Bipolar Disorder / Manic
Depression
What is manic depression?Manic depression, also known as bipolar disorder, is classified
as a type of affective disorder (also called mood disorder) that goes
beyond the day's ordinary ups and downs, and is becoming a serious medical
condition and important health concern in this country. Manic depression
is characterized by periodic episodes of extreme elation, happiness,
elevated mood, or irritability (also called mania) countered by periodic,
classic major depressive symptoms.
Who is affected by manic depression?Manic depression affects more than 2.3 million American adults,
18 years of age and older, each year. And, twenty to 30 percent of adult
bipolar patients report having their first manic episode before the age of
20. When symptoms are present before the age of 12, they are often
confused with attention-deficit/hyperactivity disorder (ADHD) - a syndrome
that is usually characterized by serious and persistent difficulties
resulting in inattentiveness or distractibility, impulsivity, and
hyperactivity.
Affecting males and females equally (although females are more likely
to experience more depressive and less manic symptoms), manic depression
often begins in adolescence or early adulthood. Manic depression is
beginning to be better recognized in young children, although diagnosis
may still be difficult.
Manic depression is likely to run in families and, in some cases, is
believed to be hereditary. Family history of substance abuse also
increases the risk of developing manic depression. Researchers are still
seeking to identify a gene (or genes) that may be responsible for this
disorder.
What are the symptoms of manic depression?
The following are the most common symptoms of manic depression. However,
each individual may experience symptoms differently.
Depressive symptoms may include:
- persistent feelings of sadness
- feeling hopeless or helpless
- having low self-esteem
- feeling inadequate
- excessive guilt
- feelings of wanting to die
- loss of interest in usual activities or activities once enjoyed
- difficulty with relationships
- sleep disturbances (i.e., insomnia, hypersomnia)
- changes in appetite or weight
- decreased energy
- difficulty concentrating
- a decrease in the ability to make decisions
- suicidal thoughts or attempts
- frequent physical complaints (i.e., headache, stomach ache, fatigue)
- running away or threats of running away from home
- hypersensitivity to failure or rejection
- irritability, hostility, aggression
Manic symptoms may include:
- overly inflated self-esteem
- decreased need for rest and sleep
- increased distractibility and irritability
- excessive involvement in pleasurable and/or high-risk activities
that may result in painful consequences; this may include provocative,
aggressive, destructive, or anti-social behavior (i.e., sexual
promiscuity, reckless driving, reckless spending, abuse of alcohol
and/or drugs).
- increased talkativeness (may include increase in rate of speech,
changes topics quickly, cannot be interrupted)
- excessive "high" or euphoric feelings
- severe mood changes including unusually happy or silly, or unusually
angry, agitated, or aggressive
- increased sex drive
- increased energy level
- uncharacteristically poor judgment
Some teenagers in a manic phase experience psychotic symptoms including
hallucinations and/or delusions.
For a diagnosis of manic depression to be made, an individual must
exhibit both depressive and manic symptoms to a varying degree, depending
upon the severity of the disorder. The symptoms of manic depression,
especially in a teenager, may resemble other problems (i.e., drug abuse,
attention-deficit/hyperactivity disorder, delinquency). Always consult
your child's physician for a diagnosis.
How is manic depression diagnosed?
Seeking early diagnosis and treatment is crucial to recovery. A diagnosis
is often made after a careful psychiatric examination and medical history
performed by a psychiatrist or other mental health professional.
Treatment for manic depression:
Specific treatment for manic depression will be determined by your child's
physician based on:
- your child's age, overall health, and medical history
- extent of your child's symptoms
- your child's tolerance for specific medications or therapies
- expectations for the course of the condition
- your opinion or preference
Mood disorders, including manic depression, can often be effectively
treated. Treatment should always be based on a comprehensive evaluation of
the child and family. Treatment may include one, or more, of the
following:
- medication (i.e., mood-stabilizing medications such as lithium,
valproic acid, or carbamazepine, and/or antidepressants)
- psychotherapy (most often cognitive-behavioral, supportive,
psychoeducational, and/or interpersonal therapy)
- family therapy
- consultation with the child's school
Parents play a vital supportive role in any treatment process.
Recognizing the varied and extreme mood swings associated with manic
depression is crucial in obtaining effective treatment, and avoiding the
potentially painful consequences of the reckless, manic behavior.
In most cases, long term, preventive treatment is necessary to
stabilize the mood swings associated with manic depression.
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