Manic-depressive psychosis is an outdated name for an endogenous mental illness, which in the international classification is defined as bipolar disorder. The original name of this disorder is circular psychosis, which reflects the main symptom of the disease or a change in mood phases. The disease has two opposite phases - mania or abnormally elevated mood and depression. The phases can alternate, replacing each other immediately or through a light interval called intermission.
Sometimes the same person has manifestations of both phases at the same time, or one phase is fully expressed and the other partially expressed. At the height of mood disorder, persistent hallucinatory-delusional structures can form. Some patients end up in psychiatric hospital once and get by with a certificate of incapacity for work, others become disabled forever.
Is manic-depressive psychosis treatable? Unfortunately, full recovery impossible. However, regular use of potent psychotropic drugs allows a person to remain in society and live a relatively normal life for many years.
They have not been definitively established, although there are indisputable statistical data. The reasons for the development of manic-depressive psychosis are:
Several studies carried out in different countries, it has been proven that in 80% the cause is a genetic defect. The study of bipolar disorder was conducted on identical twins, which excludes random factors. This means that the twins who lived in different conditions and countries, showed the same clinical picture at the same age. Defects found in different parts 18th and 21st chromosomes. The hereditary factor is considered decisive.
Family influence and environment with MDP it ranges from 7 to 20%. These include living together with mentally unstable individuals, severe social upheavals, armed conflicts, man-made and natural disasters.
Provoking factors
The frequency distribution of bipolar psychosis in people of both sexes is approximately the same, but biphasic disorder develops more often in men, and single-phase disorder in women. Women's psychiatric disorders are more pronounced and are often provoked by changes hormonal status – menstrual cycle, pregnancy, childbirth, menopause. Occurs in women postpartum depression subsequently classified as the onset of bipolar disorder, the diagnosis is established retrospectively.
It is believed that any psychiatric disorder that occurs within 14 days after birth almost always transforms into full-blown psychosis. Bipolar disorder can also develop after childbirth in a woman who has ever suffered from any psychiatric disorder.
In practice, there is a connection between the depressive phase and traumatic events. A person initially develops reactive depression in response to some event, and then transforms into major psychosis. There is no such connection with regard to the manic phase; mania develops according to its own endogenous laws.
It has long been noted that affective disorders develop in those whose personality has special features. These are melancholic people who never see anything good in the events of life.
Also at risk are overly ordered and responsible people who eliminate all spontaneity and unpredictability from their lives. Those at risk are those who quickly become exhausted and cannot endure difficulties and troubles. Schizoids are always in danger - people are formulas, prone to theorizing.
Classification of manic-depressive psychosis
Manic-depressive psychosis is the second most common endogenous mental illness after schizophrenia. The polymorphism of symptoms, delusional inclusions, social maladaptation, rapid change of phases make this disease difficult to diagnose. According to statistics, an average of 10 years pass from the onset of the disease to the final diagnosis.
In ICD-10, bipolar disorder is coded under categories F31 and F33. In practice, the type of course of the disease matters:
A certain pattern was noted between the type of course and age of manifestation of the disease. According to statistical data, at the onset of the disease before the age of 25, a classic bipolar course develops; after 30 years, the unipolar course is more common.
Symptoms of manic-depressive psychosis
What is MDP and how does manic-depressive psychosis manifest? This is a kind of “swing” of mood, with endless fluctuations of which a person has to live.
The manic phase is a combination of three symptoms: abnormal high mood, faster thinking and higher motor activity. Clinically, the phase develops gradually, incrementally: if at first a sick person can be mistaken for a confident optimist, then at the height of the phase it is a riot that does not recognize any boundaries.
The mood begins to improve first, and no objective reasons for this purpose no. A person realizes that everything in his life is great, there are no obstacles, the future is cloudless, and his abilities and capabilities exceed those of everyone else. A logical continuation is delusions of grandeur, when the patient feels like a god or the arbiter of destinies. Behavior changes - values and acquisitions that took the whole previous life are given away, career and family collapse. There is no longer any need to eat and sleep - there is so much happiness that everything else does not matter.
Undoubtedly, such behavior leads to personality degradation. The patient requires inpatient treatment that limits his movements and actions.
