BIPOLAR DEPRESSION (MANIC-DEPRESSION) & Chronic Hypomanic Disorder
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
BIPOLAR DEPRESSION (MANIC-DEPRESSION)
We have now explored the great majority of depressions: 90 to 95 percent of
depressions are unipolar and occur without mania. This leaves between 5
and 10 percent of depressions that occur as part of manic-depression. These
are called bipolar depressions.
We classify bipolar depressions in the following way. Given the presence
Of manic symptoms, an individual is judged to be manic-depressive if he has
had one or more depressive episodes in the past. On the other hand, he is
diagnosed as having experienced only a manic episode if he has never had a
depressive episode. Mania itself can occur without depression, although this
is very rare. Usually, a depressive episode will occur eventually, once a
manic episode has happened. Finally, a chronic form of mania is called
chronic hypomanic disorder or hypomanic personality. This diagnosis is
made when an individual has experienced an unbroken two-year-long manic state.
Since the depressive component of manic-depression is highly similar to
what we have described for unipolar depression, we need only describe
mania here in order to have a clear picture of bipolar depression.
Here is what it feels like to be in the manic state of a manic-depressive disorder:
When I start going into a high, I no longer feel like an ordinary housewife. Instead,
I feel organized and accomplished, and I begin to feeI that I am my most creative self. I
can write poetry easily. I can compose melodies without effort. I can paint.
My mind feels facile and absorbs everything. I have countless ideas about improving the
conditions of mentally retarded children, how a hospital for these children should be run,
what they should have around them to keep them happy
and calm and unafraid. I see myself as being able to accomplish a great
deal for the good of people. I have countless ideas about how the environmental problem
could inspire a crusade for the health and betterment of everyone. I feel able to
accomplish a great deal for the good of my family and others. I feel pleasure; a
sense of euphoria or elation. I want it to last forever. I don't seem to need much
sleep. I've lost weight and feel healthy, and I like myself. I've just bought six new
dresses, in fact, and they look quite good on me. I feel sexy and men stare at me.
Maybe I'll have an affair, or perhaps several. I feel capable of speaking and doing
good in politics. I would like to help people with problems similar to mine so they
won't feel hopeless. (Fieve, 1975, p. 17)
SYMPTOMS OF MANIA
The onset of a manic episode usually occurs fairly suddenly, and the euphoric
mood, racing thoughts, frenetic acts, and the resulting insomnia
stand in marked contrast to the person's usual functioning. Mania presents
four sets of symptoms: mood, thought, motivational, and physical symptoms.
Mood or Emotional Symptoms
The mood of an individual in a manic state is euphoric, expansive, and elevated.
A highly successful manic artist describes his mood:
I feel no sense of restriction or censorship whatsoever. I'm afraid of nothing and
no one. During this elated state, when no inhibition is present, I feel I can race a car
with my foot on the floorboard, fly a plane when I have never flown a plane
before, and speak languages I hardly know. Above all, as an artist,
I feeI I can write poems and paint paintings that I could never dream of when
just my normal self. I don't want others to restrict me during
this period of complete and utter freedom. (Fieve, 1975)
Grandiose euphoria is not universal in mania, however. Often the dominant
mood is irritability, and this is particularly so when a manic individual
is thwarted in his ambitions. Manics, even when high, are peculiarly close to
tears, and when frustrated may burst out crying. This is one reason to believe
that mania is not wholly the opposite state of depression, but that a
strong depressive element coexists with it.
Thought Symptoms
The manic cognitions are appropriate to the mood. They are grandiose. The
manic does not believe in limits to his ability, and worse he does not recognize
the painful consequences that will ensue when he carries out his plans.
A manic who spends $50,000 buying three automobiles in a week does not
recognize that he will have a great deal of trouble trying to pay for them over
the coming years; a manic who calls the President in the middle of the night
to tell him about her latest disarmament proposal does not recognize that
this call may bring the police down on her; the manic who enters one sexual
affair after another does not realize the
permanent damage to his reputation that may ensue.
