Definition manic depressive disorder
Bipolar disorder - Symptoms and causes
Overview
Bipolar disorder, formerly called manic depression, is a mental health condition that causes extreme mood swings that include emotional highs (mania or hypomania) and lows (depression).
When you become depressed, you may feel sad or hopeless and lose interest or pleasure in most activities. When your mood shifts to mania or hypomania (less extreme than mania), you may feel euphoric, full of energy or unusually irritable. These mood swings can affect sleep, energy, activity, judgment, behavior and the ability to think clearly.
Episodes of mood swings may occur rarely or multiple times a year. While most people will experience some emotional symptoms between episodes, some may not experience any.
Although bipolar disorder is a lifelong condition, you can manage your mood swings and other symptoms by following a treatment plan. In most cases, bipolar disorder is treated with medications and psychological counseling (psychotherapy).
Bipolar disorder care at Mayo Clinic
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Symptoms
There are several types of bipolar and related disorders. They may include mania or hypomania and depression. Symptoms can cause unpredictable changes in mood and behavior, resulting in significant distress and difficulty in life.
- Bipolar I disorder. You've had at least one manic episode that may be preceded or followed by hypomanic or major depressive episodes. In some cases, mania may trigger a break from reality (psychosis).
- Bipolar II disorder. You've had at least one major depressive episode and at least one hypomanic episode, but you've never had a manic episode.
- Cyclothymic disorder. You've had at least two years — or one year in children and teenagers — of many periods of hypomania symptoms and periods of depressive symptoms (though less severe than major depression).
- Other types. These include, for example, bipolar and related disorders induced by certain drugs or alcohol or due to a medical condition, such as Cushing's disease, multiple sclerosis or stroke.
Bipolar II disorder is not a milder form of bipolar I disorder, but a separate diagnosis. While the manic episodes of bipolar I disorder can be severe and dangerous, individuals with bipolar II disorder can be depressed for longer periods, which can cause significant impairment.
Although bipolar disorder can occur at any age, typically it's diagnosed in the teenage years or early 20s. Symptoms can vary from person to person, and symptoms may vary over time.
Mania and hypomania
Mania and hypomania are two distinct types of episodes, but they have the same symptoms. Mania is more severe than hypomania and causes more noticeable problems at work, school and social activities, as well as relationship difficulties. Mania may also trigger a break from reality (psychosis) and require hospitalization.
Both a manic and a hypomanic episode include three or more of these symptoms:
- Abnormally upbeat, jumpy or wired
- Increased activity, energy or agitation
- Exaggerated sense of well-being and self-confidence (euphoria)
- Decreased need for sleep
- Unusual talkativeness
- Racing thoughts
- Distractibility
- Poor decision-making — for example, going on buying sprees, taking sexual risks or making foolish investments
Major depressive episode
A major depressive episode includes symptoms that are severe enough to cause noticeable difficulty in day-to-day activities, such as work, school, social activities or relationships. An episode includes five or more of these symptoms:
- Depressed mood, such as feeling sad, empty, hopeless or tearful (in children and teens, depressed mood can appear as irritability)
- Marked loss of interest or feeling no pleasure in all — or almost all — activities
- Significant weight loss when not dieting, weight gain, or decrease or increase in appetite (in children, failure to gain weight as expected can be a sign of depression)
- Either insomnia or sleeping too much
- Either restlessness or slowed behavior
- Fatigue or loss of energy
- Feelings of worthlessness or excessive or inappropriate guilt
- Decreased ability to think or concentrate, or indecisiveness
- Thinking about, planning or attempting suicide
Other features of bipolar disorder
Signs and symptoms of bipolar I and bipolar II disorders may include other features, such as anxious distress, melancholy, psychosis or others. The timing of symptoms may include diagnostic labels such as mixed or rapid cycling. In addition, bipolar symptoms may occur during pregnancy or change with the seasons.
Symptoms in children and teens
Symptoms of bipolar disorder can be difficult to identify in children and teens. It's often hard to tell whether these are normal ups and downs, the results of stress or trauma, or signs of a mental health problem other than bipolar disorder.
Children and teens may have distinct major depressive or manic or hypomanic episodes, but the pattern can vary from that of adults with bipolar disorder. And moods can rapidly shift during episodes. Some children may have periods without mood symptoms between episodes.
The most prominent signs of bipolar disorder in children and teenagers may include severe mood swings that are different from their usual mood swings.
When to see a doctor
Despite the mood extremes, people with bipolar disorder often don't recognize how much their emotional instability disrupts their lives and the lives of their loved ones and don't get the treatment they need.
And if you're like some people with bipolar disorder, you may enjoy the feelings of euphoria and cycles of being more productive. However, this euphoria is always followed by an emotional crash that can leave you depressed, worn out — and perhaps in financial, legal or relationship trouble.
