Manic phase of manic depressive psychosis. Atypical forms of manic-depressive psychosis

V modern psychiatry are very frequent diagnosis afflicting mankind. Their appearance is associated with global cataclysms, personal problems people, influence environment and other factors.

People, being under the pressure of problems, can fall not only into a depressive state, but also manic.

Etymology of the disease

What is manic-depressive psychosis can be explained in simple words: so it is customary to call the periodically changing state of idle and full depression.

In psychiatry, experts call this a disease that is characterized by the appearance in a person of two periodically changing polar states that differ in psychosomatic indicators: mania and depression (positive is replaced by a negative).

This disease is often referred to in the literature on psychiatry, which also studies MDP, as " manic depression or bipolar disorder.

Views (phases)

Runs in two forms:

- depressive phase
- manic phase.

depressive phase accompanied by the appearance in a sick person of an oppressed pessimistic mood, and manic phase bipolar disorder is expressed by an unmotivated cheerful mood.
Between these phases, psychiatrists allocate a time interval - intermission , during which a sick person has the preservation of all personality traits.

Today, according to the opinion of many experts in the field of psychiatry, manic-depressive psychosis is no longer a separate disease. In its turn bipolar disorder is an alternation of mania and depression, the duration of which can be from one week to 2 years. The intermission that separates these phases can be long-term, from 3 to 7 years, or it can be completely absent.

Causes of the disease

Psychiatrists refer to manic-depressive psychosis as autosomal dominant type . The most common ailment of this nature is hereditary disease passed from mother to child.

Causes psychosis lie in the violation of the full-fledged activity of the emotional centers located in the subcortical region. Failures in the work of excitatory and inhibitory processes occurring in the brain can provoke the appearance of bipolar disorder in a person.

Relationships with others, being in a stressful state can also be considered as the causes of the appearance of manic depressive psychosis.

Symptoms and signs

More often, manic-depressive psychosis affects women than men. Case statistics: per 1000 healthy people there are 7 patients in psychiatric clinics.

In psychiatry, manic depressive psychosis has whole line symptoms manifested in the phases of the disease. Teenagers The signs are the same, sometimes more pronounced.

The manic phase begins in a person with:

- changes in self-perception,
- the appearance of cheerfulness literally out of nowhere,
- a surge of physical strength and unprecedented energy,
- opening a second breath,
- the disappearance of problems that oppressed earlier.

A sick person who had any diseases before the onset of the phase suddenly gets rid of them miraculously. He begins to remember all the pleasant moments from his life that he lived in the past, and his mind is filled with dreams and optimistic ideas. The manic phase of bipolar disorder drives out all negativity and thoughts associated with it.

If a person has difficulties, then he simply does not notice them.
For the patient, the world appears in bright colors, his sense of smell and taste buds are sharpened. The speech of a person also changes, it becomes more expressive and loud, he has a lively thinking and an improvement in mechanical memory.

The manic phase changes the human consciousness so much that the patient tries to see only exclusively positive in everything, he is satisfied with life, constantly cheerful, happy and excited. He reacts negatively to third-party criticism, however, he easily takes on any business, expanding in the course of his activities the range of his personal interests and acquiring new acquaintances. Patients who prefer to live idly and cheerfully like to visit places of entertainment, they often change sexual partners. This phase is more typical for adolescents and young people with pronounced hypersexuality.

The depressive phase does not flow so brightly and colorfully. In patients staying in it, a sad state suddenly appears, which is not motivated by anything, it is accompanied by lethargy. motor function and slowness of thought processes. In severe cases, a sick person may fall into a depressive stupor (complete stupor of the body).

People may experience the following symptoms:

- sad mood
- loss of physical strength
- the appearance of suicidal thoughts,
- feeling unsuitable for others,
- absolute emptiness in the head (absence of thoughts).

Such people, feeling useless for society, not only think about committing suicide, but often they end their mortal existence in this world in precisely this way.

Patients are reluctant to make verbal contact with other people, they are extremely reluctant to respond even to the most simple questions.

Such people refuse sleep and food. Quite often, the victims of this phase are teenagers who have reached the age of 15, in more rare cases people over 40 suffer from it.

