What is manic-depressive disorder?
It is a mental disorder characterized by elated mood or depressed mood states
with related symptoms. It is also called mood disorder. The main feature is
cyclic swing of elated or depressed mood. It has periods of remission or
recurrence. When the patient is in remitted state, he will function normally.
Its prognosis is quite good. A minority of patients may run a chronic course.
What are the causes of manic-depressive disorder?
1) genetic factor :
Twins and first degree relatives of patients have higher chance of
getting this disorder.
2) neurotransmitter disturbance in the brain :
Studies showed abnormalities of some neurotransmitters, like
3) Periodic pattern :
There is seasonal trend. Manic episodes usually occur in summer and
depressive episodes usually occur in winter.
How do you know that you have the disorder?
1) Manic state :
(a) Elated mood: happy mood, optimistic attitude, sustained elation,
irritability, easily getting angry upon trivial matters, aggression
to people or properties.
(b) Flight of ideas : racing thoughts, talkativeness, husky voice due
to speaking a lot, inflated self-esteem, boastfulness
(c) Increased will power : over-friendliness, full of ideas, increased
social activities, inability to finish business, distractibility,
over-expansiveness, over-buying things, increased cosmetic
concern of female patients, casual sex attitude, increased libido,
reduced need for sleep yet remaining energetic all the time.
2) Depressed state :
(a) Depressed mood : low mood, negative cognitions, hopelessness,
reduced energy, reduced interest, loss of feelings to relatives,
hopelessness about present and future life, social withdrawal
from friends or relatives
(b) Retarded thinking : slow thinking speed, poverty of thoughts,
sluggish response, soft voice, hypochondriacal attitude,
suspicion of oneself having contracted incurable illness
(c) Decreased will power : passive lifestyle, reduced activity,
sluggish response, idling in bed, social withdrawal, self-neglect
at severe stage including refusal to eat and drink, activity of
living dependent on others, suicidal idea or attempt present at
the severest stage of depressive illness.
What are the treatments for manic-depressive disorder?
1) Medication :
(a) Mood stabilizers:
Lithium therapy reduces the frequency of relapse. Doctors will
regularly check the blood lithium level. In case of presence of
nausea, vomiting, diarrhea, confusion, muscle weakness, gross
tremor, muscle twitching, unsteady gait, irrelevant speech while
taking lithium, patient should consult doctor at once.
2) Electroconvulsive therapy: mainly used for severely depressed
3) Other rehabilitative therapy :
(a) Self-care training : personal hygiene, money management,
cooking skill, knowledge of community support network,
domestic safety, domestic hygiene
(b) Mental health education : knowledge of various mental
disorders and psychiatric medication
(c) Counseling and training on home-living and social skills
(d) Psychological treatment : stress management workshop, skills in
managing worries, skills in managing delusions and
(e) Vocational rehabilitative training : training on vocational skills
and work attitude
(f) Special accommodation arrangement : half-way house,
compassionate re-housing, long-stay care home
(g) Financial assistance: case medical officer refers patients to social
workers for financial assistance.