Manic-Depressive Psychosis
All of us have our ups and downs in mood. but the psychotic patient es an exaggerated picture of "this normal behavior. The term anic" is used to describe three main symptoms: extreme euphoria, ghtened psychomotor activity, find flight of ideas. Left on his or her n, the patient may indulge in alcoholic or sexual excesses or sibly get involved in w-ild business ventures.
In the depressed stage, we find dejection and a feeling of ,pelessness, accompanied often by feelings of guilt. Some patients ifest only the manic reaction and others only the depressive .action. Still others show some alternation between the two.
In the manic phase, there is overactivity and constant talking, rapid shifts from one topic to another. Depressive symptoms are just the reverse, and the patient becomes indifferent to both the physical and the social environment. The manic-depressive may ing from warmest kindness to near-ruthlessness. The exaggeration moods in manic-depressive reactions often does not appear to be brought on by external situations. However, in any given individual e is a predictable pattern of events. Modern psychotherapy can do much for the manic-depressive, oc:casionally even clearing up the illness in a matter of days or weeks. However, the symptoms do tend recur.
Four Subtypes
Manic-depressive psychosis is better described in terms of its sub~s. There is the manic subtype, whose elation, excitement, and ractivity can be described by those who know the person well. en to pointing out the little peculiarities-of his or her life-style. For mple, the manic subtype may become a nuisance to friends, 'ng on them at odd and inconvenient times.
The depressed subtype is revealed not only by extreme dession but also by a slowing down of psychomotor activity'. An observer may get the feeling that the person is isolated from the environment.
The circular subtype is characterized by alternation between ic and depressed episodes. This up-and-down swing may follow a fairly smooth change from one extreme tn another in one person. In her individual the picture is one of a gradual rise to the peak of manic phase with a gradual decline to normal: then afte a period
of normality the depressive phase sets in. Some patients show irregularities in 'the up-and-down swings.
A fourth subtype called involutional melancholia. is marked by extreme anxiety. Here the person is preoccupied with somethinE being wrong with body organs. Expressions of feelings of guilt an common. The depression often centers on the "decline of the self."
In the manic-depressive psychoses we should point out that thE manic attack should not be confused with joy. The apparent elation 'may well be an attempt to escape from the feelings of depression rather than being something pleasurable. In a manic phase, the individual appears to have unlimited energy, and may be too excited to even eat or sleep. Of course, exhaustion follows. In depression, anguish is often expressed by crying and verbally depreciating oneself.
Psychiatrists frequently use drugs to treat the disorder; "down~ ers" are used to reduce manic behavior, and "uppers" are used to bring the person out of his or her melancholic mood temporarily. Under medical supervision, drugs are used- at times to ready the patient for some form of psychotherapy. Self-administration of drugs may be quite harmful to the manic-depressive person.