Diagnosis of the disease

A sick person must undergo a full examination, consisting in such methods, How:
1. electroencephalography;
2. MRI of the brain;
3. radiography.

But not only similar methods survey is taken. The presence of manic-depressive psychosis can be calculated by performing surveys And tests.

In the first case, specialists try to make an anamnesis of the disease from the words of the patient and identify a genetic predisposition, and in the second, bipolar personality disorder is determined based on tests.

A test for bipolar disorder will help an experienced psychiatrist determine the degree of emotionality of the patient, alcohol, drug or other addiction (including gambling), determine the level of the coefficient of attention deficit, anxiety, and so on.

Treatment

Manic-depressive psychosis includes the following treatment:

• Psychotherapy. This means of treatment is carried out in the form of psychotherapeutic sessions (group, individual, family). This kind psychological help allows people suffering from manic-depressive psychosis to realize their disease and completely recover from it.

Pathologies mental state of a person can be associated with the degradation of his personal characteristics or with the preservation of all basic parameters. In the second case, the disorders are less acute, and the ability to full recovery mind over a period of time. Such diseases with a "temporary" course include manic-depressive psychosis.

It manifests itself in the form of cyclic mood swings: periods of violent (manic) activity are replaced by recessions in the form of depression and depression. In time, these cycles can be separated by months and years. normal functioning mental sphere brain activity. At the same time, no symptoms of manic-depressive syndrome appear.

In the vast majority of cases, it is diagnosed in women of middle and old age. Initial Complex clinical manifestations may occur during a midlife crisis or hormonal adjustment organism in menopause. Both social and personal factors can influence.

The main provocative factor on which all other causes of manic-depressive psychosis are based is negative genetic heredity. As a rule, in the family there are several recorded cases of the disease in persons belonging to different generations. But there is a practice of observations in which a clear connection may not be observed. This occurs in cases where in older women all manifestations are attributed to gerontological personality changes, quarrelsome character.

The transmission of the defective gene occurs after 1 generation. Thus, in one family clinical signs A grandmother and her granddaughter can suffer from manic-depressive psychosis at the same time.

The causes of manic-depressive psychosis are imposed on heredity, which would rather be called triggers:

• changes in endocrine system organism ( nodular goiter, dysplasia thyroid gland, malfunction of the adrenal glands, Graves' disease);
• disruption of the hypothalamus and analytical fragmentary center of the brain;
• menopausal hormonal changes;
• painful menstruation;
• postpartum and prenatal depression.

Among social and personal factors it can be noted that the tendency to the appearance of signs of manic-depressive psychosis is prone to persons who:

• suffer from a sense of their own inferiority (this also includes various complexes);
• cannot realize their inclinations and abilities;
• they do not know how to get in touch with other people and build full-fledged relationships;
• do not have a stable income and sufficient material support;
• received serious psychological trauma as a result of divorce, breakup, betrayal, betrayal.

There are other causes of manic-depressive syndrome. They can be associated with head injuries, organic lesions of brain structures against the background of strokes and disorders cerebral circulation, meningitis.

Depressive-manic psychosis and its classification

To prescribe the correct compensatory therapy for a psychiatrist, it is important to correctly classify depressive-manic psychosis according to the degree of manifestation of its clinical symptoms.

For this, a standard scale is used, according to which 2 degrees are distinguished:

1. lack of bright pronounced signs is called cyclophrenia;
2. a detailed clinical picture with severe manifestations is called cyclothymia.

Cyclophrenia is much more common and can occur in a latent form for long period time. Such patients have frequent drops sentiment for no apparent reason. Under the influence of a stress factor, a person can plunge into the primary phase of depression, which will gradually turn into a manic cycle with a bright emotional arousal and a burst of energy and physical activity.

Symptoms of manic-depressive psychosis

The clinical symptoms of manic-depressive psychosis depend on the degree of damage to the mnestic sphere of a person. With cyclophrenia, the signs of manic-depressive psychosis are weak and differ in the latent course of the disease. Very often in middle-aged women they disguise themselves as premenstrual syndrome, in which a woman has irritability, mood swings, impulsiveness and a tendency to tantrums in the period before menstruation.

In old age, the symptoms of depressive-manic psychosis in the form of cyclophrenia can be hidden behind a feeling of loneliness, depression, and impaired social contact.

