Addiction Treatment Blog

Mania is for practical purposes the mirror image of depression. Approximately 50% of people affected present with an elated, euphoric mood. They may be grandiose in their attitudes and beliefs uninhibited in their behaviour. However, the remainder may be irritable and tetchy rather than elated and euphoric and paranoid rather than grandiose. Common to both groups is an increased level of activity, so that hyperactivity is perhaps the most consistent diagnostic feature of mania. In addition, there is typically an increase in appetite and a decrease in time spent asleep.

In 1853, Falret and Baillarger independently described a bipolar disorder, in which affected individuals cycled between periods of elation, or mania, and depression. This was variously called folie circulaire or folie à deux periodes. It forms the basis for what is now recognised as manic-depressive disorder. In 1896, Emil Kraepelin divided the major psychiatric illnesses into manic-depressive illness and schizophrenia. The former was primarily a disorder of mood, the latter a disturbance of cognitive functions. The former usually followed an episodic course with individuals recovering to normal between episodes. The latter was more likely to become a chronic illness with a majority of affected individuals not every fully recovering. These distinctions have broadly speaking held to this day. Read more…

There are seven major physical treatments for depression at present.

• Tricyclic Antidepressants (Table 1). These have until recently been by far the most widely used.
• The Monoamine Oxidase Inhibitors (MAOIs) (Table 2).
• Reversible Inhibitors of Monoamine Oxidase (RIMAs) (Table 3).
• 5-HT Reuptake Inhibitors (Table 4).
• Other Antidepressants (Table 5).
• Treatments for Bipolar Disorders or Prophylaxis of Recurrent Disorders (Table 6).
• Others (Table 7)

In the last category, a number of other treatments are marketed for or used for depression and they often work, but whether they are antidepressants in the same sense as electroconvulsive therapy (ECT), imipramine or phenelzine is a matter of dispute. The 5-HT-1a agonist, buspirone, has in addition been marketed as an antidepressant, and a further compound from this group, flesinoxan, looks as though it may also emerge as an antidepressant.

Finally, there is also ECT, the mechanism of action of which, and its use clinically will not be discussed at any length in this article. Its role when antidepressants fail to work and in cases of mania will be considered at a later stage. Read more…

Traditionally, three psychoses or major categories of psychiatric illness have been described. These are schizophrenia, manic-depressive psychosis and a third group, variously termed the paranoid, reactive or sensitive psychoses, which more recently have been called the delusional disorders.

This seeming diagnostic precision, however, masks a situation in which, since World War II, there has been a tendency to label all serious psychiatric conditions as schizophrenia. Accordingly, the pharmacological management of the psychoses, in practice, reduces to the management of schizophrenia. It has also reduced in the past 30 years, to the clinical employment of a group of drugs called the neuroleptics, which have been supposed to be in some way specifically therapeutic for schizophrenia. Read more…

In children, manic depression is rarely diagnosed in the United Kingdom.

In children manic depression is rarely diagnosed in the United Kingdom; in the United States it is diagnosed quite frequently. Cardinal symptoms used to support a diagnosis of manic depression are insomnia and grandiosity (where the child has a persisting and genuine belief in his own self-importance – as opposed to temporary play acting which is of course normal). There is often co-morbid drug use which can obfuscate the picture. The area is of major importance as parents may wonder if their adolescent mischief-maker is ‘organically’ sick or just going through the growing pains of youth in a disorderly manner. There is value in early diagnosis of manic depression, though it is often only made retrospectively, and early management is important. In reality, the older the youth is the more likely manic depression is to be correct diagnosis. There is an increasing incidence into the early twenties (being the maximum age of onset).

The adolescent should have a careful evaluation by an experienced psychiatrist. Differentiation from ADHD (Attention Deficit Hyperactivity Disorder), ‘personality disorder’, drug use and behavioural disorders in a healthy child brought up in a dysfunctional manner are key. An accurate and careful diagnosis is important. Clear diagnosis may not be possible where there is a combination of these elements initially. Read more…

MDF Bipolar Organisation is a user-led charity working to enable people affected by manic depression to take control of their lives.

MDF Bipolar Organisation Charity

Contact Details

08456 340 540 (UK Only)
0044 207 793 2600 (Rest of world)

Email: mdf@mdf.org.uk

Websites

• www.mdf.org.uk
• www.mdfwales.org.uk (Wales site)
• www.pendulum.org.uk (Pendulum journal site)
• www.steady.org.uk (STEADY self-management course site)

Membership

You can become a member of MDF through the website. As a member you will receive the following benefits:

• The organization’s quarterly journal, Pendulum. This is full of current debate about manic depression, overseas news, forthcoming events, etc.
• Advice. A twenty-four hour line providing legal advice, employment advice and advice about benefits and debt. Your questions will be answered by qualified solicitors. Read more…