Manic Depression

Manic depression, also known as Bipolar disorder is characterized by extreme fluctuations in mood ranging from periods of intense "highs" or mania to periods of severe depression or "lows", however, in reality it is much more complex than that as there is no clear pattern and some can even experience mixed state bipolar, with a combination of both mania and depression.

There is also no known single cause of Bipolar and no way of predicting who will develop it although it does appear to be a tendency for it to run in families suggesting that genetics play a part. According to the Royal College of Psychiatrists, Bipolar affects around one in one hundred adults, although it is possible that these figures are on the low side as it is believed that many people with Bipolar will not seek help due to denial, misunderstanding and lack of knowledge surrounding the condition. It affects both men and women equally and usually begins in early adulthood but the way it manifests itself is anything but consistent. Episodes can be triggered by stressful events and physical illness or even nothing at all. So how do you know if you have Bipolar disorder?

Symptoms of a manic episode include:

A manic episode can be diagnosed if at least 3 of the symptoms occur along with an elevated mood for most of the time for at least a week. If the overall mood is one of irritability then another 4 symptoms must be present.

• Increased energy, activity, and restlessness
• Excessively "high," overly good, euphoric mood
• Extreme irritability
• Racing thoughts and talking quickly, jumping from one idea to another
• Distractibility, lack off concentration
• Little sleep needed
• Unrealistic beliefs in one's abilities and powers
• Poor judgment
• Spending sprees
• A lasting period of behavior that is different from usual
• Increased sexual drive
• Abuse of drugs, particularly cocaine, alcohol, and sleeping medications
• Provocative, intrusive, or aggressive behavior
• Denial that anything is wrong

Symptoms of a depressive episode include:

A depressive episode can be diagnosed if five or more of these symptoms are present for most of the time for a period of at least 2 weeks.

• feeling sad, anxious, or empty mood
• Feelings of hopelessness or pessimism
• Feelings of guilt, worthlessness, or helplessness
• Loss of interest or pleasure in activities once enjoyed, including sex
• Decreased energy, a feeling of fatigue or of being "slowed down"
• Difficulty concentrating, remembering, making decisions
• Restlessness or irritability
• Sleeping too much, or can't sleep
• Change in appetite and/or unintended weight loss or gain
• Chronic pain or other persistent bodily symptoms that are not caused by physical illness or injury
• Thoughts of death or suicide, or suicide attempts

The gaps in between a high and a low episode can vary significantly with each individual. Some people will experience rapid shifts between moods and others will change more slowly over a period of time. Conventional treatment usually consists of some form of mood stabilizing medication to reduce the severity and duration of the episodes, for example, Lithium is the most commonly used. Achieving the correct dosage is crucial as high levels of Lithium can be toxic so this will be carefully evaluated and monitored by a GP or health professional. However, it doesn't always prove to be effective and isn't suitable for everyone. The side effects can be difficult to cope with for some people and include, thirst, nausea, weight gain, anxiety, shakes, dry mouth, disturbed sleep, hair loss, and sexual dysfunction.

Types of Bipolar

Bipolar has been classified into types Bipolar 1, Bipolar 2, Rapid Cycling and Cyclothymia.

Bipolar 1

The classic symptoms of Bipolar 1 involve recurrent manic and depressive episodes with either stable periods in between or going directly from a depressive episode into a manic phase or vice versa. Periods of depression vary from individual to individual and can last for only a short time or for months.

Bipolar 11

This type of Bipolar presents with only mild or perhaps even no manic periods at all but more depressive episodes than periods of mania. This type is more common in women.

Rapid Cycling

Bipolar is classified as rapid cycling type if the person experience more than 4 manic or depressive episodes or fluctuations between both within the space of a year.

Cyclothymia

A less severe form of mood swings but they often persist for longer than those with other types of Bipolar.

Conclusion

Bipolar disorder can be distressing for both the sufferer and the family and friends closest to them. Neither they nor the person with Bipolar can know when an episode of depression or mania is likely to occur or how long it will last. Relationships, occupation and finances can all suffer leading to more stress and worry and a worsening of the symptoms. Apart from seeking professional help and finding out as much as you can about the condition, it is advisable for both the sufferer and their loved ones to learn how to recognise the warning signs and triggers that can precipitate a manic or depressive episode so appropriate action can be taken to minimise any negative effects.

David McEvoy