The depressive phase carries with it the threat of suicide, especially in adolescence. The danger is that not only the mood decreases, but the way of thinking changes - the person believes that life has reached a dead end with no way out. From depression, having no life experience and not knowing how to withstand the blows of fate. Not a single country or city, not even Moscow, can completely cope with teenage suicides.
The depressive phase can also culminate in delirium, but its content is different: the patient may be convinced that not only his life is wasted, but his body is being destroyed - eaten by worms, burned from the inside, or turned into jelly.
Extremely dangerous depressive disorders if the person has never been treated. There are known cases of extended suicide, when a parent, wanting to save their child from the inevitable end of the world, passes away with him.
In less severe cases, a person loses interest in life so much that they refuse food due to a change in its taste (“like grass”), stop taking care of themselves, do not change clothes and do not wash. Women in the depressive phase often stop having periods.
Diagnostics
The nosological affiliation does not immediately become clear. The manic phase, especially if it occurs in the form of hypomania, is often not perceived as a painful condition by either the patient himself or his relatives. The short phase, if it was interrupted before the patient had time to commit reckless acts, is perceived as an episode of a vibrant life.
The following methods are used to diagnose manic-depressive psychosis:
Treatment of manic-depressive psychosis
How is manic-depressive psychosis treated? Requires true skill and extensive experience. A restrictive regime, sometimes strict supervision, medications, and psychotherapy are used.
IN outpatient setting Only cyclothymia or an erased variant can be treated bipolar disorder, at which social adaptation person is not violated. All other forms of manic-depressive disorder are treated in a hospital in a closed psychiatric department. Hospitalization is carried out in accordance with current legislation, the patient gives informed consent to treatment.
If the patient’s condition does not allow him to assess everything that is happening around him, the medical commission makes a decision on involuntary hospitalization according to the next of kin. Staying in a closed department is the main condition for achieving remission, when the patient is ensured safety and regular medication intake.
Treatment of the first episode is most effective. With all subsequent exacerbations, susceptibility to medications decreases, and the quality of intermission deteriorates.
Drug treatment
In the treatment of manic-depressive psychosis, drugs from the following groups are used:
This is a typical set of drugs, which is expanded according to individual indications. The goal of treatment is to interrupt the current phase and resist its inversion, that is, a change to the opposite one. To do this, high doses of drugs are used, combining them depending on the patient’s condition. How to treat manic-depressive psychosis is decided by the attending physician.
None folk remedies the course of the disease is not stopped or changed. It is allowed to use soothing and restorative preparations during periods of calm.
Psychotherapeutic treatments
The capabilities of this method are limited and are used only in intermission. From exacerbation to exacerbation the patient's personality disorders, and this narrows the doctor’s range of options. Chronic disorder requires changes in approaches throughout treatment.
The following methods are effective:
An important part of a psychotherapist’s work is increasing the patient’s confidence in the doctor, developing a positive attitude towards treatment, and psychological support during long-term medication use.
Prognosis and prevention
The prognosis after treatment of manic-depressive psychosis depends entirely on the duration of the phases and their severity. Patients who become ill for the first time with a short period of hospital stay are issued a certificate of temporary incapacity for work with a rehabilitation diagnosis. Some harmless disease is indicated - a reaction to stress, etc.
If a person is in a hospital for a long time, a disability group is established - third, second or first. Patients in the third disability group have limited ability to work - they can perform light work or their number of hours is reduced, night shift work is prohibited. If the condition is stabilized and intelligence is preserved, the disability group can be removed.
If a sick person commits a crime, a forensic psychiatric examination is ordered. If the court establishes the fact of insanity at the time of the crime, compulsory treatment is prescribed. Prevention of disease is the use of medications prescribed by a doctor and a calm, measured life.
Manic-depressive psychosis is a mental illness characterized by the development of two polar states in one person, which replace each other: euphoria and deep depression. The mood is changeable and has big swings.
In this article we will look at the symptoms, signs, and methods of treating this mental disorder.
general characteristics
Patients experience a period of intermission and the immediate course of the disease. Usually the disorder manifests itself only as one of the phases of psychosis during a certain period. In the pauses between active manifestations of the disease, there comes a time when the individual leads completely normal, habitual life activities.