There is a seasonal link: afferent disorders appear cyclically at the same time every year. Typically, the crisis periods are deep autumn and early spring. Prolonged forms are diagnosed, in which depressive-manic psychosis shows signs throughout the winter, from late autumn to mid-spring.

Patients may present with:

• general mental lethargy, which after a few days can be replaced by pronounced excitement and joyful mood;
• refusal to communicate, with a sharp change in mood towards obsessive pestering other people with conversations;
• speech disorders;
• immersion in one's own experiences;
• the expression of fantastic ideas.

common clinical forms cyclophrenic manic-depressive psychosis, in which a long-term phase of depression is released with bursts manic behavior. Upon exiting this state, a complete recovery is observed.

Depressive symptoms are more pronounced manic syndrome in cyclothymic form. Here, in addition to mental disorders somatic and autonomic symptoms manic depressive psychosis.

Among them are:

• a tendency to search for various "deadly" diseases against the background of depression;
• ignoring clinical signs somatic disease against the background of a manic phase;
• psychogenic pain syndromes;
• disorders of the digestive process: lack or increase in appetite, tendency to constipation and diarrhea;
• tendency to insomnia or constant drowsiness;
• cardiac arrhythmias.

The appearance of a patient suffering from signs of manic-depressive psychosis in the stage of depression is quite characteristic. These are lowered shoulders, a dreary and sad look, the absence of movements of the facial muscles of the facial zone, self-absorption (the patient does not immediately answer the question asked of him, does not perceive the appeal to him). When the phase changes to the manic stage, an unhealthy gleam appears in the eyes, the patient is agitated, he has a constant physical activity. Joy and aspiration to "exploits" are imprinted on the face. To simple questions that require a monosyllabic answer, the patient begins to give out whole theories and lengthy reasoning.

Manic-depressive psychosis can last a few days, or it can haunt a person for years and decades.

Treatment of manic-depressive psychosis

Pharmacological treatment of manic-depressive psychosis is required in patients with cyclothymia. With cyclophrenia, lifestyle changes are recommended, active classes physical education attending psychotherapy sessions.

With the severity of symptoms of depression, antidepressants are prescribed: azafen, melipramine, noveril or amitriptyline. Sidnocarb and mesocarb can be used for a long time. Treatment always begins with the application large dosages, which are gradually reduced to a maintenance level. Only a psychiatrist can calculate the dosage based on the data obtained from the history, height, weight, sex and age of the patient.

Alternative therapies include:

• extreme physical exercise in the form of deprivation of food, the possibility of sleep and heavy physical labor;
• electroshock methods of influence;
• electrosleep;
• acupuncture and reflexology.

At the stage of excitation, the treatment of manic-depressive psychosis is reduced to the suppression of excessive mental activity. Haloperidol, tizercin, chlorpromazine may be prescribed. These drugs cannot be used without constant surveillance by the attending physician.

Manic-depressive psychosis (MDP) refers to severe mental illness that occurs with a succession of two phases of the disease - manic and depressive. Between them there is a period of mental "normality" (light interval).

Table of contents:

Causes of manic-depressive psychosis

The onset of the development of the disease can be traced most often at the age of 25-30 years. Relative to common mental illnesses, the level of MDP is about 10-15%. There are 0.7 to 0.86 cases of the disease per 1000 population. Among women, pathology occurs 2-3 times more often than in males.

Note:the causes of manic-depressive psychosis are still under study. A clear pattern of transmission of the disease by inheritance was noted.

The period of pronounced clinical manifestations of pathology is preceded by personality traits - cyclothymic accentuations. Suspiciousness, anxiety, stress and a number of diseases (infectious, internal) can serve as a trigger for the development of symptoms and complaints of manic-depressive psychosis.

The mechanism of the development of the disease is explained by the result of neuropsychic breakdowns with the formation of foci in the cortex hemispheres, as well as problems in the structures of the thalamic formations of the brain. The dysregulation of norepinephrine-serotonin reactions, caused by a deficiency of these substances, plays a role.

Violations nervous system at the MDP, V.P. Protopopov.

How does manic-depressive psychosis manifest?

Symptoms of manic-depressive psychosis depend on the phase of the illness. The disease can manifest itself in a manic and depressive form.