If you have any symptoms of depression or mania, see your doctor or mental health professional. Bipolar disorder doesn't get better on its own. Getting treatment from a mental health professional with experience in bipolar disorder can help you get your symptoms under control.
When to get emergency help
Suicidal thoughts and behavior are common among people with bipolar disorder. If you have thoughts of hurting yourself, call 911 or your local emergency number immediately, go to an emergency room, or confide in a trusted relative or friend. Or contact a suicide hotline. In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24 hours a day, seven days a week. Or use the Lifeline Chat. Services are free and confidential.
If you have a loved one who is in danger of suicide or has made a suicide attempt, make sure someone stays with that person. Call 911 or your local emergency number immediately. Or, if you think you can do so safely, take the person to the nearest hospital emergency room.
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Causes
The exact cause of bipolar disorder is unknown, but several factors may be involved, such as:
- Biological differences. People with bipolar disorder appear to have physical changes in their brains. The significance of these changes is still uncertain but may eventually help pinpoint causes.
- Genetics. Bipolar disorder is more common in people who have a first-degree relative, such as a sibling or parent, with the condition.
Researchers are trying to find genes that may be involved in causing bipolar disorder.
Risk factors
Factors that may increase the risk of developing bipolar disorder or act as a trigger for the first episode include:
- Having a first-degree relative, such as a parent or sibling, with bipolar disorder
- Periods of high stress, such as the death of a loved one or other traumatic event
- Drug or alcohol abuse
Complications
Left untreated, bipolar disorder can result in serious problems that affect every area of your life, such as:
- Problems related to drug and alcohol use
- Suicide or suicide attempts
- Legal or financial problems
- Damaged relationships
- Poor work or school performance
Co-occurring conditions
If you have bipolar disorder, you may also have another health condition that needs to be treated along with bipolar disorder. Some conditions can worsen bipolar disorder symptoms or make treatment less successful. Examples include:
- Anxiety disorders
- Eating disorders
- Attention-deficit/hyperactivity disorder (ADHD)
- Alcohol or drug problems
- Physical health problems, such as heart disease, thyroid problems, headaches or obesity
More Information
- Bipolar disorder care at Mayo Clinic
- Bipolar disorder and alcoholism: Are they related?
Prevention
There's no sure way to prevent bipolar disorder. However, getting treatment at the earliest sign of a mental health disorder can help prevent bipolar disorder or other mental health conditions from worsening.
If you've been diagnosed with bipolar disorder, some strategies can help prevent minor symptoms from becoming full-blown episodes of mania or depression:
- Pay attention to warning signs. Addressing symptoms early on can prevent episodes from getting worse. You may have identified a pattern to your bipolar episodes and what triggers them.
Call your doctor if you feel you're falling into an episode of depression or mania. Involve family members or friends in watching for warning signs.
- Avoid drugs and alcohol. Using alcohol or recreational drugs can worsen your symptoms and make them more likely to come back.
- Take your medications exactly as directed. You may be tempted to stop treatment — but don't. Stopping your medication or reducing your dose on your own may cause withdrawal effects or your symptoms may worsen or return.
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Bipolar disorder - Diagnosis and treatment
Diagnosis
To determine if you have bipolar disorder, your evaluation may include:
- Physical exam. Your doctor may do a physical exam and lab tests to identify any medical problems that could be causing your symptoms.
- Psychiatric assessment.
Your doctor may refer you to a psychiatrist, who will talk to you about your thoughts, feelings and behavior patterns. You may also fill out a psychological self-assessment or questionnaire. With your permission, family members or close friends may be asked to provide information about your symptoms.
- Mood charting. You may be asked to keep a daily record of your moods, sleep patterns or other factors that could help with diagnosis and finding the right treatment.
- Criteria for bipolar disorder. Your psychiatrist may compare your symptoms with the criteria for bipolar and related disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.
Diagnosis in children
Although diagnosis of children and teenagers with bipolar disorder includes the same criteria that are used for adults, symptoms in children and teens often have different patterns and may not fit neatly into the diagnostic categories.
Also, children who have bipolar disorder are frequently also diagnosed with other mental health conditions such as attention-deficit/hyperactivity disorder (ADHD) or behavior problems, which can make diagnosis more complicated. Referral to a child psychiatrist with experience in bipolar disorder is recommended.
Care at Mayo Clinic
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- Bipolar disorder care at Mayo Clinic
- Bipolar in children
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Treatment
Treatment is best guided by a medical doctor who specializes in diagnosing and treating mental health conditions (psychiatrist) who is skilled in treating bipolar and related disorders. You may have a treatment team that also includes a psychologist, social worker and psychiatric nurse.
Bipolar disorder is a lifelong condition. Treatment is directed at managing symptoms. Depending on your needs, treatment may include:
- Medications. Often, you'll need to start taking medications to balance your moods right away.