In medicine, the concept of bipolar is sometimes used. affective disorder, and the acute phases of its manifestation are psychotic episodes. If the disease occurs in milder forms, then it is called cyclothymia.
This psychosis is seasonal. Basically, the difficult periods are spring and autumn. Both adults and children suffer from it, starting from adolescence. As a rule, it is formed by the person’s thirtieth birthday.
According to statistics, the disease is more common in women. According to general data, 7 out of 1000 people suffer from manic-depressive syndrome. Almost 15% of patients in psychiatric clinics have this diagnosis.
Usually, the first symptoms of a developing disease appear weakly; they can be easily confused with other problems of growing up during puberty, or at 21-23 years of age.
Genetic theory of the development of the disorder
Today, the theory that explains the origin of manic-depressive state is genetic, which studies hereditary factors.
Statistics have repeatedly shown that this disorder transmitted genetically in 50 percent of cases. That is, there is a family continuity of the disease. It is important to diagnose the disease in a timely manner in a child whose parents suffer from this syndrome in order to eliminate complications. Or to accurately establish whether there are characteristic manifestations, or whether the children managed to avoid the disease.
According to geneticists, the risk of illness in a child is 25% if only one of the parents is sick. There is evidence that identical twins are susceptible to the disease with a 25% probability, and in fraternal twins the risk increases to 70-90%.
Researchers who adhere to this theory suggest that the gene for manic psychosis is contained on chromosome 11. The information, however, has not yet been proven. Clinical trials indicate a possible localization of the disease in the short arm. The subjects were patients with a confirmed diagnosis, therefore the reliability of the information is quite high, but not one hundred percent accurate. Genetic predisposition these patients have not been studied.
Main Factors
Researchers give significant influence to the following factors:
- Unfavorable environmental conditions. They stimulate the active development of pathology, although experts are considering the possibility of compensating for hereditary defects.
- Unhealthy food. Products containing preservatives, flavors, and carcinogens can provoke mutations and diseases.
- Modified products. Their consumption affects not the person who uses such products, but his children and subsequent generations.
Experts note that genetic factors are only 70% of the likelihood of a person developing manic disorder. depressive syndrome. 30% - the above factors, as well as the environmental situation and other possible etiological issues.
Minor causes of psychosis
Manic-depressive psychosis has been poorly studied, so there are still no clear reasons for its occurrence.
In addition to genetic and the above factors, the occurrence of the disorder in baby fetus influenced by the stress experienced by the pregnant mother, as well as how her birth proceeds. Another feature is the functioning of the nervous system in an individual individual. In other words, the disease is provoked by disturbances in the functioning of nerve impulses and the neural system, which are located in the hypothalamus and other basal areas of the brain. They appear due to changes in activity chemical substances– serotonin and norepinephrine, which are responsible for the exchange of information between neurons.
Most of the reasons influencing the appearance of manic-depressive disorder can be classified into two groups:
- Psychosocial
- Physiological
The first group is those reasons that are caused by the individual’s need to seek protection from severe stressful conditions. A person unnecessarily strains his mental and physical efforts at work, or, on the contrary, goes on a merry spree. Promiscuous sex, risky behavior - everything that can stimulate the development of bipolar disorder. The body wears out and gets tired, which is why the first signs of depression appear.
The second group is disruption of the thyroid gland and other problems associated with the processes of the hormonal system. As well as traumatic brain injuries, severe head diseases, tumors, drug and alcohol addiction.
Types and symptoms
Sometimes in clinical picture In different patients, only one type of disorder is observed - depressive. The patient suffers from deep despondency and other manifestations typical of this type. In total, there are two bipolar disorders with manic psychosis:
- Classic – the patient has certain symptoms that affect different mood phases;
- The second type is difficult to diagnose, in which the signs of psychosis are weak, due to which confusion may occur with the usual course of seasonal depression, a manifestation of melancholy.
There are signs that experts consider for a manic-depressive state: those that are characteristic only of manic psychosis and those that appear only in depressive psychosis.
