Irritability, anxiety, depressed mood can be more than just the consequences of a hard week at work or any setbacks in your personal life. It may not just be nerve problems, as many prefer to think. If a person for a long time without a significant reason feels mental discomfort and notices strange changes in behavior, then you should seek help from a qualified psychologist. Maybe it's a manic-depressive illness.
Two concepts - one essence
In various sources and various medical literature on mental disorders, you can find two concepts that at first glance may seem completely opposite in meaning. These are manic-depressive psychosis (MDP) and bipolar affective disorder.disorder (BAD). Despite the difference in definitions, they express the same thing, they talk about the same mental illness.
The fact is that from 1896 to 1993, a mental illness, expressed in a regular change of manic and depressive phases, was called manic-depressive disorder. In 1993, in connection with the revision of the International Classification of Diseases (ICD) by the world medical community, MDP was replaced by another abbreviation - BAR, which is currently used in psychiatry. This was done for two reasons. First, not always bipolar disorder is accompanied by psychosis. Secondly, the definition of TIR not only frightened the patients themselves, but also repelled other people from them.
Statistics
Manic-depressive psychosis is a mental disorder that occurs in about 1.5% of the world's inhabitants. Moreover, the bipolar type of the disease is more common in women, and the monopolar one in men. About 15% of patients treated in psychiatric hospitals suffer from manic-depressive psychosis.
In half of the cases, the disease is diagnosed in patients aged 25 to 44 years, in a third of cases - in patients older than 45 years, and in older people there is a shift towards the depressive phase. Quite rarely, the diagnosis of TIR is confirmed in people under 20 years old, because in this period of life, a quick change of mood with a predominance of pessimistic tendencies is the norm, since the psyche of a teenager is in the process of formation.
TIR characteristics
Manic-depressive psychosis is a mental illness in which two phases - manic and depressive - alternate with each other. During the manic phase of the disorder, the patient experiences a huge surge of energy, he feels great, he seeks to channel excess energy into new hobbies and hobbies.
The manic phase, which lasts quite a short time (about 3 times shorter than the depressive one), is followed by a "light" period (intermission) - a period of mental stability. During the period of intermission, the patient is no different from a mentally he althy person. However, the subsequent formation of the depressive phase of manic-depressive psychosis is inevitable, which is characterized by a depressed mood, a decrease in interest in everything that seemed attractive, a detachment from the outside world, and the emergence of suicidal thoughts.
Causes of disease
As with many other mental illnesses, the causes and development of TIR are not fully understood. There are a number of studies proving that this disease is transmitted from mother to child. Therefore, the presence of certain genes and hereditary predisposition is important for the onset of the disease. Disruptions in the endocrine system, namely, an imbalance in the amount of hormones, also play a significant role in the development of TIR.
Often a similar imbalance occurs in women during menstruation, after childbirth, during menopause. That is why manic-depressive psychosis in womenobserved more frequently than in men. Medical statistics also show that women diagnosed with depression after childbirth are more susceptible to the onset and development of TIR.
Among the possible reasons for the development of a mental disorder is the patient's personality itself, its key features. More than others, people with a melancholic or statothymic personality type are susceptible to the occurrence of TIR. Their distinguishing feature is a mobile psyche, which is expressed in hypersensitivity, anxiety, suspiciousness, fatigue, an unhe althy desire for orderliness, as well as solitude.
Diagnosis of the disorder
In most cases, bipolar manic-depressive disorder is extremely easy to confuse with other mental disorders, such as anxiety disorder or some forms of depression. Therefore, it takes a psychiatrist some time to diagnose MDP with certainty. Observations and examinations continue at least until the patient has a clearly identified manic and depressive phase, mixed states.
Anamnesis is collected using tests for emotionality, anxiety and questionnaires. The conversation is conducted not only with the patient, but also with his relatives. The purpose of the conversation is to consider the clinical picture and the course of the disease. Differential diagnosis allows the patient to exclude mental illnesses that have symptoms and signs similar to manic-depressive psychosis (schizophrenia, neuroses andpsychosis, other affective disorders).