- Continued treatment. Bipolar disorder requires lifelong treatment with medications, even during periods when you feel better. People who skip maintenance treatment are at high risk of a relapse of symptoms or having minor mood changes turn into full-blown mania or depression.
- Day treatment programs. Your doctor may recommend a day treatment program. These programs provide the support and counseling you need while you get symptoms under control.
- Substance abuse treatment. If you have problems with alcohol or drugs, you'll also need substance abuse treatment. Otherwise, it can be very difficult to manage bipolar disorder.
- Hospitalization. Your doctor may recommend hospitalization if you're behaving dangerously, you feel suicidal or you become detached from reality (psychotic).
Getting psychiatric treatment at a hospital can help keep you calm and safe and stabilize your mood, whether you're having a manic or major depressive episode.
The primary treatments for bipolar disorder include medications and psychological counseling (psychotherapy) to control symptoms, and also may include education and support groups.
Medications
A number of medications are used to treat bipolar disorder. The types and doses of medications prescribed are based on your particular symptoms.
Medications may include:
- Mood stabilizers. You'll typically need mood-stabilizing medication to control manic or hypomanic episodes. Examples of mood stabilizers include lithium (Lithobid), valproic acid (Depakene), divalproex sodium (Depakote), carbamazepine (Tegretol, Equetro, others) and lamotrigine (Lamictal).
- Antipsychotics. If symptoms of depression or mania persist in spite of treatment with other medications, adding an antipsychotic drug such as olanzapine (Zyprexa), risperidone (Risperdal), quetiapine (Seroquel), aripiprazole (Abilify), ziprasidone (Geodon), lurasidone (Latuda) or asenapine (Saphris) may help.
Your doctor may prescribe some of these medications alone or along with a mood stabilizer.
- Antidepressants. Your doctor may add an antidepressant to help manage depression. Because an antidepressant can sometimes trigger a manic episode, it's usually prescribed along with a mood stabilizer or antipsychotic.
- Antidepressant-antipsychotic. The medication Symbyax combines the antidepressant fluoxetine and the antipsychotic olanzapine. It works as a depression treatment and a mood stabilizer.
- Anti-anxiety medications. Benzodiazepines may help with anxiety and improve sleep, but are usually used on a short-term basis.
Finding the right medication
Finding the right medication or medications for you will likely take some trial and error. If one doesn't work well for you, there are several others to try.
This process requires patience, as some medications need weeks to months to take full effect. Generally only one medication is changed at a time so that your doctor can identify which medications work to relieve your symptoms with the least bothersome side effects. Medications also may need to be adjusted as your symptoms change.
Side effects
Mild side effects often improve as you find the right medications and doses that work for you, and your body adjusts to the medications. Talk to your doctor or mental health professional if you have bothersome side effects.
Don't make changes or stop taking your medications. If you stop your medication, you may experience withdrawal effects or your symptoms may worsen or return. You may become very depressed, feel suicidal, or go into a manic or hypomanic episode. If you think you need to make a change, call your doctor.
Medications and pregnancy
A number of medications for bipolar disorder can be associated with birth defects and can pass through breast milk to your baby. Certain medications, such as valproic acid and divalproex sodium, should not be used during pregnancy. Also, birth control medications may lose effectiveness when taken along with certain bipolar disorder medications.
Discuss treatment options with your doctor before you become pregnant, if possible. If you're taking medication to treat your bipolar disorder and think you may be pregnant, talk to your doctor right away.
Psychotherapy
Psychotherapy is a vital part of bipolar disorder treatment and can be provided in individual, family or group settings. Several types of therapy may be helpful. These include:
- Interpersonal and social rhythm therapy (IPSRT). IPSRT focuses on the stabilization of daily rhythms, such as sleeping, waking and mealtimes. A consistent routine allows for better mood management. People with bipolar disorder may benefit from establishing a daily routine for sleep, diet and exercise.
- Cognitive behavioral therapy (CBT). The focus is identifying unhealthy, negative beliefs and behaviors and replacing them with healthy, positive ones.
CBT can help identify what triggers your bipolar episodes. You also learn effective strategies to manage stress and to cope with upsetting situations.
- Psychoeducation. Learning about bipolar disorder (psychoeducation) can help you and your loved ones understand the condition. Knowing what's going on can help you get the best support, identify issues, make a plan to prevent relapse and stick with treatment.
- Family-focused therapy. Family support and communication can help you stick with your treatment plan and help you and your loved ones recognize and manage warning signs of mood swings.
Other treatment options
Depending on your needs, other treatments may be added to your depression therapy.
During electroconvulsive therapy (ECT), electrical currents are passed through the brain, intentionally triggering a brief seizure. ECT seems to cause changes in brain chemistry that can reverse symptoms of certain mental illnesses. ECT may be an option for bipolar treatment if you don't get better with medications, can't take antidepressants for health reasons such as pregnancy or are at high risk of suicide.
