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manic depression

Alternative Names
bipolar disorder, bipolar affective disorder, affective bipolar disorder

Manic depression or bipolar disorder is a major psychiatric illness characterised by periods of either elevated or depressed mood. Behavioural changes occur and the duration of the disturbance is usually at least several days. Sometimes the mood state can persist for weeks or even months if not treated. Sometimes periods of depression alternate with periods of mania. For the diagnosis to be made there has to have been at least one episode of mania or hypomania (a mild form of mania).

What are the signs and symptoms of the condition?
The symptoms of the manic and hypomanic phase of this condition include:
  • a decreased need for sleep, irritability, increased activity, talkativeness, and an inflated sense of self-importance
  • a tendency to be easily distracted
  • an increase in goal-directed activity at home, work or school
  • excessive involvement in high risk/consequence activities, such as spending sprees, unwise business ventures, and irresponsible sexual behaviour
A hypomanic or manic episode may last from a few days to several months.

The depressive phase of this disorder is characterised by:
  • low self-esteem and feelings of worthlessness
  • sadness and tearfulness nearly every day
  • suicidal thinking or frequent thoughts of death
  • decreased interest or pleasure in routine activities
  • weight loss or gain
  • insomnia
  • hypersomnia, which is excessive sleep
  • difficulty concentrating
  • loss of energy or fatigue

What are the causes and risks of the condition?
Usually this disorder first appears when the person is between the ages of 15 and 25. Adolescents who have had a major depressive episode are at greater risk for developing manic depression in their late teens or 20s.

While the exact cause of manic disorder, or bipolar disorder, is unknown, genetics does seem to play a role. Studies have found that if one parent has a bipolar disorder, there is a 25% chance that the child will have a mood disorder. If both parents have bipolar disorder, there is a 50% to 75% chance that their child will develop a mood disorder. Fifty percent of all individuals with bipolar disorder have at least one parent with a mood disorder.

What can be done to prevent the condition?
There is no known way to prevent manic depression.

How is the condition diagnosed?
Diagnosis depends on what symptoms the patient is showing. A doctor will conduct a thorough psychological and social history, as well as a physical examination. If symptoms are extreme enough to cause problems in social settings or at work, or require hospitalisation, a bipolar I (bipolar-manic) diagnosis is made.

What are the long-term effects of the condition?
People with this disorder often have problems in their relationships due to the constant mood swings and associated behaviour.

Suicide is a risk for people with bipolar disorders.

What are the risks to others?
There are no risks to others, as manic depression is not contagious.

What are the treatments for the condition?
Treatments include psychotherapy and medication. Medications that have been shown to work include mood stabilisers, such as valproate, carbamazepine, and lithium.

What are the side effects of the treatments?
Side effects depend on the medication used.

What happens after treatment for the condition?
Treatment for bipolar disorder tends to be ongoing and therefore medication is monitored. Blood levels are checked frequently to be sure that the medication level is therapeutic.

How is the condition monitored?
Psychotherapy is usually continued on a regular basis to monitor medication compliance and to be sure symptoms remain well controlled.

Author: Ann Reyes, Ph.D.
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Potential conflict of interest information for reviewers available on request

This website and article is not a substitute for independent professional advice. Nothing contained in this website is intended to be used as medical advice and it is not intended to be used to diagnose, treat, cure or prevent any disease, nor should it be used for therapeutic purposes or as a substitute for your own health professional's advice.  All Health and any associated parties do not accept any liability for any injury, loss or damage incurred by use of or reliance on the information.


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