BASIC INFORMATION
DESCRIPTION
A disorder that is characterized by extreme mood
swings, and the relationship between the moods and
what is actually happening in the person's life is not
direct. Periods of unexplainable elation and overactivity
(mania) alternate on an irregular, but cyclical, basis with
deep depression. Periods of normal behavior (that can
last for a short time or for years) occur in between the
mania and the depression.
FREQUENT SIGNS AND SYMPTOMS
Mania:
- Accelerated energy levels; euphoric mood.
- Getting up earlier and earlier in the morning (some
may not sleep at all for 3 to 4 days).
- Easily distracted and restless (which can cause work
output to fall). Enthusiastically start, but rarely finish,
new projects.
- May go on spending sprees.
- May become sexually promiscuous.
- Often irritable and has attacks of rage.
- Speech becomes rapid, wild and illogical.
- May have very high opinion of one's abilities and
exaggerated thinking (grandiosity).
- May forget to eat; may lose weight and become
exhausted.
- May develop delusions of grandeur or intense anger at
one's ability to carry out wild schemes.
Depression:
- May become increasingly withdrawn; has disturbed
sleep; late rising becomes a habit.
- May stay in one's room, afraid to face the world; lacks
self-esteem.
- Self-neglect.
- Decreased sex drive.
- Slowing of speech and movement.
- Imagined problems multiply.
- Excessive worrying about imagined illnesses.
CAUSES
Unknown. Biologic, psychological and hereditary factors
may play a part. Extreme stress or a death may trigger
a sudden episode of mania or depression.
RISK INCREASES WITH
Family history of the disorder.
PREVENTIVE MEASURES
No specific preventive measures known.
EXPECTED OUTCOMES
May be restored to nearly normal health with long-term
therapy that reduces the frequency and severity of
episodes. Many famous executives, scientists and government
leaders have this disorder.
POSSIBLE COMPLICATIONS
- Relapse, especially if medication is stopped.
- Job loss; marital problems.
- Failure to improve.
- Suicide.
TREATMENT
GENERAL MEASURES
- Medical history and physical exam by a doctor (sometimes
a psychiatrist). Psychological testing.
- Psychotherapy or counseling along with drug treatment
achieves the best results.
- Hospitalization or inpatient care at a treatment center
may be required for severe symptoms.
- Electroconvulsive therapy (ECT) may be used for
patients who fail to respond to medication.
- Comply with the medication regimen provided by
your doctor. Schedule regular office visits to monitor
the effectiveness of the treatment and to watch for side
effects.
- Do not discontinue medication when you feel better.
This may cause a relapse that may not respond well to
medication.
- Counseling can provide the methods needed to help
you cope with the disorder. Family members should
learn to recognize signs of an impending episode and
how to help the person.
- Seek support groups. Contact social agencies for help.
Call the local suicide prevention hot line if you feel suicidal.
- For additional information, contact National
Depressive and Manic Depressive Association,
Merchandise Mart, Box 3395, Chicago, IL 60654; (800)
82-NDMDA.
MEDICATIONS
Your doctor may prescribe lithium, valproic acid or carbamazepine
(Tegretol). Antipsychotic medications may
be necessary for more severe symptoms.
ACTIVITY
No restrictions. Maintain daily activities, even if you
don't feel like it.
DIET
Eat a normal well balanced diet, even if you have no
appetite. Vitamin and mineral supplements may be necessary.
Your doctor may advise you to avoid caffeine, as
it is a stimulant.
NOTIFY YOUR PHYSICIAN IF
- You or a family member has symptoms of depression
or mania.
- You feel suicidal or hopeless.
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