So, what are the symptoms of manic-depressive psychosis? In medicine they are combined into general concept"sympathicotonic syndrome"
All patients in phase manic disorder, characterized by increased excitability, activity and dynamism. People can be described like this:
- They are too talkative
- They have high self-esteem
- Active gestures
- Aggressiveness
- Expressive facial expressions
- Pupils are often dilated
- Blood pressure is higher than normal
- Irritable, vulnerable, react sharply to criticism
Patients have decreased sweating and a lot of emotion on their face. They think they have a fever, signs of tachycardia, problems with gastrointestinal tract, insomnia. Mental activity may remain unchanged.
Patients in the manic phase experience a desire to take risks in various areas, from gambling to committing crimes.
At the same time, people feel unique, omnipotent, very lucky, and they have unprecedented faith in their own abilities. Therefore, patients quite easily succumb to financial scams and frauds in which they are drawn. They spend their last savings on lottery tickets and place sports bets.
If the disease is in the depressive phase, then such patients are characterized by: apathy, taciturnity and quiet, inconspicuous behavior, a minimum of emotions. They are slow in their movements and have a “sorrowful mask” on their face. Such a person complains of breathing problems and a feeling of pressure in the chest. Sometimes patients refuse to eat food, water, and stop taking care of their appearance.
Patients with depressive disorder often think about suicide, or even commit it. At the same time, they do not tell anyone about their desires, but think through the method in advance and leave suicide notes.
Diagnostics
We mentioned above that bipolar disorder is difficult to diagnose, since the signs and symptoms of manic-depressive psychosis sometimes coincide with other mental conditions person.
In order to be installed accurate diagnosis, doctors interview patients and their close relatives. Using this method, it is important to determine whether a person has a genetic predisposition or not.
The patient takes a series of tests, based on the results of which the level of his anxiety is determined, addictions, propensity to them, and emotional state are indicated.
In addition, if a person is suspected of manic-depressive psychosis, he is prescribed EEG studies, radiography, and MRI of the head. They are used to exclude the presence of tumors, brain injuries, intoxication consequences.
When the full picture is established, the patient receives appropriate treatment.
Treatment for bipolar disorder
Manic-depressive psychosis is sometimes treatable. Specialists prescribe medications, psychotropic drugs, antidepressants - those drugs that stabilize the general emotional state and mood.
One of the main components that has a positive effect on the treatment of the disease is lithium salt. It can be found in:
- Micalita
- Lithium carbonate
- Lithium oxybutyrate
- And in other similar drugs
However, it should be borne in mind that with diseases of the kidneys and gastrointestinal tract, with hypotension such medicines contraindicated.
In particularly difficult situations, patients are prescribed tranquilizers, antipsychotics (Aminazine, Galaperidol, as well as thioxanthene derivatives), antiepileptic drugs (Carbamazepine, Finlepsin, Topiramate, etc.).
In addition to medical therapy, for effective comprehensive care, the patient should also undergo a course of psychotherapy. But visiting this specialist is possible only during the period of stabilization and intermission.
In addition, to consolidate the effect of drug therapy the patient should additionally work with a psychotherapist. These classes begin after the patient’s mood has stabilized.
The psychotherapist allows the patient to accept his illness and realize where it stems from, and what its mechanisms and symptoms are. Together, they build a behavioral strategy for periods of exacerbation and work on ways to control emotions. Often, the patient’s relatives are also present at the sessions, so that they can calm him down during attacks; the classes will also help loved ones prevent exacerbation situations and control them.
Preventive measures
In order to avoid frequent episodes of psychosis, a person must provide himself with a state of peace, reduce the amount of stress, be able to always seek help, and talk to someone significant during difficult periods. Medications based on lithium salts help to delay the acute phase of manic-depressive syndrome, but here the dosage prescribed by the doctor must be followed; it is selected in each case separately, and it depends on the degree of development of the disease.
But sometimes patients, after they have safely overcome acute period, forget or refuse medications, which is why the disease returns with a vengeance, sometimes with much more strong consequences. If the medication continues, according to the doctor’s instructions, then the affective phase may not occur at all. The dosage of medications may remain the same for many years.