Diagnosis also includes examinations such as ultrasound, MRI, tomography, all kinds of blood tests. They are necessary to exclude physical pathologies and other biological changes in the body that could provoke the occurrence of mental abnormalities. These are, for example, improper functioning of the endocrine system, cancerous tumors, and various infections.
Depressive phase of TIR
The depressive phase usually lasts longer than the manic phase and is characterized primarily by a triad of symptoms: depressed and pessimistic mood, slow thinking, and retardation of movement and speech. Mood swings are common during the depressive phase, ranging from depressed in the morning to positive in the evening.
One of the main signs of manic-depressive psychosis during this phase is a sharp weight loss (up to 15 kg) due to lack of appetite - food seems bland and tasteless to the patient. Sleep is also disturbed - it becomes intermittent, superficial. A person may be disturbed by insomnia.
With the growth of depressive moods, the symptoms and negative manifestations of the disease intensify. In women, a sign of manic-depressive psychosis during this phase may even be a temporary cessation of menstruation. However, the aggravation of symptoms, rather, consists in slowing down the patient's speech and thought process. Words are hard to find and connect with each other. The person closes inhimself, renounces the outside world and any contacts.
At the same time, the state of loneliness leads to such a dangerous complex of symptoms of manic-depressive psychosis as apathy, melancholy, extremely depressed mood. It can cause suicidal thoughts to form in the patient's head. During the depressive phase, a person diagnosed with TIR needs professional medical help and support from loved ones.
TIR manic phase
Unlike the depressive phase, the triad of symptoms of the manic phase is exactly the opposite in nature. This is an elevated mood, violent mental activity and speed of movement, speech.
The manic phase begins with the patient feeling a surge of strength and energy, a desire to do something as soon as possible, to realize himself in something. At the same time, a person has new interests, hobbies, and the circle of acquaintances expands. One of the symptoms of manic-depressive psychosis in this phase is a feeling of overabundance of energy. The patient is infinitely cheerful and cheerful, does not need sleep (sleep can last 3-4 hours), makes optimistic plans for the future. During the manic phase, the patient temporarily forgets past grievances and failures, but remembers the names of films and books lost in memory, addresses and names, phone numbers. During the manic phase, the efficiency of short-term memory increases - a person remembers almost everything that happens to him at a given time.
Despite seemingly productivitymanifestations of the manic phase, they do not play into the hands of the patient at all. So, for example, a stormy desire to realize oneself in something new and an unbridled desire for vigorous activity usually does not end with something good. Patients in the manic phase rarely see things through. Moreover, hypertrophied self-confidence and good luck from the outside during this period can push a person to rash and dangerous actions for him. These are big bets in gambling, uncontrolled spending of financial resources, promiscuity and even committing a crime for the sake of getting new sensations and emotions.
The negative manifestations of the manic phase are usually visible immediately to the naked eye. Symptoms and signs of manic-depressive psychosis in this phase also include extremely fast speech with swallowing words, energetic facial expressions and sweeping movements. Even preferences in clothes can change - it becomes more catchy, bright colors. During the climactic stage of the manic phase, the patient becomes unstable, excess energy turns into extreme aggressiveness and irritability. He is unable to communicate with other people, his speech may resemble the so-called verbal okroshka, as in schizophrenia, when sentences are divided into several logically unrelated parts.
Manic-depressive psychosis treatment
The main goal of a psychiatrist in the treatment of a patient diagnosed with TIR is to achieve a period of stable remission. It is characterized by partial or almost completealleviation of the symptoms of the existing disorder. To achieve this goal, it is necessary both to use special preparations (pharmacotherapy) and to turn to special systems of psychological influence on the patient (psychotherapy). Depending on the severity of the disease, the treatment itself can take place both on an outpatient basis and in a hospital.