The manic phase can be classic version and with some special features.

In the most typical cases, it is accompanied by the following symptoms:

• inadequately joyful, exalted and improved mood;
• sharply accelerated, unproductive thinking;
• inadequate behavior, activity, mobility, manifestations of motor excitation.

The beginning of this phase in manic-depressive psychosis looks like a normal burst of energy. Patients are active, talk a lot, try to take on many things at the same time. Their mood is upbeat, overly optimistic. Memory sharpens. Patients talk and remember a lot. In all the events that take place, they see an exceptional positive, even where there is none.

Excitation gradually increases. The time allotted for sleep decreases, patients do not feel tired.

Gradually, thinking becomes superficial, people suffering from psychosis cannot focus their attention on the main thing, they are constantly distracted, jumping from topic to topic. In their conversation, unfinished sentences and phrases are noted - "language is ahead of thoughts." Patients have to constantly return to the unsaid topic.

The patients' faces turn pink, facial expressions are overly lively, active hand gestures are observed. There is laughter, increased and inadequate playfulness, those suffering from manic-depressive psychosis talk loudly, scream, breathe noisily.

The activity is unproductive. Patients simultaneously "grab" a large number of affairs, but none of them is brought to a natural end, they are constantly distracted. Hypermobility is often combined with singing, dance moves, jumping.

In this phase of manic-depressive psychosis, patients seek active communication, intervene in all matters, give advice and teach others, and criticize. They show a pronounced reassessment of their skills, knowledge and capabilities, which are sometimes completely absent. At the same time, self-criticism is sharply reduced.

Increased sexual and food instincts. Patients constantly want to eat, sexual motives clearly appear in their behavior. Against this background, they easily and naturally make a lot of acquaintances. Women are beginning to use big amount cosmetics.

In some atypical cases, the manic phase of psychosis occurs with:

• unproductive mania- in which there are no active actions and thinking is not accelerated;
• solar mania– behavior is dominated by an overjoyful mood;
• angry mania- anger, irritability, dissatisfaction with others come to the fore;
• manic stupor- manifestation of fun, accelerated thinking is combined with motor passivity.

In the depressive phase, there are three main signs:

• painfully depressed mood;
• sharply slowed down pace of thinking;
• motor retardation up to complete immobilization.

The initial symptoms of this phase of manic-depressive psychosis are accompanied by sleep disturbance, frequent nocturnal awakenings, and the inability to fall asleep. Appetite gradually decreases, a state of weakness develops, constipation appears, pain in the chest. The mood is constantly depressed, the face of patients is apathetic, sad. The depression is on the rise. Everything present, past and future is presented in black and hopeless colors. In some patients with manic-depressive psychosis, ideas of self-accusation arise, patients try to hide in inaccessible places experiencing painful experiences. The pace of thinking slows down dramatically, the circle of interests narrows, symptoms of "mental chewing" appear, patients repeat the same ideas, in which self-deprecating thoughts stand out. Suffering from manic-depressive psychosis, they begin to remember all their actions and give them ideas of inferiority. Some consider themselves unworthy of food, sleep, respect. It seems to them that doctors are wasting their time on them, unreasonably prescribing them medicines, as unworthy of treatment.

Note:sometimes it is necessary to transfer such patients to forced feeding.

Most patients experience muscle weakness, heaviness in the whole body, they move with great difficulty.

With a more compensated form of manic-depressive psychosis, patients independently look for the dirtiest work. Gradually, the ideas of self-accusation lead some patients to thoughts of suicide, which they can fully translate into reality.

Most pronounced in the morning, before dawn. By evening, the intensity of her symptoms decreases. Patients mostly sit in inconspicuous places, lie on beds, like to go under the bed, because they consider themselves unworthy of being in a normal position. They are reluctant to make contact, they respond monotonously, with a slowdown, without further ado.

On the faces there is an imprint of deep sorrow with a characteristic wrinkle on the forehead. The corners of the mouth are lowered down, the eyes are dull, inactive.

Options for the depressive phase:

• asthenic depression– patients with this type of manic-depressive psychosis are dominated by ideas of their own soullessness in relation to relatives, they consider themselves unworthy parents, husbands, wives, etc.
• anxious depression- proceeds with manifestation extreme anxiety, fears, bringing patients to. In this state, patients may fall into a stupor.

