Manic-depressive psychosis is a disorder that, although it continues to be included in the main diagnostic classifications, the truth is that it is described under another name: bipolar disorder. In any case and as its name indicates, manic-depressive psychosis refers to a disorder in which manic, hypomanic and depressive episodes alternate.
Manic-depressive psychosis or bipolar disorder is a disorder that has received a lot of attention in the scientific literature, and although there is a need to continue researching, the truth is that we have numerous studies that have allowed us to conceptualize and understand this psychopathological condition. In the following Psychology-Online article we expose the manic-depressive psychosis: what it is, symptoms, causes and treatment.
What is manic-depressive psychosis
Manic-depressive psychosis or bipolar disorder is included in the diagnostic classifications DSM-5 (American Psychiatric Association) and ICD-11 (World Health Organization).
It’s about a disorder in which major depressive episodes, manic episodes, and hypomanic episodes occur which can alternate more or less quickly over time (there can even be four different episodes in a year in the case of rapid cyclers). Depending on the appearance of one or other episodes we can distinguish:
- Bipolar disorder type I: this is characterized by the appearance of a manic episode and, before or after this, they may be present episodes of major depression and/or hypomanic.
- Bipolar disorder type II: there is a history of one or more major depressive episodes and presence or history of a hypomanic episode.
- Cyclothymic disorder: appear depressive and/or manic symptoms but they do not meet the criteria required for the diagnosis of the episodes.
In addition to these, other categories appear in the diagnostic classifications, such as bipolar disorder due to the intake of substances and/or medications.
Finally, we state that there seems to be some evidence for the existence of a third type of bipolar disorder, bipolar disorder type III. In this type, patients have a family history of bipolar disorder and episodes of depression and hypomania would occur in the context of pharmacological treatment with antidepressants (González Parra, D. et al, 2007).
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Symptoms of manic-depressive psychosis
The symptoms of manic-depressive psychosis will depend on the episode in which the patient is, and each episode presents different symptoms. Below, the main characteristics of each of the episodes are explained and the symptoms associated with them are indicated following the DSM-5 diagnostic classification.
major depressive episode
Within the major depressive episode, which lasts at least two weeks, we can find the following symptoms:
- Experiencing depressed mood.
- Absence of pleasure and/or interest in all or almost all activities.
- Increase or decrease in body weight and/or loss of appetite.
- Insomnia or hypersomnia.
- Psychomotor agitation or retardation.
- Fatigue or loss of energy.
- Feeling of excessive guilt and/or worthlessness.
- Decreased ability to concentrate and/or make decisions.
- Recurrent suicidal ideas and/or thoughts of death.
hypomanic episode
During the hypomanic episode we find an abnormally high, expansive or irritable mood. Among the symptoms necessary for diagnosis in the DSM-5 classification we find:
- Increased self-esteem or feeling of greatness.
- Disminution of necesity of sleep.
- He is more talkative than normal.
- He presents a flight of ideas or, where appropriate, a subjective experience that his thoughts are going too fast.
- He is easily distracted.
- Psychomotor agitation or increased goal-directed activity.
- Excessively participates in activities that may have negative consequences (such as compulsive shopping, risky sexual behavior, etc.)
manic episode
The symptoms that we can find in the manic episode are the same as those found in the hypomanic episode, although in this case the severity of these symptoms is such that they cause deterioration in various areas of the patient’s life, such as social or work. On the other hand, if psychotic characteristics were present, by definition the episode would be manic and not hypomanic. In the following article, you will find more information about what a .
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Causes of manic-depressive psychosis
Following Sevillá, J., Pastor, C. and Ruiz, L. (2014), there does not seem to be a well-defined and established cause for the origin of manic-depressive psychosis. Considering the complexity of the disorder, we must take into account numerous variables that may be influencing its appearance and development.
Among them we can attend to the biological variables, specifically the neurotransmitter functioning, to the functioning of the endocrine system or to problems in the regulation of circadian rhythms. Here you can see.
Regarding psychological theories, specifically cognitive-behavioral theories, they complement the previous ones and highlight the role of vulnerability factors in the development of bipolar disorder or manic-depressive psychosis.
For all this, we must attend to the origin and development of manic-depressive psychosis from a biopsychosocial point of view, in which we integrate all the variables that may be intervening in the case.
Treatment of manic-depressive psychosis
Treatment of manic-depressive psychosis is fundamentally pharmacologicalthe most used drugs being:
- Mood stabilizers such as lithium or the valproic acid.
- Drugs antipsychotics for the control, above all, of manic and hypomanic episodes.
- Drugs antidepressants for the control of depressive episodes. Here we explain.
Regarding psychological therapy, psychoeducation and cognitive-behavioral therapy are indicated, always in combination and complementing pharmacological therapy. This psychological intervention is more aimed at working on adherence to medication, detecting signs of relapse and working on possible complications that appear in the course of the disease.
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This article is merely informative, at Psychology-Online we do not have the power to make a diagnosis or recommend a treatment. We invite you to go to a psychologist to treat your particular case.
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References
- Sevillá, J., Pastor, C. and Ruiz, L. (2014). Bipolar disorder and related disorders. En Caballo, VE, Salazar, IC and Carrobles, JA (2014) Manual of Psychopathology and Psychological Disorders. Madrid. Pyramid.
Bibliography
- American Psychiatric Association (2014). DSM-5. Reference guide to the diagnostic criteria of the DSM-5-Breviary. Madrid: Panamericana Medical Editorial.
- González Parra, D., González de María, V., Leal Sánchez, C., Sánchez Iglesias, S. (2007) Bipolar illness. Medicine, 9 (85) 5461-5468
- World Health Organization (WHO) (2018) International Classification of Diseases, 11th revision. Recovered from https://icd.who.int/es