22Mar

Manic-depressive psychosis: symptoms, course and treatment

The name manic depressive psychosis is due to the combination of forms of mental disorders of the individual: the manic phase is replaced by the depressive and vice versa. As with any mental disorder, there is no clear gradation of the duration and intensity of each phase with this disease: any of them can last from a couple of days to several years.

What is typical for the disease is manic depressive psychosis

Bipolar affective disorder( BAP) is now commonly referred to as a disease that until recently was called manic-depressive psychosis( MDP).This, like schizophrenia, is an endogenous mental illness, that is, it develops through internal mechanisms. Bipolar affective disorder( manic depressive psychosis) is determined by the "breakage" of certain genes and, as a consequence, by a metabolic disorder, for example, noradrenaline, serotonin in certain areas of the brain, in particular in the center responsible for the biological rhythms of our body. With this, it is connected that the onset and exacerbation of the disease occur more often in the spring and autumn, as well as during the formation and termination of menstruation, can be provoked by pregnancy. This is the basis for the prevention of recurrence of the disease.

What is characteristic of manic depressive psychosis and how does this mental illness occur? The course of manic depressive psychosis occurs in the form of seizures( phases) of mood disorders( depressive or manic), separated by light intervals( intermissions) with complete recovery of mental health, when a person can return to his former job. The duration of the phases without treatment can be from several days to several years, on average 3-6 months. In humans, the course of the disease can be monophasic when there is an alternation of light intervals only with depressive or only with manic phases. And a two-phase( bipolar) type of bipolar affective disorder that alternates with alternating depressive and 1 maniacal phases with light intervals, or without them, is already a continuous flow. The number of attacks with manic depressive disorder varies from person to person during life up to several exacerbations per year. They begin more often gradually, with the appearance of insomnia, emotional fluctuations, mental discomfort.

The main signs of the depressive phase of bipolar affective personality disorder

The depressive phase of bipolar affective disorder is characterized by low mood, slowing down of mental processes, motor inhibition. Patients are depressed, silent, perceive everything in gloomy tones. One of the main signs of the depressive phase of bipolar affective personality disorder is a constant sense of longing with a sense of hopelessness and despair, often combined with painful heaviness and burning pain in the heart. And this is already a manifestation of deep depression. Here, an "explosion of longing" is possible - a sudden explosion of despair with excitement, sobs, groans, the desire to damage yourself. This condition is extremely dangerous for the possibility of suicide. Such people simply need constant supervision.

In patients with symptoms of bipolar affective disorder in a state of depression, the appetite decreases until a complete refusal to eat. The dream is broken: difficulties in falling asleep, early awakenings already with a feeling of longing and anxiety. They have a quiet, monotonous speech, the patients complain that they find it difficult and do not want to talk. Mimicry and the expression of the eyes are very sad, suffering, the corners of the mouth mournfully lowered. Pose monotonous;most of the time patients sit with their heads bent and do not interfere in anything.

Another sign of bipolar affective disorder in a state of depression is the emergence of overvalued and delusional ideas. These can be ideas of self-incrimination, when insignificant acts are perceived as crimes. The past seems like an endless series of mistakes, they blame themselves for what they did not do: treason, embezzlement, death of loved ones. With the ideas of self-deprecation, patients consider themselves insignificant people, and what happens to them is regarded as punishment for their "crimes".

There may be a manifestation of a depressive phase in the form of hidden, masked depression, when mood is reduced indistinctly or depression is overshadowed by other symptoms.

Symptoms of manic-depressive psychosis in this phase may include shemostopathies( extremely unpleasant sensations in the body: transfusion, squeezing, drilling, burning) and pain in the head, chest, abdomen, despite the fact that doctors do not find any real illness.

It can be just a disturbance of sleep, when several weeks, months, sometimes years, until a person turns to a specialist, he is disturbed by difficulties in falling asleep, superficial sleep, early awakenings without sensations of rest. A bad mood here is considered a consequence, not a cause. But sleeping pills are not an option here.

These can be diencephalic or hypothalamic crises, so-called vegetative-vascular dystonia, when in the form of attacks there are fluctuations in blood pressure, a feeling of heat or chills, rapid breathing, sweating, fever, flatulence, very often anxiety, fear of death,and there may be attacks of suffocation very similar to bronchial asthma.