In almost all patients in the depressive phase, the Protopopov triad occurs - palpitations, dilated pupils.

Symptoms of disordersmanic-depressive psychosisfrom the internal organs:

• dry skin and mucous membranes;
• lack of appetite;
• in women, disorders of the monthly cycle.

In some cases, TIR is manifested by dominant complaints of persistent pain, discomfort in body. Patients describe the most versatile complaints from almost all organs and parts of the body.

Note:some patients try to mitigate complaints to resort to alcohol.

The depressive phase can last 5-6 months. Patients are unable to work during this period.

Cyclothymia is a mild form of manic-depressive psychosis.

Allocate as separate form diseases, and a light version of TIR.

Cyclotomy proceeds with phases:

How does TIR work?

There are three forms of the course of the disease:

• circular- periodic alternation of phases of mania and depression with a light interval (intermission);
• alternating- one phase is immediately replaced by another without a light gap;
• unipolar- the same phases of depression or mania go in a row.

Note:usually phases last for 3-5 months, and light intervals can last several months or years.

Manic-depressive psychosis in different periods of life

In children, the onset of the disease may go unnoticed, especially if the manic phase dominates. Juvenile patients look hyperactive, cheerful, playful, which does not immediately allow us to notice unhealthy traits in their behavior against the background of their peers.

In the case of the depressive phase, children are passive and constantly tired, complaining about their health. With these problems, they quickly get to the doctor.

IN adolescence in the manic phase, symptoms of swagger, rudeness in relationships dominate, and disinhibition of instincts is observed.

One of the features of manic-depressive psychosis in childhood and adolescence is the short duration of the phases (average 10-15 days). With age, their duration increases.

Treatment of manic-depressive psychosis

Therapeutic measures are built depending on the phase of the disease. Expressed clinical symptoms and the presence of complaints require treatment of manic-depressive psychosis in a hospital. Because, being depressed, patients can harm their health or commit suicide.

The difficulty of psychotherapeutic work lies in the fact that patients in the phase of depression practically do not make contact. An important point treatment during this period is the correct selection antidepressants. The group of these drugs is diverse and the doctor prescribes them, guided by own experience. Usually we are talking about tricyclic antidepressants.

With dominance in the status of lethargy, antidepressants with analeptic properties are selected. anxiety depression requires the use of drugs with a pronounced sedative effect.

In the absence of appetite, the treatment of manic-depressive psychosis is supplemented with restorative drugs

In the manic phase, antipsychotics with pronounced sedative properties are prescribed.

In the case of cyclothymia, it is preferable to use milder tranquilizers and antipsychotics in small dosages.

Note:quite recently, lithium salt preparations were prescribed in all phases of MDP treatment, at present this method is not used by all doctors.

After leaving the pathological phases, patients should be included in different types activities, it is very important to maintain socialization.

Explanatory work is carried out with relatives of patients about the need to create a normal home psychological climate; a patient with symptoms of manic-depressive psychosis during light intervals should not feel like an unhealthy person.

It should be noted that, in comparison with other mental illnesses, patients with manic-depressive psychosis retain their intelligence and performance without degradation.

Interesting! From a legal point of view committed crime in the phase of exacerbation, TIR is considered not subject to criminal liability, and in the phase of intermission - criminally punishable. Naturally, in any state suffering from psychosis are not subject to military service. In severe cases, disability is assigned.

Clinicians divide all mental illnesses into psychoses and neuroses. Psychotic disorders are characterized by a distorted perception of reality and corresponding behavioral changes. The most striking form is manic psychosis, which is manifested by extreme excitability.

Disease or Syndrome?

How independent disease Manic psychosis is quite rare. It is usually represented by a manic syndrome, which is included in one of the more common diseases:

• affective insanity ();
• disorder;
• hypomania;
• as stage BAR;
• mania with oneiroid, etc.

In rare cases, mania can be an independent phenomenon. Then they talk about manic psychosis as such. The disease is quite severe and difficult to control. Often cope with mania without medication and urgent hospitalization fails. The most common form is a manic-depressive disorder, in which the patient alternates and.