A manic may have thoughts or ideas racing through his mind faster than
he can write them down or say them. This flight of ideas easily becomes
derailed because the manic is highly distractible. In some extreme cases, the
manic has delusional ideas about himself: he may believe that he is a special
messenger of God; he may believe that he is an intimate friend of famous
political and show business figures. The manic's thinking about other people
is black and white: the individuals he knows are either all good or all bad;
they are his best friends or his sworn enemies.
Motivational Symptoms
Manic behavior is hyperactive. The manic engages in frenetic activity, be it
in his occupation, in political or religious circles, in sexual relationships, or
elsewhere. Describing the mania of a woman, one author wrote:
Her friends noticed that she was going out every night, dating many new men,
attending church meetings, language classes, and dances, and showing a rather
frenetic emotional state. Her seductiveness at the office resulted in her going to
bed with two of the available married men, who didn't realize that she was ill. She
burst into tears on several occasions without provocation and told risque jokes
that were quite out of character. She became more talkative and restless, stopped eating
and didn't seem to need any sleep. She began to talk with religious feeling about being in
contact with God and insisted that several things were now necessary to carry out God's wishes.
This included giving herself sexually to all who needed her. When she was admitted to the hospital,
she asked the resident psychiatrist on call to kiss her. Because he refused to do so, she became suddenly silent.
Later, she talked incessantly, accusing the doctor of trying to seduce her and began
to talk about how God knew every sexual thought that she or the doctor might have. (Fieve, 1975,nn. 22-23)
The activity of the manic has an intrusive, demanding, and domineering
quality to it. Manics sometimes make us uncomfortable because of this. It is
difficult to spend much time with an individual who delivers a rapid succession
of thoughts and who behaves in a frenetic way almost in disregard of
those around him. Other behaviors that commonly occur during mania are
compulsive gambling, reckless driving, poor financial investments, and
flamboyant dress and makeup.
Physical Symptoms
With all this flurry of activity comes a greatly lessened need for sleep. Such
hyposomnia virtually always occurs during mania. After a couple of days of
this, exhaustion inevitably sets in and the mania slows down.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Treating:
Depression
Post-Traumatic Stress Disorder (PTSD)
Social Anxiety
Generalized Anxiety
Panic Disorder
Major Depression Disorder
Agoraphobia
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
For the Therapy I recommend click here:
The Liberator Method
BIPOLAR DEPRESSION (MANIC-DEPRESSION)
We have now explored the great majority of depressions: 90 to 95 percent of
depressions are unipolar and occur without mania. This leaves between 5
and 10 percent of depressions that occur as part of manic-depression. These
are called bipolar depressions.
We classify bipolar depressions in the following way. Given the presence
Of manic symptoms, an individual is judged to be manic-depressive if he has
had one or more depressive episodes in the past. On the other hand, he is
diagnosed as having experienced only a manic episode if he has never had a
depressive episode. Mania itself can occur without depression, although this
is very rare. Usually, a depressive episode will occur eventually, once a
manic episode has happened. Finally, a chronic form of mania is called
chronic hypomanic disorder or hypomanic personality. This diagnosis is
made when an individual has experienced an unbroken two-year-long manic state.
Since the depressive component of manic-depression is highly similar to
what we have described for unipolar depression, we need only describe
mania here in order to have a clear picture of bipolar depression.
Here is what it feels like to be in the manic state of a manic-depressive disorder:
When I start going into a high, I no longer feel like an ordinary housewife. Instead,
I feel organized and accomplished, and I begin to feeI that I am my most creative self. I
can write poetry easily. I can compose melodies without effort. I can paint.
My mind feels facile and absorbs everything. I have countless ideas about improving the
conditions of mentally retarded children, how a hospital for these children should be run,
what they should have around them to keep them happy
and calm and unafraid. I see myself as being able to accomplish a great
deal for the good of people. I have countless ideas about how the environmental problem
could inspire a crusade for the health and betterment of everyone. I feel able to
accomplish a great deal for the good of my family and others. I feel pleasure; a
sense of euphoria or elation. I want it to last forever. I don't seem to need much
sleep. I've lost weight and feel healthy, and I like myself. I've just bought six new
dresses, in fact, and they look quite good on me. I feel sexy and men stare at me.
