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BIPOLAR DISORDER (MANIC DEPRESSION) - a patient's
guide
Editorial Team
Overview
Manic depression is now known as bipolar disorder.
It is characterised by mood swings from elation to depression.
The disorder affects about one percent of the population.
Most people can function well with treatment which may be
long term.
There is a high risk of suicide with bipolar disorder.
There is a genetic link in some people with the illness.
Treatment usually involves drug therapy, with supportive
counselling and education.
What is it?
Manic depression is now also called bipolar mood disorder
This is a serious mood disorder characterised by large
mood swings of elation (mania), and depression.
These big mood swings can cause difficulty in taking part
in everyday life and some sufferers lose touch with reality
and develop psychosis.
The disorder affects about one percent of the population,
and normally begins between the ages of 15 and 40.
The majority of sufferers can recover after severe episodes
but 20 to 30 percent will experience ongoing problems.
The illness can lead to severe difficulties with relationships,
problems with drug or alcohol abuse, and problems with the
law.
There is a high risk of suicide with bipolar disorder.
There is a risk of violent behavior during periods of
mania or psychotic episodes, during which the sufferer may
not be behaving rationally.
It is not known what causes bipolar disorder. There is
a genetic link in some cases. People with a family member
with the condition have a slightly higher than average risk
of developing the condition.
The condition may be caused by changes in the chemical
messenger system in the brain.
Stressful life events such as poverty, unemployment, and
relationship problems can trigger manic or depressive episodes.
What are the symptoms?
Signs of mental illness may develop suddenly in people
who have coped well with stressful problems in the past.
In other cases the disorder develops gradually over months
or years.
Some people will have had a previous episode of depression.
There is no medical test to diagnose the disorder. Diagnosis
is made when there has been a distinct period of abnormally
and persistently elevated mood and some of the following
symptoms have been present to a significant degree:
Symptoms of mania include:
Elation and happiness when the person will seem like the
and soul of the party. However, their behaviour will seem
excessive to those who know them well.
Irritable mood swings in between feelings of elation
Rapidly changing emotions from laughter to tears
Reduced need for sleep. Those with severe mania may go
without sleep for days
Boundless energy
Increased desire for food, sex and other pleasurable activities.
They may end up subsequently regretting their actions
Increased activities such as doing all the house work at
once, but this can lead to disorganisation
Loud and fast talking
Racing thoughts, jumping from one subject to another
Increased sense of self importance. In severe cases a sufferer
may believe they have a special relationship with God or
other famous figures
Loss of awareness their behaviour is a result of a mental
illness
Sometimes people with severe mania may develop symptoms
of psychosis. They may have unusual or altered beliefs,
hear voices about their own importance or develop paranoia
that they are being wrongly persecuted.
Bipolar disorder sufferers may or may not have episodes
of depression.
Symptoms of depression include:
Persistent low or sad feelings
Loss of interest in activities normally enjoyed such as
loss of interest in sex
Irritable mood changes
Problems sleeping or sleeping too much, unrefreshing quality
of sleep
Change in appetite such as not feeling like eating, or
alternatively over eating
Tiredness and fatigue
Slower movements or sudden activity such as pacing the
room
Thoughts of worthlessness or guilt
Thoughts of hopelessness or wanting to die
Problems thinking clearly and concentrating
Episodes of mania and depression may occur one after the
other. Many people have isolated episodes with long periods
of good mental health in between depression or mania. However,
some people's gaps will become shorter between episodes,
particularly as they grow older.
What can be done to help?
Treatment involves medication with anti-depressants and
mood stabilising drugs. Mood stabilisers such as lithium
carbonate, tegretol or epilim are used to prevent further
episodes and are used long term to maintain wellness.
Anti-psychotic drugs may used, particularly during a manic
episode and possibly longer term, depending on the severity
and nature of the illness in a particular patient.
Treatment for an episode is necessary as soon as possible.
The earlier the treatment begins the better chance of recovery.
Most people will recover quicker from an episode of mania
than of depression.
Psychotherapy and counselling is also useful. Education
about the disorder for the patient and family is very important,
as well as a good relationship with the doctor involved.
Electro-convulsive therapy (ECT) is sometimes used for
severe mania and depression, and can help where other treatments
have failed.
Inpatient treatment and hospital care is used in situations
when a person's symptoms are endangering their lives or
the safety of others.
How can it be prevented?
There is no known way to prevent bipolar disorder at this
stage, but sustained use of mood stabilisers can prevent
episodes of mania or depression.
Getting help
Your doctor, psychiatrist or local mental health team will
be able to help.
The Mental Health Foundation of New Zealand, Ph 09 638
8573
* Information supplied by the Mental Health Foundation
of New Zealand
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