Types of mania

Manic psychosis is a syndrome that manifests itself increased activity and excitability, along with productive symptoms in the form of,. Depending on the clinical manifestations, manic psychosis can be:

• manic-paranoid variant - accompanied by delusional disorder in the form of ideas of relation and persecution;
• delusional form of manic psychosis - often this form is accompanied by a delusion of the patient's own grandeur, usually accompanied by professional affiliation;
• oneiroid - a special kind of psychosis, which manifests itself in the whole clinical picture of a manic syndrome with pronounced hallucinatory experiences of a fantastic experience.

Usually, these types are also included in the complex of syndromes for various mental illnesses. A prime example is manic bipolar psychosis, in which mania is one of the stages. Later comes depressive psychosis.

Etiology

Of particular interest to psychiatrists and psychotherapists are the causes of manic syndrome. During clinical research identified several possible causes:

1. Genetic predisposition - this factor occurs equally in all mental illnesses. At the same time, there is not enough weighty evidence in favor of genetics as the root cause.

2. Age and gender are another weakly proven assumption. Scientists believe that middle-aged men are more likely to develop manic psychosis.

3. Violations of the functionality of the brain in all areas responsible for activity, emotional background and human mood.

4. Hormonal imbalance at the level of the whole organism (for example, serotonin deficiency).

None of the above reasons has yet earned the proud title real reason occurrence of manic psychosis.

Symptoms

Like any other disease, manic psychosis has well-defined symptoms. They can be expressed more or less intensely, appear all at the same time or be absent in most. The easiest way to identify manic psychosis is by symptoms:

• hyperthymia - constantly elevated mood, a surge of strength and faith in the future, which may not correspond to the circumstances at all;
• acceleration of speech and thinking - an increase in the quality and quantity of tasks performed, an increase in the number of active ideas, difficulties in concentration.
• increase in physical activity - the need for sleep and rest decreases, productivity increases, aggressiveness and increase physical strength and endurance.

Manic psychosis, the causes of which are precisely psychotic disorders, is accompanied by productive symptoms:

• hallucinations;
• crazy ideas;
• loom.

IN different combinations various types of syndromes are formed with the participation of mania. An easy way to get an idea of ​​what manic psychosis looks like and manifests is with videos that are in abundance on the web.

Mentally, manic psychosis is manifested by agitation and high motor activity what people call "inadequacy".

Treatment

Diagnosed with acute manic psychosis special problems, the clinical picture is recognizable. If necessary, of course, they resort to tomography and a hormonogram, but the fastest and easiest way to diagnose both depressive and manic psychosis is BAR test. At established diagnosis you can start treatment. As in any case, when the root of the disease is mental, manic psychosis requires complex treatment:

1. Psychotherapy.
2. Medical.
3. Instrumental.

At the stage, or rather in the form, of cyclothymia, lifestyle modification and psychotherapy can be dispensed with. But when the disease of manic psychosis progresses, more thorough treatment is needed. Among medicines, the first place is occupied by non-stimulant antidepressants and antipsychotic drugs . They are prescribed exclusively in a hospital setting. Additionally appoint tranquilizers and multivitamin complexes .
In severe cases, it may be prescribed electroconvulsive therapy. The procedure looks terrible, but patients voluntarily agree to it, because their quality of life improves significantly. If you regularly and comprehensively take the disease under control, the signs of manic psychosis will decrease and the patient will be able to be a fully-fledged member of society.

Manic-depressive psychosis is a complex mental illness, which is manifested by two states that are polar in their psychopathic characteristics: mania and depression. Usually, the patient has a periodic onset of only one of the affective states, and in the interval between them, the patient is in a state of intermission or interphase. Periods of exacerbation of manic-depressive psychosis are more often called phases or psychotic episodes. With a sharp change from one of the polar states to another, the disease acquires the most severe mixed form with symptoms of manic-depressive psychosis of both phases.

Manic-depressive psychosis is also called bipolar. affective disorder. Its milder, less pronounced form is called cyclotomy. Symptoms of manic-depressive psychosis are 3-4 times more likely to be diagnosed in women. The prevalence of the disease is approximately 0.5-0.8% (average 7 patients with manic-depressive psychosis per 1000 people).