Forecasting
It should be noted that complete cure manic-depressive disorder is almost impossible. Having experienced the symptoms of psychosis once, a person runs the risk of having a repeated experience of the acute experience of the disease.
However, it is within your power to stay in remission as long as possible. And go without attacks for many months and years. It is important to strictly adhere to the prescribed doctor's recommendations.
Depressive syndrome is a mental disorder with active suppression of the mental activity of the cerebral cortex. To diagnose the condition, it is enough to identify a specific triad - lack of joy with impaired thinking, pessimism in relation to current events, inhibition of the motor sphere.
Depressive syndrome - what is it, how does it differ from psychosis?
Experts classify depressive syndrome as an affective disorder in which the active psycho-emotional background is suppressed, the person becomes lethargic, apathetic and motionless. Constant anxiety, restlessness and irritability are conditions that haunt a person throughout his life.
Various psycho-emotional factors in the disease were described by many ancient healers. Hippocrates also used the terms “mania” and “melancholy” to describe depressive syndrome. The definition was applied to people who were constantly in a stage of anxiety, apathy, and despondency.
The human psycho-emotional background is quite diverse. Changes in mood are specific to a person, so it is difficult to consider a patient who is constantly irritated, anxious, and aggressive towards people around him to be considered healthy.
Other medieval healers used other synonyms to describe depression - blues, depression, melancholy, melancholy and sadness.
Famous poets also described the disease - “sadness and melancholy eats me up,” “a drop of hope will flash, and then a sea of despair will rage.” Close attention to nosology is explained by the specific behavior of a person. Anxiety, irritability, and negative mood are the “golden triad” of depressive disorder.
If you tell us what depressive syndrome is, you need to rely not only on abnormal emotional sphere, anxiety, but also the peculiarities of the cerebral cortex. For the development of pathology, the formation of a stable focus of inhibition of nerve impulse transmission is required.
A person’s psycho-emotional state will never become stable. Too many external events affect the quality of functioning of the mental sphere. Problems at work bad relationship in the family, unpleasant stock market reports - all these factors affect the functioning of the cerebral cortex.
Negative external circumstances - divorce from a husband, death of close relatives - can affect a person’s quality of life. Coping with the blows of fate is not easy, but with optimal functioning of the cerebral cortex, within 3 days fear should disappear and calmness should form.
With correct behavior of the cerebral cortex, no foci of inhibition are formed. If anxiety and irritability continue for more than 2 weeks, there is a high probability of developing a depressive syndrome, which will require consultation with a psychiatrist. Depending on the stage of severity, the specialist makes a decision regarding the need for inpatient or outpatient treatment of the person.
MDP is a serious mental illness caused by pathological physiological changes in the body caused only by internal factors, scientifically described in 1854 by French researchers as “circular psychosis” and “insanity in two forms.” Its classic version consists of two pronounced phases of affect: mania (hypomania) and depression, and periods of relative health between them (interphases, intermissions).
The name manic-depressive psychosis has existed since 1896, and in 1993 it was recognized as traumatic and carrying some scenario of the disease, and the correct one was recommended - bipolar affective disorder (BAD). The problem implies the presence of two poles, and, having one, has a forced name: “bipolar disorder of the unipolar form.”
Each of us can experience mood swings, periods of decline or causeless happiness. MDP is a pathological form with a long course of these periods, which are characterized by extreme polarity. In the case of manic-depressive psychosis, no reasons for joy can bring the patient out of depression, nor can negative things bring the patient out of an inspired and joyful state (manic phase). Moreover, each stage can last a week, months or years, interspersed with periods of an absolutely critical attitude towards oneself, with complete restoration personal qualities.
Bipolar disorder is not diagnosed in childhood, often coexisting with hyperactivity, age-related crises or developmental delays, manifesting itself in adolescence. Often in childhood, the phase of mania passes as a manifestation of disobedience and denial of norms of behavior.
Identified by age in the approximate ratio:
- in adolescence - 16-25 years old, there is a high probability of depression, with suicidal risk;
- 25-40 years old - the majority - about 50% of those with MDP; up to 30 years of age, bi- (i.e. depression plus mania) is more common; after that - monopolarity (only one affective phase);
- after 40-50 years – about 25% of diseases, with an emphasis on depressive episodes.
