive episode, such patients are diagnosed with endogenous depression. And with a manic syndrome - the diagnosis includes a wide range of mental disorders, this also includes schizophrenia. There is also a mixed form, which is characterized by a rapid alternation of mania and depression, it is for this course of the disease that it is easy to identify true manic-depressive psychosis (circular psychosis).

It is much more difficult to understand whether MDP is an independent nosological entity or is a consequence of another mental disorder. We all have mood swings, a state of deep depression or explosive euphoria, but not all people have a depressive-manic syndrome.

The causes of manic-depressive psychosis are varied. Moreover, unlike other mental disorders, TIR is not always associated with genetics, although in most cases it is inherited. Factors that cause this disease include:

• Personal characteristics. The so-called manic personality type: a person is confident in his rightness, pedantic, responsible, serious. Hypomanic: friendly, soft, vulnerable, sensitive, whiny. In other words, choleric and melancholic people are most susceptible to MDP;
• Manic-depressive syndrome as a consequence of another mental disorder;
• Burdened heredity;
• Economic and social trouble;
• Stress (physical or mental abuse, strict upbringing);
• Injuries of the skull and head.

Prevalence

This disorder most often occurs in women due to specific character traits and hormonal instability. According to the latest statistics, it can be concluded that the female half of the population has 1.5 times more patients with TIR than men. The risk of getting sick increases if a woman is experiencing severe stress, is in the postpartum or premenopausal period. The peak of the disease usually falls on 20-30 years, which also makes it difficult to diagnose it in advance. By the end of the 20th century, the number of people with TIR reached 1%, and of these, 0.3% have a severe course.

In adolescents, TIR develops imperceptibly, the symptoms are mistakenly accepted by others and parents as a manifestation of character (depression, unwillingness to communicate with anyone, or vice versa, motor and speech excitement, aggressiveness).

Classification of manic-depressive psychosis

Depending on the predominance of one or another affective symptom, MDP is distinguished:

• Unipolar. With this form, a person has only:

Periodic mania;

Periodic depression.

• Bipolar. There is an alternation of these two symptoms.

True bipolar personality disorder has 4 forms of the possible course of the disease:

• Properly interlaced. Depression and mania alternate with each other, and there are light intervals between episodes;
• Wrongly interleaved. The alternation of these two symptoms is chaotic, sometimes several depressive episodes are observed in a row at once, or vice versa, there are light intervals between attacks;
• Double - mania is replaced by depression and is one big episode, there is a light gap before the next symptom complex;
• Circular. The alternation of depression and mania is constant, and there are no inter-attack light intervals.

Each episode of manic-depressive psychosis can last from several days to several years, with an average phase duration of up to six months. The classic picture of MDP is a depression to mania ratio of 3:1. A clear period in the form of the absence of symptoms can reach 7-8 years, however, it is often limited to only a few months.

Symptoms of manic-depressive psychosis

Clinical manifestations depend on the phase in which the patient with TIR is.

Hypomanic psychosis is characterized by an increase in vitality, an improvement in thought processes, and an increase in physical activity. A person in this state walks “like on springs”, enjoys minor trifles, the need for sleep decreases. This phenomenon is called tachypsychia. The hypomanic state lasts about 3-4 days.

Moderate mania is accompanied by the addition of dysphoria, a good mood is easily overshadowed by bad events, and then it is also easily restored. With this form, social interaction with other people is difficult, a person becomes forgetful, absent-minded. The duration of moderate mania ranges from a week to several months.

Severe mania has more pronounced symptoms, often in this state people are prone to violence. Sometimes there are delusions and hallucinations.

The depressive phase includes bradypsychia, which is mental retardation, a painful decrease in mood, and a decrease in motor activity. In patients, appetite disappears, the need for sexual intimacy disappears, an anxiety-phobic disorder develops. These symptoms are more pronounced in the morning, and gradually decrease in the evening (a characteristic feature for people with TIR, which will allow differential diagnosis with depression).

Types of depression in TIR

For MDP depressive form, several types of depression are characteristic:

• Simple. It is characterized by low mood, decreased physical and mental activity. That is, it represents the triad of classical depression;
• Hypochondriacal. In addition to a depressed mood, the patient experiences fear for his health, an anxiety-phobic disorder joins. Especially common is carcinophobia - the fear of cancer;
• Delusional. In addition to the classic triad, there is the presence of hallucinations, delusions. Often - depersonalization, in which a person looks at himself as if from the outside;
• Agitated. Classic depressive symptoms alternate with excessive motor and speech arousal, increased anxiety, a delusional disorder in the form of a delusion of guilt is characteristic;
• Anesthetic. Inability to feel anything, patients complain of "emptiness inside."

The depressive symptom itself can be both with somatic and without somatic manifestations. In the first option, patients may complain of headaches, discomfort in any part of the body, feeling of a lump in the throat, difficulty breathing, heaviness behind the sternum.

All people with some form of depression are prone to suicidal attempts, so they must be carefully monitored.

Diagnostics

Diagnosis of manic-depressive psychosis is based on the exclusion of another mental disorder or the confirmation of true TIR.