Maybe I'll have an affair, or perhaps several. I feel capable of speaking and doing
good in politics. I would like to help people with problems similar to mine so they
won't feel hopeless. (Fieve, 1975, p. 17)
SYMPTOMS OF MANIA
The onset of a manic episode usually occurs fairly suddenly, and the euphoric
mood, racing thoughts, frenetic acts, and the resulting insomnia
stand in marked contrast to the person's usual functioning. Mania presents
four sets of symptoms: mood, thought, motivational, and physical symptoms.
Mood or Emotional Symptoms
The mood of an individual in a manic state is euphoric, expansive, and elevated.
A highly successful manic artist describes his mood:
I feel no sense of restriction or censorship whatsoever. I'm afraid of nothing and
no one. During this elated state, when no inhibition is present, I feel I can race a car
with my foot on the floorboard, fly a plane when I have never flown a plane
before, and speak languages I hardly know. Above all, as an artist,
I feeI I can write poems and paint paintings that I could never dream of when
just my normal self. I don't want others to restrict me during
this period of complete and utter freedom. (Fieve, 1975)
Grandiose euphoria is not universal in mania, however. Often the dominant
mood is irritability, and this is particularly so when a manic individual
is thwarted in his ambitions. Manics, even when high, are peculiarly close to
tears, and when frustrated may burst out crying. This is one reason to believe
that mania is not wholly the opposite state of depression, but that a
strong depressive element coexists with it.
Thought Symptoms
The manic cognitions are appropriate to the mood. They are grandiose. The
manic does not believe in limits to his ability, and worse he does not recognize
the painful consequences that will ensue when he carries out his plans.
A manic who spends $50,000 buying three automobiles in a week does not
recognize that he will have a great deal of trouble trying to pay for them over
the coming years; a manic who calls the President in the middle of the night
to tell him about her latest disarmament proposal does not recognize that
this call may bring the police down on her; the manic who enters one sexual
affair after another does not realize the
permanent damage to his reputation that may ensue.
A manic may have thoughts or ideas racing through his mind faster than
he can write them down or say them. This flight of ideas easily becomes
derailed because the manic is highly distractible. In some extreme cases, the
manic has delusional ideas about himself: he may believe that he is a special
messenger of God; he may believe that he is an intimate friend of famous
political and show business figures. The manic's thinking about other people
is black and white: the individuals he knows are either all good or all bad;
they are his best friends or his sworn enemies.
Motivational Symptoms
Manic behavior is hyperactive. The manic engages in frenetic activity, be it
in his occupation, in political or religious circles, in sexual relationships, or
elsewhere. Describing the mania of a woman, one author wrote:
Her friends noticed that she was going out every night, dating many new men,
attending church meetings, language classes, and dances, and showing a rather
frenetic emotional state. Her seductiveness at the office resulted in her going to
bed with two of the available married men, who didn't realize that she was ill. She
burst into tears on several occasions without provocation and told risque jokes
that were quite out of character. She became more talkative and restless, stopped eating
and didn't seem to need any sleep. She began to talk with religious feeling about being in
contact with God and insisted that several things were now necessary to carry out God's wishes.
This included giving herself sexually to all who needed her. When she was admitted to the hospital,
she asked the resident psychiatrist on call to kiss her. Because he refused to do so, she became suddenly silent.
Later, she talked incessantly, accusing the doctor of trying to seduce her and began
to talk about how God knew every sexual thought that she or the doctor might have. (Fieve, 1975,nn. 22-23)
The activity of the manic has an intrusive, demanding, and domineering
quality to it. Manics sometimes make us uncomfortable because of this. It is
difficult to spend much time with an individual who delivers a rapid succession
of thoughts and who behaves in a frenetic way almost in disregard of
those around him. Other behaviors that commonly occur during mania are
compulsive gambling, reckless driving, poor financial investments, and
flamboyant dress and makeup.
Physical Symptoms
With all this flurry of activity comes a greatly lessened need for sleep. Such
hyposomnia virtually always occurs during mania. After a couple of days of
this, exhaustion inevitably sets in and the mania slows down.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Treating:
Depression
Post-Traumatic Stress Disorder (PTSD)
Social Anxiety
Generalized Anxiety
Panic Disorder
Major Depression Disorder
Agoraphobia
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
For the Therapy I recommend click here:
The Liberator Method