It has been established that bipolar psychosis is more common in men, and monopolarity is more common in women.
The risk group includes women who have experienced postpartum depression at one time, or this is a delayed first episode of the disease. There is also a connection between the first phases of the disease and the menstrual and menopausal periods.
Causes
The causes of manic-depressive psychosis are internal, non-somatic (that is, not related to diseases of the body). Non-hereditary genetic and neurochemical prerequisites can be traced, possibly provoked by mechanical interventions and emotional stress, and not necessarily traumatic. Often, an episode of depression that appears random (isolated) turns out to be the first precursor to the subsequent development of the clinical picture of MDP.
According to the latest data, people are equally susceptible to the disease, regardless of ethnicity, social background and gender. Until recently, it was believed that women are at twice the risk of the disease.
According to psychiatry, 1 out of 2 thousand people in Russia are susceptible to manic-depressive psychosis, which is 15% of the total flow of mentally ill people. According to foreign statistics: up to 8 people out of a thousand are susceptible to the disease to one degree or another.
There is no single approach to the study of bipolar disorder; even in the classification there are different spectrums with the identification of new types of pathology; as a result, there is no clarity of the boundaries of the diagnosis and difficulties in assessing the prevalence.
We can talk about a predisposition to bipolar disorder in people of a melancholic nature with emotional instability, with a fear of breaking rules, who are responsible, conservative and conscientious. Manic-depressive pedantry with a brightly colored neurotic reaction to moments that are insignificant for the average person may be observed.
The difficulty of answering the question of why people develop bipolar disorder is aggravated by complex symptoms, the lack of a unified approach, and the human psyche will remain a mystery for a long time.
Clinical picture
The course of manic-depressive psychosis can follow different scenarios, differing in the frequency and intensity of periods of mania, depression and intermission, accompanied by mixed states.
- Unipolarity:
- periodic mania;
- periodic depression. The type that occurs more often than others. Not all classifiers apply to MDS.
- Correctly intermittent type - phases of depression are replaced by mania through periods of intermission. After unipolar depression, it is the most characteristic course of manic-depressive syndrome.
- An irregularly intermittent appearance is a disordered change of phases, one of which can be repeated again, subject to intermission.
- Double type - change of phases: mania-depression or depression-mania, interphase - between couples, not between.
- Circular – changing periods of illness without intermissions.
The duration of mania is usually from one and a half weeks to 4 months, depression is longer, and mixed conditions are common.
Main symptoms
Symptoms of the manic phase
The course of manic-depressive psychosis often begins with a manic phase, generally characterized by an increase in mood, mental and physical activity.
Stages of mania:
- Hypomania is erased mania: energy, increased mood, increased rate of speech, possible improvement of memory, attention, appetite, physical activity, decreased need for sleep.
- Severe mania - the patient does not listen to others, is distracted, there may be a rush of ideas, anger, communication is difficult. Speech and motor activity are intense and unconstructive. The emergence of delusional projects against the backdrop of awareness of omnipotence. At this stage, sleep up to 3 hours.
- Manic frenzy is an extreme exacerbation of symptoms: disinhibited motor activity, unrelated speech, containing fragments of thoughts, communication is impossible.
- Motor sedation is a symptom with preservation of active speech activity and moods, the manifestations of which also gradually tend to normal.
- Reactive – indicators return to normal. Amnesia during periods of severe and violent stages is common.
The passage of the manic phase can be limited only by the first stage - hypomania.
The severity and severity of the stage is determined using the Young Mania Rating Scale.
Symptoms of the depressive phase
In general, the depressive phase is more typical of the clinical picture of MDS. Depressed mood, slow thinking and physical activity, with morning exacerbation and positive dynamics in the evening.
Its stages:
- Initial – a gradual decrease in activity, performance, vitality, fatigue appears, sleep becomes superficial.
- Increasing - anxiety, physical and mental exhaustion, insomnia, decreased speech rate, loss of interest in food appear.