An examination of the brain is carried out to detect an organic lesion (MRI) and / or perversion of the conduction of nerve impulses (EEG). A conversation with relatives about the health of a sick person is desirable, since, often, there is no criticism of their condition in such patients.

In order to make a diagnosis of manic-depressive psychosis, at least two episodes of mood disturbance must be present. And one of them must be a manic syndrome. The correct interpretation of the clinical picture, comparison with risk factors, with heredity, with instrumental and laboratory methods of research, and passing by the patient a number of tests for bipolar personality disorder, will allow the psychiatrist to make a correct diagnosis. It is imperative to differentiate MDP from depression, drug abuse, neurotic conditions, schizophrenia, and other disorders arising as a result of a neurological or other somatic disease.

Treatment

Severe forms of manic-depressive psychosis are considered exclusively in a psychiatric hospital. With a mild or moderate form, outpatient treatment is possible, subject to the adequacy of the patient. Therapy differs depending on the phase of the disease. With depression - antidepressants and mood stabilizers. With manic syndrome - normotimics. If the TIR is severe, then antipsychotic drugs are used. Additionally, conversations are held with a psychotherapist and / or a psychiatrist, it turns out the reason that led to the development of TIR. In children and adolescents, it is necessary to exclude juvenile schizophrenia, attention deficit hyperactivity disorder (a number of tests are carried out that will allow a correct diagnosis). In the depressive phase, occupational therapy, engaging in a favorite hobby is recommended. With manic - aromatherapy, acupuncture, massages. Treatment with folk remedies (ginseng, decoctions of mint, chamomile, etc.) has little effect on the patient's condition and can only be carried out in combination with prescribed medications.

Prevention

To prevent the occurrence of TIR, it is necessary to isolate oneself from stressful effects - not to get involved in conflicts, to avoid uncomfortable situations. If a person feels the approach of a depressive or manic phase, he should take medication prescribed by a doctor to smooth out the picture of TIR. With the systematic use of drugs, the risk of a new affective disorder is significantly reduced.

Forecast

In the interictal period, as a rule, there are no complaints, but, unfortunately, TIR is a chronic disease, and the goal of therapy is to create favorable conditions for lengthening the light intervals (achieving stable remission). With a circular form, people often get disability, since the endless alternation of mania and depression without light intervals greatly undermine the emotional state of the patient.

Manic depression is a mental disorder that manifests itself in 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:

• All information on the site is for informational purposes and is NOT a guide to action!
• Give you an ACCURATE DIAGNOSIS only DOCTOR!
• We kindly ask you DO NOT self-medicate, but book an appointment with a specialist!
• Health to you and your loved ones!

• manic;
• depressive;
• mixed.

Bipolar depression is characterized by a sharp change of 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 only manic or only depressive phases.

The duration of the phase can vary from a few weeks to several years, with an average duration of 3 to 7 months. As a rule, manic phases are 3 times shorter than depressive phases.

After this period, a calm period sets in, 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 evaluation criteria and the inevitable subjectivity in diagnosing. 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. In women who have experienced a mental disorder in the postpartum period, the likelihood of developing it is significantly increased. For example, if an attack occurs within 2 weeks after childbirth, this risk increases by 4 times.

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

The reasons

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

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

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

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, try not to talk. People with this diagnosis do not like long pauses.

As additional symptoms, there may be: lack of appetite, bradycardia, problems with the gastrointestinal tract, insomnia, weight loss. Patients are haunted by suicidal thoughts and delusions. The patient's hands are in constant motion, the look runs. He often changes his position, constantly fiddling with something.

There are 2 stages in which it is urgent to call an ambulance for hospitalization of the patient:

Common are the latent forms of manic depression - cyclomitia. It is believed that they affect about 80% of the population. At the same time, the symptoms are so vague that neither those around nor the person himself even suspect about the disease. The person is active, able-bodied, the condition that has arisen does not cause obvious inconvenience, does not affect work.

Phases

depressive

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

During the depressive phase, the following symptoms are observed:

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

When these conditions are identified, they must be treated without fail. If no action is taken, the disease can progress, ending in a state of complete stupor, in which the patient stops moving and talking at all.

Visually, the disease can be manifested by dilated pupils, interruptions in the rhythm of the heart (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 performance.

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

The patient is characterized by an illusory perception of the world, he is overly optimistic about any situation, does not take reality into account. Crazy ideas may arise, a 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 opposed to the rest.

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

In children

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

More common are cases in children over 10 years old, however, medicine also fixes 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 seizures. For young children, the dominance of the manic rather than the depressive phase is characteristic.

Diagnostics

Accurate diagnosis of the disease requires constant monitoring of symptoms, changes in behavior, duration and frequency of attacks. The most common symptom is a sudden change in mood, but it can occur in different ways.

If you suspect this condition, you should seek the advice of a psychiatrist. The doctor conducts an examination, is interested in the presence of mental illness in the family. If the change of mood occurs more than 4 times a year, then it will be more difficult to get rid of the disorder.