Transcranial magnetic stimulation (TMS) is being investigated as an option for those who haven't responded to antidepressants.
Treatment in children and teenagers
Treatments for children and teenagers are generally decided on a case-by-case basis, depending on symptoms, medication side effects and other factors. Generally, treatment includes:
- Medications. Children and teens with bipolar disorder are often prescribed the same types of medications as those used in adults. There's less research on the safety and effectiveness of bipolar medications in children than in adults, so treatment decisions are often based on adult research.
- Psychotherapy. Initial and long-term therapy can help keep symptoms from returning. Psychotherapy can help children and teens manage their routines, develop coping skills, address learning difficulties, resolve social problems, and help strengthen family bonds and communication.
And, if needed, it can help treat substance abuse problems common in older children and teens with bipolar disorder.
- Psychoeducation. Psychoeducation can include learning the symptoms of bipolar disorder and how they differ from behavior related to your child's developmental age, the situation and appropriate cultural behavior. Understanding about bipolar disorder can also help you support your child.
- Support. Working with teachers and school counselors and encouraging support from family and friends can help identify services and encourage success.
More Information
- Bipolar disorder care at Mayo Clinic
- Bipolar medications and weight gain
- Bipolar treatment: I vs. II
- Cognitive behavioral therapy
- Electroconvulsive therapy (ECT)
- Family therapy
- Psychotherapy
- Transcranial magnetic stimulation
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Clinical trials
Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.
Lifestyle and home remedies
You'll probably need to make lifestyle changes to stop cycles of behavior that worsen your bipolar disorder. Here are some steps to take:
- Quit drinking or using recreational drugs. One of the biggest concerns with bipolar disorder is the negative consequences of risk-taking behavior and drug or alcohol abuse. Get help if you have trouble quitting on your own.
- Form healthy relationships. Surround yourself with people who are a positive influence. Friends and family members can provide support and help you watch for warning signs of mood shifts.
- Create a healthy routine. Having a regular routine for sleeping, eating and physical activity can help balance your moods. Check with your doctor before starting any exercise program. Eat a healthy diet. If you take lithium, talk with your doctor about appropriate fluid and salt intake. If you have trouble sleeping, talk to your doctor or mental health professional about what you can do.
- Check first before taking other medications. Call the doctor who's treating you for bipolar disorder before you take medications prescribed by another doctor or any over-the-counter supplements or medications. Sometimes other medications trigger episodes of depression or mania or may interfere with medications you're taking for bipolar disorder.
- Consider keeping a mood chart. Keeping a record of your daily moods, treatments, sleep, activities and feelings may help identify triggers, effective treatment options and when treatment needs to be adjusted.
Alternative medicine
There isn't much research on alternative or complementary medicine — sometimes called integrative medicine — and bipolar disorder. Most of the studies are on major depression, so it isn't clear how these nontraditional approaches work for bipolar disorder.
If you choose to use alternative or complementary medicine in addition to your physician-recommended treatment, take some precautions first:
- Don't stop taking your prescribed medications or skip therapy sessions.
Alternative or complementary medicine is not a substitute for regular medical care when it comes to treating bipolar disorder.
- Be honest with your doctors and mental health professionals. Tell them exactly which alternative or complementary treatments you use or would like to try.
- Be aware of potential dangers. Alternative and complementary products aren't regulated the way prescription drugs are. Just because it's natural doesn't mean it's safe. Before using alternative or complementary medicine, talk to your doctor about the risks, including possible serious interactions with medications.
Coping and support
Coping with bipolar disorder can be challenging. Here are some strategies that can help:
- Learn about bipolar disorder. Education about your condition can empower you and motivate you to stick to your treatment plan and recognize mood changes. Help educate your family and friends about what you're going through.
- Stay focused on your goals. Learning to manage bipolar disorder can take time. Stay motivated by keeping your goals in mind and reminding yourself that you can work to repair damaged relationships and other problems caused by your mood swings.
- Join a support group. Support groups for people with bipolar disorder can help you connect to others facing similar challenges and share experiences.
- Find healthy outlets. Explore healthy ways to channel your energy, such as hobbies, exercise and recreational activities.
- Learn ways to relax and manage stress. Yoga, tai chi, massage, meditation or other relaxation techniques can be helpful.
Preparing for your appointment
You may start by seeing your primary care doctor or a psychiatrist. You may want to take a family member or friend along to your appointment, if possible, for support and to help remember information.
What you can do
Before your appointment, make a list of:
- Any symptoms you've had, including any that may seem unrelated to the reason for the appointment
- Key personal information, including any major stresses or recent life changes
- All medications, vitamins, herbs or other supplements you're taking, and the dosages
- Questions to ask your doctor
Some questions to ask your doctor may include:
- Do I have bipolar disorder?
