Manic - depressive psychosis

Manic - depressive psychosis (synonym circular psychosis) - a disease characterized by periodic development of depressive and manic episodes, after the disappearance of which the so-called light periods of full restoration of mental health. The ratio of depressive and manic episodes (see Affective syndromes), which is formed manic depression, can be quite varied: can only be depressed or only manic attacks, i.e.
the disease is in the form of recurrent depression or periodic mania; meets the alternation of depressive and manic episodes - in some cases with "bright intervals between them, others for many years continuously one type of attack (e.g., depression) is replaced by the opposite without the "light of the gaps" (type continua); finally, there may be a period of dual attacks - manic directly replaced depressed, then there is a "lucid interval". The duration of the attacks varies from several days and weeks to several months, and even years. The duration of the "light of the gaps"separating the attacks, also varies within a broad range - from several days to several tens of years. The number of attacks can be very different. Meet patients who underwent during the life of just one or two episodes, other number of attacks can reach several dozens. Many patients in whom attacks of the disease recur frequently, you can mark their presence in certain periods of the year, even in certain months, the so-called seasonality of the disease.
Expressed depressive and manic episodes of manic - depressive psychosis often begin after 40 years. Often, however, in a detailed survey of patients diagnosed cases of manic - depressive psychosis in Mature and late age, you can find that in the past they were shallow and short (days, weeks, sometimes months) periodic status with elevated mood, slight agitation (Hypo-manic attacks) or the state of any depression, low mood (hypotonia). Disease, occurring in the form of such light affective disorders, represents a softened form of manic - depressive psychosis and called cyclothymia. The disease in the form of cyclothymia can last a lifetime.
Usually depressive episodes of manic - depressive psychosis proceed with emotional speech and motor braking depressive triad in the form of typical depression - gipotermicescoe, anesthetic depression or depression with brad self-blame (see Affective syndromes). At the beginning of the disease after 50 and especially after the age of 60 are most often found different ways agitated hypochondriac or depression.
Manic attacks in young and middle age is most often occur in the form of cheerful or angry mania. After 50 years manic status is often combined with non-deployed and non-systemized ideas of persecution, as well as disorders resembling psevdomatematicheskoe (see Psevdomatematicheskoe syndrome),euphoria, ideas of grandeur, increased sexual desire, gluttony.
Manic and especially depressive episodes with constancy are accompanied by a variety of somatic disorders. Often depressive episodes of manic - depressive psychosis can be determined primarily not affective, and a variety of somatic disorders: vegetative - with bouts of sweating, coldness, the paresthesia, palpitations, pain in the heart; complaints about lack of sleep, appetite, constipation, vomiting. This condition is called "vegetative depression". Often they arise under the influence of mental injuries, and therefore also known as endoreactive of destiny.
To differentiate manic - depressive psychosis should first of all with attacks periodic schizophrenia (see) and the involutionary melancholy (see Predtechenskii psychosis).
Forecast of manic - depressive psychosis with rare attacks are quite favorable, is deteriorating in cases frequent occurrence of seizures continuous change (type continua), as well as in the transition of attacks in chronic depression or chronic mania that usually occurs only after 50 years. At this age often previously favored continuing the disease becomes more severe: increased stroke, in their structure have more severe symptoms, increases the duration of attacks are shortened "bright holes.
Treatment as deployed, and lungs (cyclothymic) episodes of manic - depressive psychosis should be carried out in a psychiatric hospital. When suspected cases of manic - depressive psychosis patient must consult with the doctor, and the heavy able to send accompanied by a medical assistant or relatives in a hospital. With typical depression is used alone or in combination with each other antidepressant means. Most often this melipramine (Tofranil, Kisin), trinisol (amitriptyline), tizertsin (nozinan). When agitated depression antidepressants combined with neuroleptic means - chlorpromazine, the propazine, occasionally haloperidol. When protracted resistant to psychotropic drugs depression shows electroconvulsive therapy. Manic state treat neuroleptic means, chlorpromazine, haloperidol; less rezerpinom.