Manic depression or manic-depressive psychosis
The bipolar affective disorder (BD, also called manic depression or manic-depressive psychosis) is a mood (affective) disorder. Patients diagnosed with bipolar disorder experience episodes of depression and mania or hypomania, with periods without symptoms in between the episodes. Depending on whether a patient experiences mania or hypomania episodes, we can recognize bipolar disorder type 1 or type 2. BD is not the same as mood swings that all of us have.
A manic episode (mania) is a period of abnormally and persistently elevated, expansive or irritable mood lasting at least one week and present most of the day, almost every day. The patient may experience at least three of the following symptoms (after DSM V) during their episode:
- inflated self-esteem or grandiosity
- decreased need for sleep;
- more talkative than usual;
- racing thoughts;
- distractibility;
- increase in activities or psychomotor agitation;
- excessive involvement in activities that have a high potential for painful consequences (e.g. engaging in unrestrained buying sprees, sexual indiscretions or sudden changes).
- low self-esteem and guilt
- difficulty with thinking, concentration, and decision-making
- recurring suicidal thoughts or feelings of hopelessness
The mood disturbance causes marked impairment in occupational or social functioning. An episode of depression and mania may be accompanied by psychotic symptoms.
The above symptoms are less intense in hypomania episodes and do not significantly disturb a patient’s functioning. However, the change in mood and behaviour should be clear and visible to others. The length and frequency of each episode varies from patient to patient. The diagnosis of bipolar disorder is not easy and usually requires longer observation. Sometimes episodes of hypomania go unnoticed.
Pharmacology is the pillar for treating affective bipolar disorders. Integrating it with psychotherapy brings enormous benefits to the patients. In the course of psychotherapy, patients learn how to deal with their disorder, i.a. deal with symptoms that cannot be fully remedied by any medications, or how to change their lifestyle to make the treatment more effective. Patients master the methods of early symptom detection, stress management and problem solving. Cognitive behavioural psychotherapy is an effective method of helping patients with affective bipolar disorder.
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