- Are there any other possible causes for my symptoms?
- What kinds of tests will I need?
- What treatments are available? Which do you recommend for me?
- What side effects are possible with that treatment?
- What are the alternatives to the primary approach that you're suggesting?
- I have these other health conditions. How can I best manage these conditions together?
- Should I see a psychiatrist or other mental health professional?
- Is there a generic alternative to the medicine you're prescribing?
- Are there any brochures or other printed material that I can have?
- What websites do you recommend?
Don't hesitate to ask other questions during your appointment.
What to expect from your doctor
Your doctor will likely ask you a number of questions. Be ready to answer them to reserve time to go over any points you want to focus on. Your doctor may ask:
- When did you or your loved ones first begin noticing your symptoms?
- How frequently do your moods change?
- Do you ever have suicidal thoughts when you're feeling down?
- Do your symptoms interfere with your daily life or relationships?
- Do you have any blood relatives with bipolar disorder or depression?
- What other mental or physical health conditions do you have?
- Do you drink alcohol, smoke cigarettes or use recreational drugs?
- How much do you sleep at night? Does it change over time?
- Do you go through periods when you take risks that you wouldn't normally take, such as unsafe sex or unwise, spontaneous financial decisions?
- What, if anything, seems to improve your symptoms?
- What, if anything, appears to worsen your symptoms?
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Manic-depressive psychosis.
![](/800/600/http/soothingminds.com.au/wp-content/uploads/2016/10/Bipolar-Symptoms.jpg)
It is not always possible to distinguish a person with a sick psyche from a healthy one, because during periods of “enlightenment” they are quite ordinary people living the most ordinary life. But in the phase of exacerbation, the disease reveals all the secrets. Today we will talk about such a deviation as manic-depressive psychosis.
The concept of manic-depressive psychosis
The disease has many names - manic-depressive psychosis, MDP, bipolar personality disorder, manic-depressive syndrome, manic-depressive disorder, and in modern psychiatry it is referred to as bipolar affective disorder (BAD). nine0003
In its most general form, the term is interpreted as a mental disorder characterized by prolonged polar mood swings. A person can stay in a state of increased excitability and activity for several months - this is how a manic state manifests itself - or go into severe depression for the same period. There are also mixed states.
It is important to understand here that this is not just ordinary mood swings. For a bipolar person, it has extreme highs and lows, when a person is capable of reckless, and sometimes dangerous, actions. nine0003
According to the World Health Organization, almost 45 million inhabitants of the planet have TIR. Since the disease is detected at a fairly adult age, there are no accurate statistics on children yet.
Causes of pathology
It has not yet been possible to find out the reasons due to which BAD occurs. However, this is the problem with most mental disorders. The main version is hereditary predisposition.
It is also believed that bipolar mental disorders have a complex etiology. What do the results of genetic, biological studies, the study of neuroendocrine structures, as well as a number of psychosocial theories say. nine0003
To date, there are no visible reasons for the development of TIR. Presumably, a violation can provoke any factor. For example, another medical condition or personality trait, such as:
- melancholic temperament;
- increased conscientiousness and various psychasthenic traits;
- anxiety, suspiciousness;
- emotional instability. nine0031
- the classic manic triad - a very good mood, quick thinking, increased speech and motor activity.
- a lot of energy, grasping at several things at the same time, but soon give them up.
- a person is often distracted during conversations, can laugh out loud and shout, incoherent speech.
- due to the high speed of thinking, a person may not keep up with his own thoughts, so sometimes it seems that he is delusional. nine0024
- endogenous depression - when a person is very upset for no reason. nine0024
- depressive triad - bad mood, slow thinking and motor speech activity.
- mood swings during the day - in the morning, people, as a rule, can experience melancholy and anxiety.
- lack of appetite, feeling that food has no taste, weight loss.
- psychomotor retardation.
- sometimes women miss their periods.
- the physical feeling of anguish is like a heaviness in the chest. nine0024
- decrease or complete disappearance of libido and maternal instinct.
- Protopopov's triad - tachycardia, dilated pupils and constipation.
- delusions, hallucinations (usually auditory).
- simple depression - there is a classic depressive triad, there are no delusions and hallucinations.
- hypochondriacal depression - delirium with affective coloring, associated with anxiety about one's own health.
- delusional depression - passes very brightly with a feeling of anxiety and worries about the fate of humanity and the planet.
For example, a “premonition” of a global cataclysm that will destroy all life.
- agitated depression - manifests itself as nervous excitement. nine0024
- anesthetic depression - when a person experiences absolutely no feelings for a long time.
- insomnia;
- suicidal mood;
- poor appetite;
- various psychotic traits.
- in women, bipolarity appears later and, most often, begins with a depressive phase;
- women have more depressive phases than manic or mixed phases; nine0024
- the beginning of the phase, as a rule, coincides with hormonal changes;
- MDP increases the risk of developing alcoholism in women by about seven times.
