Bipolar Disorder: Description And Symptoms

Bipolar disorder, formerly called manic-depressive illness or manic depression, causes extreme mood shifts ranging from mania to depression.

It is a chronic or episodic (which means occurring occasionally and at irregular intervals) mental disorder. Bipolar disorder can cause unusual, often extreme and fluctuating changes in mood, energy, activity, and concentration or focus.

In bipolar disorder the range of mood changes can be extreme. In manic episodes (distinct period of abnormally and persistently elevated), someone might feel very happy, irritable, or “up,” and there is a marked increase in activity level. While in depressive episodes, someone might feel sad or empty, irritable mood, indifferent, or hopeless, in combination with a very low activity level.

The illnesses frequently are first diagnosed in adolescence or early adulthood after several years of symptoms. Among the symptoms of bipolar disorder include periods of mania, hypomania, psychosis, or depression interspersed with periods of relative wellness.

Bipolar disorders include four subtypes: Bipolar I Disorder, Bipolar II Disorder, Cyclothymic Disorder, Other Specified and Unspecified Bipolar and Related Disorders
Bipolar Disorder: Description And Symptoms

Cyclothymic disorder

Cyclothymic disorder is defined as a ‘chronic, fluctuating disturbance’ with many periods of hypomania and of depression.

People with cyclothymic disorder have continuous mood cycles that are usually briefer and less severe than those characteristics of bipolar I or II disorders.

To be diagnosed as suffering from cyclothymic disorder, patients need to exhibit these dramatic fluctuations for at least two years.

Children and adolescents can be classified as cyclothymic after only one year, however.

Patients with cyclothymic disorder may constitute from 3 to 5 percent of all psychiatric outpatients, perhaps particularly those with significant complaints about marital and interpersonal difficulties.

Cyclothymic disorder, like other mood disorders, usually begins in late adolescence or early adulthood and without treatment, tends to have a chronic course, with no significant symptom-free period.

Cyclothymic depressions symptoms such as sadness, anhedonia, low energy, pessimism, poor concentration and sleep and appetite changes resembling those observed in episodes of major depression. Cyclothymic disorder can present as predominantly depressed predominantly hypomanic or balanced with approximately equal proportions of high and low periods.

Most patients with cyclothymic disorder seen by psychiatrics have not succeeded in their professional and social lives as a result of their disorder, but a few have become high achievers who have worked especially long hours and have required little sleep.
Cyclothymic disorder

Normal Moods and Depression

Normal Moods and Depression
There is little agreement among authorities regarding the relationship of depression to the changes in mood experienced by normal individuals. The term, mood, or generally applied to a spectrum of feelings extending from elation and happiness at one extreme, to sadness and unhappiness at the other. The particular feelings encompassed by this term, consequently, are directly related to either happiness or sadness Subjective states, such as anxiety or anger, that do not fit into the happiness sadness categories are not generally included.

Some authors believe that all individuals have mood swings and that normal individuals may have “blue” hours or “blue” days. This belief has been supported by systematic studies of oscillations in mood in normal subjects.

The episodes of low mood or of feeling blue experienced by normal individuals are similar in a number of ways to the clinical states of depression.

First, there is similarity between the descriptions of the subjective experience of normal low mood and of depression. The word used to describe normal low mood tend to be the same used by depressive to describe their feelings – blue, sad, unhappy, empty, low, lonely. It is possible, however, that this resemblance may be due to the depressed patient’s drawing on his familiar vocabulary to describe a pathological state for which he has no available words. Some patients, in fact state that their feelings during their depression are quite distinct from any feelings they have ever experienced when not in a clinical depression.

Second the behavior of the depressed patient resembles that of a person who is sad or unhappy, particularly in the mournful facial expression and the lowering of the voice.

Third, some of the vegetative and physical manifestations characteristics of depression are occasionally seen in individuals who are feelings sad but who would not be considered clinically depressed. A person who has fail an examination, lost a job, or even jilted, may not only feel discouraged and forlorn, but may experience anorexia, insomnia, and fatigability.

Finally many individuals experience blue states that seem to oscillate in a consistent or rhythmic fashion, independently or external stimuli, suggestive of the rhythmic variations in the intensity of depression.
Normal Moods and Depression

Description of Depression

Description of Depression
The condition that today we label depression has been described by a number of ancient writers under classification of “melancholia.” The first clinical description of melancholia was made by Hippocrates in the 4th century B.C. He also referred to swings similar to mania and depression.

Aretaeus, physician living in the 2nd century, A.D described the melancholic patient as “sad, dismayed, sleepless…They become this by their agitation and loss of refreshing sleep…At more advanced stage, they complain of a thousand futilities and desire death.” It is noteworthy that Aretaeus specifically delineated the manic-depressive cycle. Some authorities believe that he anticipated the Kraepelinian synthesis of manic depressive psychosis.

Pinel at the beginning of the nineteenth century described melancholia as follows:
“The symptoms generally comprehend by the term melancholia are taciturnity, a thoughtful pensive air, gloomy suspicious and a love of solitude. Those traits, indeed, appear to distinguish the characters of some men otherwise in good health, and frequently in prosperous circumstances. Nothing, however, can be more hideous than the figure of a melancholic brooding over his imaginary misfortune. If moreover possessed of power, and endowed with a perverse disposition and a sanguinary heart, and image is rendered still more repulsive.”

Because the disturbed feelings are generally a striking feature of depression, it has become customary in recent years to regard this condition as a “primary mood disorder” or as an “affective disorder.” The central importance ascribed to the feeling component of depression is exemplified by the practice of utilizing affective adjective check lists to define and measure depression. The representation of depression as an affective disorder is a misleading as it would be to designate scarlet fever as a “disorder of the skin” or as a “primary febrile disorder.” There are many components to depression other than mood deviation.

Depression may now be defined in terms of the following attributes:

• A specific alteration in mood: sadness, loneliness, apathy
• A negative self concept associated with self-reproaches and self blame.
• Regressive and self punitive wishes: desires to escape, hide or die.
• Vegetative changes: anorexia, insomnia, loss of libido
• Change in activity level: retardation or agitation.
  

Description of Depression