In addition, the symptoms of manic depressive psychosis are states of obsession and fears - they too can mask depression.

Alcohol and drugs can be taken to relieve anxiety, stress, to increase mood, and after the depressive phase has passed, it goes away and drinking, and you do not want to drink vodka at all. But here, with frequent aggravation, you can get into a real addiction, and this is a completely different story.

And, finally, bipolar manic depressive psychosis in the variant of latent depression can be characterized by periodic impotence or frigidity.

In some cases, the development of mournful numbness is possible. The sick people say that they have become indifferent to their loved ones, even to their children. At the same time, insensitivity is very difficult for patients, and they themselves suffer from this. Unlike patients with schizophrenia, during this phase of manic depressive psychosis, a critical evaluation of their condition remains.

How to determine the manic phase of depressive psychosis

And how to determine the manic phase of depressive psychosis and what signs accompany this disorder?

The manic phase of a depressive psychosis is characterized by opposite symptoms of depression - heightened mood, acceleration of mental processes and motor activity, sometimes reaching a degree of manic excitement.

At first, when the attack is not yet deep, the hypomanic condition is extremely well tolerated. There is a rush of vivacity, mood improves, a feeling of increasing physical and mental strength appears. The surrounding is perceived iridescent, all mental processes proceed easily, without delays, intellectual activity is very productive. Such people sleep little, but wake up rested and full of energy, easily get up, quickly do all the work, and they all manage. Increased self-esteem, cheerful mood, facial expressions. Appetite, sexual desire, blood pressure increased.

With further development of the attack, the mood becomes inadequately cheerful, not appropriate for the situation. Despite the troubles, the patients are in a good mood, cheerful( euphoria).The energy is inexhaustible, the thirst for activity is increased( hyperbulia).But the activity is already unproductive. Because of the high distractibility of attention, patients react to any stimulus and are not able to bring one thing to an end. They talk without interruption, they interfere in everything, they give advice to everyone. A characteristic symptom of manic-depressive disorder in this phase is the acceleration of thinking up to the "jumping of ideas", the speech is very fast, sometimes it seems incoherent. Disinhibited sexual attraction, patients easily find casual acquaintances, enter random sex relations. Some become cynical, rude, can swear obscenely, although in the ordinary state it is educated, intelligent people. Women are beginning to throw themselves dressy, immoderately using cosmetics, talking loudly, laughing.

In pronounced cases, delirium develops. Patients overestimate the qualities of their personality, exaggerate their merits and achievements. They consider themselves rich and talented people, hand out all the money and property to people. They say that they can occupy the highest posts, make great discoveries. The case can reach the title of "Lord of the Universe".

If a person has had craniocerebral injuries or other injuries in his life, a typical euphoric, joyful mood can give way to irritability and anger - this is called an angry mania.

During the intervals between the phases, mental health is restored completely, the person is perfectly able to work.

Than to treat manic depressive psychosis: effective drugs

Treatment of bipolar affective disorder needs to start immediately, with the first signs, you should not wait until everything "goes by itself".There is no prowess in "enduring" depression. A person can simply "fall" out of life: figuratively( step aside, close) or really( die).You need relatives, friends, acquaintances. Consult a physician. And excessive joy, euphoria is fraught with a subsequent depressive "pullback" at the expense of depletion of resources. Yes, and stupid things can be done abound, as there are a lot of energy, but there is no criticism. A person takes loans, gives up relatives, starts "all the hard."

Than to treat manic depressive psychosis in manic and depressive phases?

Principles of treatment of this mental illness are the same as in schizophrenia. Treatment of manic depressive psychosis is carried out as drugs that improve the nutrition of the brain, as well as other methods: cleansing the body, laser therapy, unloading and dietary therapy for certain forms, insulin-co-therapy, electroconvulsive therapy. In the last three, a brain restart takes place, the body is shaken and the process of recovery begins. These methods can, if not stop the attack of the disease, then at least increase the sensitivity to drugs.

Antidepressants are effective in the treatment of depressive disorder. They are different in direction: mostly soothing, stimulating, affecting serotonin, norepinephrine, melatonin and others. The main drugs in the manic state - normotimics, they are also used for depression to prevent an attack of the disease. I remind you again: drugs can not be "hooked" if the brain is able to independently balance.