- BAD type I is characterized by the presence of manic and depressive episodes;
- type II bipolar disorder is characterized by the predominance of the depressive phase, the manic phase is either absent or there is hypomania.
- relief therapy - to eliminate symptoms and minimize side effects.
- maintenance therapy - strengthens the effect of the first stage of treatment.
- anti-relapse therapy - designed to prevent recurrence of episodes.
- Appointment prepayment
- Face-to-face, video consultations: 30 minutes. — 2750 UAH, 45 min. — 3600 UAH, 60 min. — 4450 UAH..
- On-site consultation from - 10 000 UAH.
- The recommended duration of the initial consultation is at least 60 minutes.
- Please bring with you the results of psychological tests sent to you the day before by our administrator; desirable (but not required) - a description (!!!) of an electrocardiogram (ECG) and a complete blood count not older than 1 year, especially for people over 45 years old.
nine0372 16:30
- 17:00
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Note! In women, the risk of developing TIR increases during periods of hormonal changes. Especially those who already had various mental disorders.
Symptoms of disease
Symptoms of the disease depend on the phase in which the person is. There are three of them: manic, depressive and mixed.
Manic phase
The manic stage (episode) has a different degree of severity: from the mildest (hypomania) to very severe, when psychotic symptoms appear. It is believed that hypomania sometimes even benefits the patient, because it makes him more productive and sociable. nine0003
Symptoms:
Another variant of the manic phase is anger. It is characterized by strong irritability, aggressiveness and pickiness towards others.
Depressive phase
During this phase, the patient may experience suicidal ideation, so hospitalization is sometimes required.
Symptoms:
Sometimes a non-standard variant of the depressive phase happens, when, on the contrary, a person has a great appetite and the duration of sleep greatly increases. In general, doctors distinguish the following options for the course of this period: nine0003
Mixed phase
This is the third variant of the course of the disease, which has its own signs, and therefore stands out in a separate category. It combines the signs of the first two phases, lasting at least two weeks and quickly replacing each other. They appear bright enough.
Symptoms: nine0003
A vivid example of such a phase is a great mood against the background of a deep stupor.
Parasuicide - a demonstrative attempt to commit suicide or simply self-harm without the goal of ending life - occurs in almost half of cases with bipolar affective disorder. If your loved one shows such or similar desires, call our specialists by phone at any time of the day - they are in touch with you 24/7. Doctors will advise you on treatment, give practical advice on how to live with a “difficult” person and how to help him. nine0003
Features of bipolar disorder in women
A man and a woman have the same signs of bipolar, as well as suffer from it with the same frequency. However, the disease is characterized by a number of differences:
Pay attention! If a woman has such a diagnosis, then the likelihood of developing an “attack” after childbirth increases significantly.
What causes TIR
While the causes of the disease are unknown, it is impossible to track the process of its formation. Recent studies lead scientists to hypothesize that biological factors play an important role here. nine0003
Another important point is genetics. Today's accumulated data allow us to determine the quantitative relationship between genetic and environmental factors in the development of bipolar disorder: heredity accounts for 70%, and the external environment - 30%. At the same time, the contribution of random environmental factors was equated to 8%, and family-wide - to 22%.
Classification and stages of development of BAP
Bipolar disorder in the International Classification of Diseases (ICD-10) is designated by the F31 code. Now, according to her, pathology is usually divided into three types: nine0003
Type of mental disorder | How the disease manifests itself |
bipolar flow | when the patient has both manic and depressive phases, but there are intermissions between them - the so-called “light intervals”, when the person is quite normal nine0003 |
monopolar flow | when the patient shows only one phase, often depressive |
continual flow | when there are no intermissions, and the phases alternate with each other | nine0161
The alternative to the ICD in America is the DSM. According to it, bipolar disorder is of types 1 and 2:
Complications of manic-depressive psychosis
The worst complication for a bipolar person is suicide. In rare cases, it is conscious when the patient really wants it. Mostly we are talking about accidents associated with parasuicide. This may include an overdose of medications, too deep cuts and other self-harm, careless actions. nine0003
It is important to understand that on an emotional upsurge, that is, in a manic phase, a person practically does not feel danger and is not afraid of the consequences. He is full of energy, absolutely confident in himself and believes that he will succeed.
Depressive-manic psychosis deprives a person of the opportunity to analyze information, therefore such people are prone to risk and addictions - alcohol, drugs or gambling. They can spend all their savings on some trinkets or invest in a loss-making enterprise, take out a bad loan, or simply lose everything, up to mortgaging the property. A bipolar person is capable of committing a crime for the sake of interest or on a dare, driving around the city, violating the rules of the road, which will endanger not only himself, but also those around him. nine0003
Promiscuous sex can lead to sexually transmitted diseases or unwanted pregnancies.
