Going To Extremes:Manic-Depressive Illness
Q: There is a tendency to romanticize manic-depressive illness. Many
artists, musicians and writers have suffered from its mood swings. But
in truth, many lives are ruined by this disease and, without effective
treatment, the illness leads to suicide in nearly 20 percent of cases.
Manic-depressive illness, also known as bipolar disorder, a serious
brain disease that causes extreme shifts in mood, energy, and
functioning, affects approximately 2.3 million adult Americans- about
one percent of the population. Men and women are equally likely to
develop this disabling illness. Different from normal mood states of
happiness and sadness, symptoms of manic-depressive illness can be
severe and life threatening. Manic-depressive illness typically emerges
in adolescence or early adulthood and continues to flare up across the
life course, disrupting or destroying work, school, family, and social
life. Manic-depressive illness is characterized by symptoms that fall
into several major categories:
A:Depression: Symptoms include a persistent sad mood; loss of interest or
pleasure in activities that were once enjoyed; significant change in
appetite or body weight; difficulty sleeping or oversleeping; physical
slowing or agitation; loss of energy; feelings of worthlessness or
inappropriate guilt; difficulty thinking or concentrating; and recurrent
thoughts of death or suicide.
Mania: Abnormally and persistently elevated (high) mood or irritability
accompanied by at least three of the following symptoms: overly-inflated
self-esteem; decreased need for sleep; increased talkativeness; racing
thoughts; distractibility; increased goal-directed activity such as
shopping; physical agitation; and excessive involvement in risky
behaviors or activities.
Psychosis: Severe depression or mania may be accompanied by periods of
psychosis. Psychotic symptoms include: hallucinations (hearing, seeing,
or otherwise sensing the presence of stimuli that are not there) and
delusions (false personal beliefs that are not subject to reason or
contradictory evidence and are not explained by a person's cultural
concepts). Psychotic symptoms associated with manic-depressive illness
typically reflect the extreme mood state at the time.
"Mixed" state: Symptoms of mania and depression are present at the same
time. The symptom picture frequently includes agitation, trouble
sleeping, significant change in appetite, psychosis, and suicidal
thinking. Depressed mood accompanies manic activation.
Symptoms of mania, depression, or mixed state appear in episodes, or
distinct periods of time, which typically recur and become more frequent
across the life span. These episodes, especially early in the course of
illness, are separated by periods of wellness during which a person
suffers few to no symptoms. When four or more episodes of illness occur
within a 12-month period, the person is said to have manic-depressive
illness with rapid