Manic Depression: Symptoms, Causes and Treatments

Manic depression: this concept, hardly used today, refers to one of the most common mood disorders and acquaintances after depression.

This is one of the old names for what is currently known as bipolar disorder. Although for some this name may even have romantic connotations, the truth is that it is a disorder that generates great suffering and that can cause serious alterations in the daily life of those who suffer from it, making its treatment essential.

In this article we will see what is manic depression what causes are attributed to it and some of the main treatments applied.

What is manic depression?

Manic depression, manic-depressive psychosis or bipolar disorder. These different names have emerged in different historical contexts in which different orientations and currents of thought also prevailed, although in practice they refer to the same disorder.

Specifically, in all cases reference is being made to a mental disorder categorized within mood disorders and characterized by the presence of one or more episodes of mania and/or hypomania. in alternation or in the absence of depressive episodes

Thus, in this disorder the mood can go from an episode of maximum exaltation and increased activity and energy to a state of deep sadness, hopelessness and passivity. This fluctuation may be followed or separated by an asymptomatic period and the transition from one pole to the other can occur in short periods of time.

Types of bipolar disorder or manic depression

There are two basic types of bipolar disorder: in type 1, at least one manic or mixed episode occurs, which may be preceded or followed by a major depressive episode. However, the latter is not essential for the diagnosis. Regarding bipolar disorder type 2, its diagnosis requires the presence of one or more major depressive episodes along with at least one hypomanic episode, without a manic or mixed episode occurring in any case.

An expansive mood appears in manic episodes, euphoric or even irritable in that there is a high level of agitation and activity for almost the entire day for at least a week. In this state, a feeling of grandiosity usually appears (which can lead to delirium), logorrhea, flight of ideas or the feeling that the train of thought is lost, tachypsychia, distractibility, disinhibition, aggressiveness, hallucinations and a tendency to take risks and not evaluate the consequences of the acts themselves. Hypomanic symptoms are similar, but they are not as severe, symptoms such as hallucinations and delusions cannot occur, and they last for at least four days.

In depressive episodes, there is a low mood and/or loss of interest and the ability to feel pleasure along with other symptoms such as hopelessness, lack of energy and passivity. eating and sleeping disturbances, fatigue, or thoughts of death or suicide for at least two weeks.

Effects of symptoms

The symptoms referred to above, whether manic and depressive episodes alternate or not, generate a large number of repercussions in the subject that can alter and limit a wide variety of vital elements and domains.

At an academic and work level, the existence of episodes can affect the ability to develop and follow plans, reduce performance or generate conflictive or unproductive behaviors, as well as reduce the subject’s ability to concentrate. You may also have difficulties when evaluating aspects such as the value and use of money. due to the extreme impulsivity that can occur

The social sphere can also be affected. In the manic phase, the subject may show uninhibited sexuality and/or be irritable and even aggressive, present delusions of grandeur and antisocial behavior, at the same time as in depressive phases. you may lose interest in socializing

In any case, one of the aspects with which the greatest care must be taken is the possibility of suicide. In fact, manic depression is one of the mental disorders in which there is a higher risk of suicide.

Possible causes

Although the origin of manic depression is not completely clear, the proposed explanations generally start from factors of biological origin very similar to those of depression. The existence of imbalances in the synthesis and reuptake of neurotransmitters is proposed.

Specifically, it has been observed that norepinephrine levels decrease during depressive episodes and increase in maniacs. The same thing happens with dopamine. Regarding serotonin, it is found in lower proportions than usual in both types of episodes.

Structures such as the amygdala are altered, and hypoperfusion is also observed in different brain areas in different types of episodes (less blood reaches the frontotemporal in mania and the left prefrontal in depression than it should). Likewise, it has been proposed that bipolar or manic-depressive symptoms may be related to problems in nervous signal transport.

The environment also participates in its genesis, stressful events destabilizing the biological rhythm. Furthermore, it is also proposed, as in depression, the existence and influence of cognitive distortions that generate dysfunctional schemas The cognitive triad of thoughts regarding oneself, the world and one’s own future would oscillate between negative depressogenic thoughts and other expansive and glorified ones.

Treatments

Treatment of manic depression or bipolar disorder requires a multidisciplinary approach. The main objective of treatment is to keep your mood stable. For it At a pharmacological level, mood stabilizers are used, the main one being lithium salts. This substance has a little-known but generally highly effective mechanism of action, based on its modulation of synaptic transmission. Once the subject is stabilized, it is necessary to establish a maintenance dose that prevents new crises.

However, pharmacological treatment can lead to uncomfortable side effects It is therefore necessary to apply strategies such as psychoeducation in order to promote adherence. You can also teach strategies for self-assessment of the state and symptoms that can warn of the arrival of a crisis and prevent them from occurring.

Working with the environment is also essential, so that the family members of the affected person know the reason for certain attitudes and behaviors, relational problems are resolved and they can contribute to helping the affected person and know how to identify possible symptoms. The subject with manic depression can benefit from other psychological treatments used in depression, like Beck’s cognitive therapy

Likewise, there is interpersonal and social rhythm therapy as a treatment based on the regulation of biorhythms and personal relationships that can be helpful for subjects with this disorder.

In some especially severe cases, and especially in cases where there are severe manic symptoms, psychotic symptoms or risk of imminent suicide, electroconvulsive therapy has been successfully applied (which is currently applied in a controlled manner, with sedation and monitoring).

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