The diagnosis exhausts them both mentally and physically. People suffer from their own actions, sinking into depression even more. Their immunity deteriorates, psychosomatic illnesses occur, and the quality of life decreases.
A separate problem is the inability to establish full communication with other people.
nine0002 People with bipolar disorder can behave recklessly, so the support of loved ones is extremely important here. If you are unsure how to help, talk to your doctor.![](/800/600/http/i.pinimg.com/236x/ad/ce/41/adce41a3b64877c25b03b1a77de2ede6--bipolar-disorder-disorders.jpg)
Diagnosis of manic-depressive psychosis
Manic depression as an official diagnosis is made only after the manifestation of at least two episodes of bipolar disorder, one of which must be manic or mixed. nine0003
A psychiatrist will diagnose and treat TIR. For a correct conclusion, it is necessary to collect complete information about the patient and his immediate family. Further special studies are required. For example, the degree of depression is determined by scales.
In the case of manic episodes, the doctor needs to be especially careful. Here it is important to exclude diseases similar in symptoms, external causes and the effect of the action of drugs.
TIR Treatment
The Russian Society of Psychiatrists recommends treating manic-depressive psychosis according to three stages:
Psychotherapeutic methods
Psychotherapeutic measures must be carried out in combination with medications, which include antiepileptic drugs, antidepressants, tranquilizers, etc. Otherwise, there will be no effect. Today, there are special techniques for the treatment of bipolar affective disorder that help reduce interpersonal conflicts and regulate cyclical changes in various environmental factors.
In addition, cognitive-behavioral exercises are actively used in the treatment; individual, group, and family forms of psychotherapy to reduce the risk of relapse; and self-monitoring sheets to monitor mood swings. nine0003
Important! Some medical institutions conduct special educational programs for their patients, where they are told about the disease, explain its features and methods of treatment. Awareness calms a sick person and helps to form the right attitude towards what is happening to him.
Disease prognosis
The prognosis for manic-depressive psychosis can be different, it all depends on the individual characteristics of the disease. Outpatient treatment is enough for someone, hospitalization is required for someone, and in some cases the pathology is so strong that they will have to apply for disability. nine0003
According to WHO estimates, bipolar disorder is the 12th leading cause of disability. It overtook even asthma.
However, a well-designed treatment regimen can significantly improve the patient's quality of life. It is only worth remembering that it will not be possible to completely get rid of the diagnosis - at the moment it is incurable.
FAQ
Bipolar Disorder - What is it? nine0003
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Bipolar affective disorder of the brain or manic-depressive psychosis is a psychiatric disorder characterized by prolonged extreme mood swings.
What is circular psychosis?
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This is the former name for manic-depressive psychosis, and now bipolar affective disorder.
How to live with bipolar disorder in women? nine0003
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Manic-depressive psychosis is much more common in women than in men. However, the clinical picture is relatively similar, with the only major difference being that the depressive phase predominates in the former. In any case, the help of a psychiatrist is required.
Bipolarity in psychology is...?
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This term is used in both psychology and psychiatry. It means a sharp mood swing. nine0003
Expert opinion
Most mental disorders, including MDP, arise due to hereditary predisposition. It is almost impossible to prevent such "vices", but this does not mean that it is impossible to reduce the frequency of new episodes or reduce their severity.
Many people with BAD are quite successful. There is evidence that such a diagnosis was made to actors Catherine Zeta-Jones and Mel Gibson, singer Mariah Kerry. The writer Ernest Hemingway, actress Marilyn Monroe, and Nirvana frontman Kurt Cobain are believed to have suffered from TIR. Remember that it is important to contact qualified specialists in time and strictly follow their recommendations. nine0003
Bipolar affective disorder (Manic-depressive psychosis): Causes, Symptoms, Treatment
Bipolar affective disorder - a violation of the mental status of a person, accompanied by a change in periods of mania, depression and intermission. This condition was previously called manic-depressive psychosis .
Mania is a special mental state in which a person resides, characterized by high spirits, a feeling of superiority over others, a sense of emancipation, reduced need for rest, etc., lasting at least a week. nine0003
Depression is a period of mental depression, accompanied by sadness, depression, sleep disturbance, irritability, suicidal thoughts, etc.
Intermission (interphase) is called the "light" period in the mental state of a patient with bipolar affective disorder, in which his consciousness and activity are completely restored. It is worth noting that the alternation of mania and depression can occur without periods of intermission.
Attention!