- The stage of severe depression is an extreme expression of psychotic symptoms - depression, fear, anxiety, stupor, self-flagellation, possible delirium, anorexia, suicidal thoughts, voices - hallucinations.
- Reactive – the last stage of depression, normalization of body functions. If it begins with the restoration of motor activity, while the depressed mood remains, the danger of suicide increases.
Depression may be atypical, accompanied by drowsiness and increased appetite. Feelings of unreality of what is happening may appear, and somatic signs may appear - gastrointestinal and urinary disorders. After an attack of depression, signs of asthenia are observed for some time.
The degree of depression is assessed by the Depression Self-Inventory and the Zang Inventory.
Why is manic-depressive psychosis dangerous?
The diagnosis of manic-depressive psychosis includes mania, lasting about 4 months, which on average accounts for 6 months of depression, and during these periods the patient may disappear from life.
The flare-up phases are not only detrimental to those suffering from the disorder.
In a state of mania, a patient, driven by uncontrollable feelings, often commits rash acts that lead to the most disastrous consequences - taken out loans, trips to the other side of the world, loss of apartments, promiscuity.
In depression, a person, as a result of feelings of guilt, often after mania, and deconstructive behavior, destroys established relationships, including family ones, and loses ability to work. Suicidal tendencies are possible. At this time, questions of control and patient care become acute.
Negative personality changes traumatize people who are forced to live with the patient during the crisis. The patient can cause irreparable harm to himself and loved ones in a state of passion.
The state of health of a person who has suffered a negative phase of the disease may last a lifetime, i.e., an exacerbation may not occur. But in this case, it is customary to talk about a long interphase, and not about a healthy person with an unpleasant episode in his life.
A person susceptible to such conditions must be prepared for such manifestations of the disease, and at the first symptoms, take measures - begin treatment for manic-depressive psychosis or its correction.
In case of violation of the law, bipolar disorder as a mental illness is considered as a mitigating circumstance only when it is in the disease phase. During remission, the offender is called upon to answer according to the law.
Diagnostics
To diagnose manic-depressive psychosis, use differential method, considering the spectrum of psychoneurological diseases and not only: schizophrenia, mental retardation, variants of depression, neuroses, psychoses, social disorders, somatic diseases. Separating, among other things, symptoms provoked by alcohol or medical and narcotic drugs.
Screening and study of the severity of phases takes place as a result of the use of questionnaires - self-assessment tests.
Treatment with a timely diagnosis is quite effective, especially when prescribed after (or during) the first phase of MDS. To make a correct diagnosis, at least one period of manic (hypomanic) properties is needed; as a result, bipolar disorder is often diagnosed only 10 years after the first episode.
Difficulties in diagnosing the disorder are aggravated by the relative nature of the pathology, the subjectivity of any questionnaires, and the frequent concomitance of other mental problems, the individual course of the disease and the inconsistency of research data. Research data cannot be objective due to huge amount medications that TIR patients are forced to take.
An erroneous diagnosis and incorrect medication use can provoke a rapid change in cycles, shorten interphases, or otherwise aggravate the course of the disease, leading to disability.
Treatment and prevention
The goal of treatment for MDP is to achieve intermission and normalize the psyche and health. During periods of prophylaxis and in the manic phase, mood stabilizers are used - drugs that stabilize mood: lithium preparations, anticonvulsants, neuroleptics.
The effectiveness of drugs is individual, their combinations may be intolerable, provoke deterioration, antiphase or shortening periods of health. Treatment of manic-depressive psychosis involves the constant use of a combination of drugs, prescribed and adjusted exclusively by a doctor and under his close supervision.
Insulin therapy and electric shock, by-product which is memory loss, actively used in the 20th century, is extremely unpopular as inhumane, and is considered as a method of treatment in extreme cases when other means have failed. Well, before 1900, depression was treated with heroin.
Psychotherapy
Manifestations of bipolar disorder can be smoothed out. Life values can temporarily change in the most dramatic way, leaving behind a person only a misunderstanding of his behavior and regret about a specific life episode where he messed up.
If such things are repeated and periods of depression are observed, it’s time to think: how to help yourself if you have bipolar affective disorder?
