Manic-depressive psychosis (mdp)

The disease, which takes the form of depressive and manic phases (seizures), in the intervals between which the patient is practically healthy. In other words, the patient leaves the attack without changes in personality traits, with complete disappearance of all psychopathological symptoms. The absence of a personality defect even after multiple seizures is evidence of a favorable prognosis of the disease as a whole. TIR is considered an endogenous psychosis. The causes of this disease include hereditary and constitutional factors.
The disease manifests itself in the form of depressive and manic phases, and depressive symptoms are noted several times more often than maniacal ones. This is possible, probably because patients in a weakly expressed manic state (hypomania) do not consult a doctor and others do not cause much trouble. Depressive state is determined by a depressed mood, inhibition of mental and motor processes. Patients complain of longing (a depressing sense of despair, heartache, an aching feeling in the heart, a epigastrium in the pit of one's stomach), indifference to loved ones, to everything that used to be fun. Patients are hindered, sometimes immobilized, sitting in one position or lying in bed. The expression of the face is mournful, sad. The questions are answered in monosyllables, with a delay, because "Tightly flowing thoughts." The future seems hopeless, life is meaningless. The past is considered only in terms of failures and errors.
Patients talk about their worthlessness, uselessness, insolvency, they humiliate themselves, underestimate. In this state, thoughts of suicide may arise, which are often put into practice. In addition, patients lose appetite, food seems tasteless ("like grass"), patients lose weight, sometimes significantly (1015 kg). In women for the period of depression, menstruation disappears (amenorrhea). With a shallow depression, the daily mood swings characteristic for MDP are noted: the state of health is worse in the morning (wake up early with a feeling of longing and anxiety, are inactive, indifferent), by the evening the mood and activity are somewhat increased. With age, in the clinical picture of depression, an increasing place is occupied by anxiety (unmotivated anxiety, premonition that "something must happen," "inner excitement"). The manic state is expressed in a heightened, upbeat mood, excessively active activity. Patients are in excellent spirits, they feel extraordinary cheerfulness, a burst of energy. They are cheerful, long-winded, joking, easily distracted, mistaken for unnecessary deeds, and finding unusual occupations. Numerous ideas arising from them, do not lead to the end. Overestimating their opportunities, they offer their candidacy for various positions that do not correspond to their level of knowledge and qualifications. Quite often they discover their extraordinary abilities, they pretend to be an actor, a poet, a writer. Sometimes they leave their work with the goal of doing creativity or simply changing their profession. The patients have a wonderful appetite, however, they can lose weight, because Spend too much energy. A short sleep (3-4 hours), but this is enough for them, otherwise "you'll spend the rest of your life." Increases sexual desire, which can lead to promiscuous sexual intercourse. In those cases, if manic syndrome is not very pronounced, they speak of a hypomanic state. In hypomania, patients are extremely productive, because There is still increased distraction, disinhibition. Good working capacity, the memory is wonderful, the mood is magnificent, no problems - in this state a person is ready to roll mountains. People of creative work - composers, artists, poets, scientists, being in a similar condition, create masterpieces in art and outstanding works in science. But, unfortunately, the line between the hypomanic and manic state is very fuzzy and it's easy to cross it, and beyond this side is already a serious painful condition. If the patient has only hypomania and subdepression, then this disease is called cyclotomy. But if in hypomania patients do not turn to a doctor, then in subdepression requires the help of a doctor, at least outpatient.
A significant number of patients in their entire life there is only one phase of the disease, after which recovery occurs. However, the probability of the appearance of the second and third phases is preserved until the end of life. More than half of the patients have the disease only in the form of Depressive phases, about 5% - only manic (monopolar flow). If the manic and depressive phases alternate - this is a bipolar flow type. In some patients, bouts of depression are repeated yearly, and at certain times of the year (in the fall or early spring).
Treatment and prevention. Treatment depends on the nature of the phase, depressive or manic. Depression is treated with antidepressants. If depression with severe inhibition, prescribe antidepressants with a stimulating effect (melipramine), if with a pronounced anxiety, anxiety, then drugs with a calming effect (amitriptyline, triptyzole). With insomnia, tranquilizers are added. The manic state is stopped with neuroleptics (aminazine, haloperidol, etc.). For the prevention of subsequent seizures, lithium salts are used, and recently finlexin (tegretol) has been widely used as a mood stabilizer for these purposes. In the period of illness (except for hypomania), patients are disabled. After exiting the attack, the work capacity is restored. Disability of patients is transferred only in cases when attacks are very frequent or the course of the disease acquires a continuous character, i.e. One phase replaces another.