Here you can choose a doctor who specializes in the treatment of Bipolar affective disorder (Manic-depressive psychosis) If you are not sure about the diagnosis, make an appointment with a general practitioner or general practitioner to clarify the diagnosis. nine0003
Articles on the topic Bipolar affective disorder (manic-depressive psychosis):
Causes
Symptoms
Diagnostics
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Face-to-face consultations (including at home), remote consultations (video, audio, text) — Phone, Skype, Viber, WhatsApp, Messenger, Telegram, Instagram, Facebook. Specialization: depression, anxiety, fear, panic attacks, insomnia, irritability, VSD, bipolar disorder, schizophrenia, senile dementia, obsessive-compulsive disorder, neurosis, psychosis, alcoholism, drug addiction (see below for a complete list). Leading specialist of the Center for Psychotherapy. Work experience as the head of the department in the clinical hospital "Feofaniya". Doctor of the highest category. Psychotherapist, psychiatrist, psychologist, narcologist. Experience 29years..
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Irina Nikolaevna is a psychiatrist of the highest category with over 20 years of experience. Specializes in the treatment of mood disorders, depression, anxiety and panic disorders, obsessive-compulsive disorders, dementia, schizophrenia and others. 18 December Mon 19 December keyboard_arrow_right
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Engaged in effective treatment of working capacity disorder, sleep depressive states, anxiety syndrome, chronic fatigue disorder, schizophrenia and apathy disorders in the elderly and senile. Therapeutic and preventive work among patients of psychiatric, narcological profiles. initial examination of the patient, the establishment of a preliminary diagnosis, the appointment of treatment, with further selection of supportive treatment. Also, conducts reception in English
Multidisciplinary complex of psychiatry and narcology "Renaissance-Kyiv"
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Reasons
There are a number of reasons that causes bipolar disorder. In the first place here can be attributed heredity. This is because the likelihood of getting sick is higher if other family members have the disease. Another important reason is autointoxication. In this case, there is a violation of the endocrine balance and water-electrolyte metabolism. Stressful situations can burden depression, but they are not the cause of this disease. Alcohol and drug abuse are also causes of this disorder. Also, the individual characteristics of each person, brain injuries and his diseases occupy a significant place among the causes. nine0003
Symptoms
Symptoms of bipolar affective disorder can appear in a person at any age. They differ from each other in each of the phases of the disease. During the manic phase, five stages are distinguished, namely:
- hypomanic stage. A person has an increased emotional state. During this period, a person is characterized by both physical and psychological vigor. Sleep duration begins to decrease.
- the next stage is the stage of severe mania. Patients constantly joke about something. But in between, there are short flashes of sudden anger.
A person's self-esteem rises sharply, many meaningless ideas arise. The duration of sleep continues to decrease, and in this phase it is approximately 4 hours a day; nine0024
- The maximum expression of symptoms occurs at the stage of manic frenzy. The patient's movements are abrupt. His speech becomes incomprehensible and quite often can consist of phrases or even just words;
- the intensity of the previous symptoms begins to decrease at the next stage - the stage of motor sedation. This is especially true of motor excitation.
In the last, reactive stage, the symptoms of mania return to normal.
In turn, the depressive phase covers 4 stages:
- At the initial stage, the patient complains of poor sleep. The person becomes depressed, the mood decreases. Although by the evening the patient's condition may improve;
- the stage of increasing depression is characterized by the fact that a person's working capacity decreases. The mood worsens and there is a certain anxiety.
The patient begins to speak quietly and slowly. Subsequently, insomnia begins, appetite disappears sharply;
- in the next stage, the symptoms are maximally aggravated. This stage is called the stage of severe depression. The patient is constantly accompanied by a feeling of incomprehensible anxiety and sadness. Speech becomes very quiet and slow. People can sit or lie down for a long time without changing their posture. Very often, suicidal thoughts and actions begin to appear. The patient is haunted by thoughts about the meaninglessness of being, pushing him to commit suicide; nine0024
- in the reactive stage, all symptoms gradually decrease. The person becomes more active.
There are also two main phases, manic and depressive.
The manic phase covers the following range of symptoms:
- euphoric or aggressively irritable mood;
- reduced need for sleep, as well as its duration;
- constant emotional instability;
The depressive phase includes the following symptoms:
- depression of mood;
- loss of appetite or its complete absence;
- the patient speaks very slowly and quietly;
- feeling much worse in the morning.
By evening, they gradually become normal.
Diagnosis
The diagnosis of bipolar affective disorder is that the patient is found to have repeated episodes of abrupt mood changes. The psychotherapist determines which of the periods, manic or depressive, the patient is experiencing at the moment, and in accordance with this prescribes treatment. Also check the level of motor activity. nine0003
Treatment
Currently, with the help of special medications in combination with psychotherapy, it is possible to effectively treat bipolar affective disorder. Psychotherapy is an integral part of the treatment, because it is during it that the doctor, communicating with the patient, can find out the causes of the disease. This will accordingly improve the patient's condition, set him up for positive thoughts and help solve a number of problems. A fairly common phenomenon now is the course of family psychotherapy. Relatives and friends of the patient begin to understand the disease better and help to overcome it faster.