A visit to a psychiatrist is necessary; you should not think that you will immediately receive a dangerous diagnosis. There is a presumption of mental health, but you and your loved ones may need help.
Psychotherapy will help you accept your diagnosis without feeling inferior, understand yourself and forgive mistakes. Thanks to drug support and psychotherapy, it is possible to manage full life, adjust your mental health by studying the pitfalls of your illness.
Its symptoms are recognizable and known, but in the whirlwind of days you may not pay attention to them. The source of the problem is more often a traumatic event, but it has a destructive effect on those who are in chronic fatigue. Absolutely anyone can become a victim of psychosis, but there is a risk group.
- First of all, people who are used to working hard, taking on great responsibility, making decisions are susceptible to depressive psychosis. serious problems. They are used to solving not only work issues, but also family situations. Everything rests on such people, but they themselves can give up. An organism under extreme stress inevitably begins to fail. Sudden changes moods, intrusive thoughts and desires, low mood interfere with normal life
- Women are traditionally at risk because they nervous system more labile, they have not only career concerns on their shoulders, but also household chores. The illnesses of young children and the failures of adolescents are perceived as their own, adding to stressful situations
- Impressionable people tend to replay traumatic situations in their heads over and over again in search of a better answer, a better solution. In fact, this only aggravates the condition, you need to be able to move forward
It begins with a lighter state - . It is characterized by a triad of symptoms classic for depressive states:
- decreased vital activity and some general lethargy
- constantly depressed mood
- decline thought processes, attention, memory
At the same time, the personality remains intact, the person is in complete control of himself and his life. If adequate treatment does not follow, the neurosis will worsen.
When depression takes the form of psychosis, mental changes are added somatic manifestations: dizziness, changes blood pressure, loss of appetite, tachycardia and pain in the heart (most often not associated with the cardiovascular system, they are neuralgia), problems with the gastrointestinal tract. And the worst thing is the addition of some kind of psychosis to depressive state. This could be a hallucination (visual or auditory), obsessions, or other inadequate reactions to the surrounding reality.
In difficult situations, people are not aware of the surrounding reality and live in a fictional world. They hear voices and hide from the aliens, following crazy ideas and believe that they are defending themselves from accusations of a terrible crime.
They talk nonsense and stop taking care of themselves. One of the symptoms is untidiness in clothing, hairstyle, and body hygiene. People suffering from depressive psychosis can lie on the bed all day in the same position, changing day and night.
Patients with schizophrenia also have psychosis among their symptoms, but they are much more diverse and do not depend on emotional state person. They are distinguished by ideas associated with the worthlessness of the patient’s life and his feeling of the end of the world.
If you see yourself or a loved one:
- anxiety
- depressed state
- constipation
- anxiety
- decreased mental states
- delusions or hallucinations
- immobility
You need to urgently consult a doctor and start treatment, because without medical control, manic and suicidal tendencies will develop. And here it’s not far from affective disorder.
Treatment of depressive psychosis
Treatment is carried out only in a hospital setting under the strict supervision of doctors. When prescribed adequate medications, it responds well to treatment. A stable mood is achieved with the help of antidepressants and antipsychotics, to which are added sedatives of plant origin, vitamins, supporting medications for somatic diseases accumulated during depression.
Antipsychotic drugs play a role in treatment important role, because they affect the neurotransmitters of the brain, and they, in turn, regulate the mechanism of perception and processing of data about the surrounding reality between neurons. Previously, antipsychotics were used for this purpose, but they were poorly tolerated by patients and had many side effects.
If drug treatment does not give the desired result, electroshock therapy is used. In general, recovery takes about a year, after which you may need to contact your doctor for some time. It is worth achieving maximum mutual understanding with the doctor so that he can prescribe the most appropriate treatment at this time.
Prevention of depressive psychosis
This kind of depression is a disease of workaholics. It is important to remember that the daily routine is The best way avoid the body's retribution. Learn not only to work, but also to relax distractedly. The most successful career is not worth it if you realize that there is no feeling of any joy in life. Diversify your leisure time, free up weekends for family and friends, learn to dance or ride alpine skiing. Fresh air, full, restful sleep and positive emotions are your safety net.
You may also be interested