Pharmacotherapy
Because manic-depressive psychosis is a rather serious mental disorder, its treatment is not possible without medication. The main and most frequently used group of drugs during the treatment of patients with bipolar disorder is a group of mood stabilizers, the main task of which is to stabilize the patient's mood. Normotimics are divided into several subgroups, among which lithium preparations, used mostly in the form of s alts, stand out.
In addition to lithium, the psychiatrist, depending on the patient's symptoms, may prescribe antiepileptic drugs that have a sedative effect. These are valproic acid, "Carbamazepine", "Lamotrigine". In the case of bipolar disorder, the use of mood stabilizers is always accompanied by neuroleptics, which have an antipsychotic effect. They inhibit the transmission of nerve impulses in those brain systems where dopamine serves as a neurotransmitter. Antipsychotics are used primarily during the manic phase.
It is quite problematic to treat patients in TIR without taking antidepressants in combination withnormotimics. They are used to alleviate the patient's condition during the depressive phase of manic-depressive psychosis in men and women. These psychotropic drugs, affecting the amount of serotonin and dopamine in the body, relieve emotional stress, preventing the development of melancholy and apathy.
Psychotherapy
This type of psychological help, like psychotherapy, consists in regular meetings with the attending physician, during which the patient learns to live with his illness, like an ordinary person. Various trainings, group meetings with other patients suffering from a similar disorder help an individual not only to better understand his illness, but also to learn about special skills for controlling and stopping the negative symptoms of the disorder.
A special role in the process of psychotherapy is played by the principle of "family intervention", which is the leading role of the family in achieving the patient's psychological comfort. During treatment, it is extremely important to establish an atmosphere of comfort and tranquility at home, to avoid any quarrels and conflicts, as they harm the patient's psyche. His family and he himself must get used to the idea of the inevitability of manifestations of the disorder in the future and the inevitability of taking medications.
Forecast and life with TIR
Unfortunately, the prognosis of the disease in most cases is not favorable. In 90% of patients, after an outbreak of the first manifestations of MDP, affective episodes recur again. Moreover, almost half of the people suffering from this diagnosis for a long time,goes on disability. In almost a third of patients, the disorder is characterized by a transition from a manic phase to a depressive phase, with no “bright gaps.”
Despite the seeming hopelessness of the future with a TIR diagnosis, it is quite possible for a person to live an ordinary normal life with him. The systematic use of normotimics and other psychotropic drugs allows you to delay the onset of the negative phase, increasing the duration of the "light period". The patient is able to work, learn new things, get involved in something, lead an active lifestyle, undergoing outpatient treatment from time to time.
TIR was diagnosed with many famous personalities, actors, musicians and just people, one way or another connected with creativity. These are famous singers and actors of our time: Demi Lovato, Britney Spears, Linda Hamilton, Jim Carrey, Jean-Claude Van Damme. Moreover, these are outstanding and world-famous artists, musicians, historical figures: Vincent van Gogh, Ludwig van Beethoven and, perhaps, even Napoleon Bonaparte himself. Thus, the diagnosis of TIR is not a sentence, it is quite possible not only to exist, but also to live with it.
General conclusion
Manic-depressive psychosis is a mental disorder in which depressive and manic phases replace each other, interspersed with the so-called light period - a period of remission. The manic phase is characterized by an excess of strength and energy in the patient, an unreasonably high spirits and an uncontrollable desire for action. The depressive phase, on the contrary, is characterized by a suppressedmood, apathy, melancholy, retardation of speech and movements.
Women get TIR more often than men. This is due to disruptions in the endocrine system and a change in the amount of hormones in the body during menstruation, menopause, after childbirth. So, for example, one of the symptoms of manic-depressive psychosis in women is a temporary cessation of menstruation. Treatment of the disease is carried out in two ways: by taking psychotropic drugs and conducting psychotherapy. The prognosis of the disorder, unfortunately, is unfavorable: after the treatment, almost all patients may experience new affective seizures. However, with due attention to the problem, you can live a full and active life.