Causes of manic-depressive psychosis

The disease has an autosomal dominant pattern of inheritance and is more commonly passed from mother to child. There is also a theory that the predominance of one of the two possible affective states of manic-depressive psychosis, whether it be mania or depression, is caused by different genes. differential genetic diagnosis causes of manic-depressive psychosis to date, medicine is not yet available.

Cause of manic-depressive psychosis physical level are malfunctions in the work of higher emotional centers located in the subcortical region. It is believed that disturbances in the processes of excitation and inhibition in the cerebral cortex lead to the development clinical picture diseases. The role of the most various factors external environment- relationships with others, stress, etc. can only be considered as concomitant cause manic-depressive psychosis, but not the main provoking factor.

Symptoms of manic-depressive psychosis

Polar affective states of the disease are characterized by a different set of symptoms. The symptoms of manic-depressive psychosis of the manic type include an unmotivated elevated mood of the patient, his increased motor and speech activity. Patients with symptoms of this type of manic-depressive psychosis talk a lot, joke, laugh, take on a lot of things, but because of the inability to concentrate, any attempt at activity is unproductive.

An exacerbation of a manic-depressive psychosis of the first type can last from several weeks to six months, and all this time the patient will be subject to sudden surges of ideas and hobbies: new acquaintances, casual sex, extravagant acts, alcohol abuse, extravagance, etc. Another important symptom manic-depressive psychosis of this form - complete absence in humans critical thinking. He is unable to realistically assess his capabilities, tends to exalt his achievements, does not consider himself ill and therefore does not agree to undergo procedures or take medicines.

The depressive form of the disease is manifested by a different set of symptoms. A patient with symptoms of manic-depressive psychosis of the second type is apathetic, indifferent to everything. On the faces of such patients there is a constant mournful expression, their speech is quiet, without emotions, their movements are slowed down. Patients with symptoms of this form of manic-depressive psychosis often fall into a depressive stupor - a state characterized by mental anesthesia, a complete loss of all feelings and needs, up to the primary ones: eat, drink, go to the toilet, wash.

The symptoms of manic-depressive psychosis of the second type also include thoughts of suicide. The world seems uninteresting to the patient, life is aimless, so he tries to end it and at the same time shows maximum ingenuity, deceiving others. On the physical level, the symptoms of manic-depressive psychosis are manifested by sensations of heaviness behind the sternum and breathing problems.

Diagnosis of manic-depressive psychosis

The differential diagnosis of manic-depressive psychosis is usually made with all other types. mental disorders: various forms neurosis, schizophrenia, psychosis, psychopathy, depression, etc. To rule out the possibility organic lesions of the brain as a result of injuries, infections or intoxications, a patient with suspected manic-depressive psychosis is referred for X-ray, electroencephalography, MRI of the brain.

Misdiagnosis can lead to prescription improper treatment and to the aggravation of the form of the disease, as its consequence. Many patients, unfortunately, do not receive appropriate treatment, since some of the symptoms of manic-depressive psychosis are quite easy to confuse with seasonal mood swings in a person.

Treatment of manic-depressive psychosis

Treatment of manic-depressive psychosis with manic states involves admission antipsychotics based on chlorpromazine or levomepromazine. These drugs stop arousal and produce a pronounced sedation. Additional components treatments for manic-depressive psychosis of the manic type are lithium salts and haloperedol. The intake of these drugs occurs under the strict supervision of a physician due to the likelihood of developing serious complication therapy - neuroleptic syndrome. It manifests itself in movement disorders, tremor of the limbs and general muscle stiffness.

In the treatment of manic-depressive psychosis with predominant depressive states actively used antidepressants. To achieve the fastest therapeutic effect usually an intensive course of drugs with accelerated rise doses of medication, so treatment of depression should not be delayed. The interruption of a depressive episode in the treatment of manic depressive psychosis is achieved by a sudden interruption of the course of therapy for high doses and administration of diuretics. For the treatment of manic-depressive psychosis of a protracted form, sessions of electroconvulsive therapy are used in combination with unloading diets, therapeutic fasting and sometimes sleep deprivation for up to several days.

For the prevention of psychotic episodes, mood stabilizers are prescribed - the so-called mood stabilizers. Long-term systemic use of these drugs can significantly reduce the severity of symptoms of manic-depressive psychosis and delay the onset of the next phase of the disease as much as possible.

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