In manic depressive illness, sufferers experience mood swings that are far beyond what most people ever experience in the course of their lives. These mood swings may be low, as in depression, or high, as in periods when we might feel very elated. These high periods are known as ''manic'' phases. Many sufferers have both high and low phases, but some will only experience either depression or mania. A more technical term used to describe this illness is ''bipolar affective disorder''. Here we will describe both aspects of the disorder, the particular problems they present, ways of coping with them and the range of treatments available. It is a serious condition but, with the right treatment, it is possible to live one''s life without too much interference.
HOW COMMON is manic depression?
It is much less common than simple depressive illness. About one in every hundred adults will suffer from manic depression at some point in their life. It can start at any time during or after the teenage years. Unlike other forms of depression, manic depression affects as many men as women.
WHAT CAUSES manic depression?
Nobody understands this completely, BUT research has shown that manic depression does seem to run in families, and that it seems to have more to do with genes than with upbringing. It seems that the parts of the brain which control our moods don''t work properly - this is why the symptoms of manic depression can be controlled with medication. Episodes of illness can sometimes be brought on by stressful experiences, lack of support, or physical illness. So, it''s no use expecting someone with this problem to just ''pull themselves together''.
WHAT DOES IT FEEL LIKE?
Obviously, it depends on whether the sufferer is experiencing a manic or depressive mood swing. The two very different experiences are described separately below.
DEPRESSION
Feelings of depression are something we all experience from time to time. They can help us to recognise and deal with problems in our lives. But for someone with manic depression, their depressive feelings will be worse, they will go on for longer and they will make it harder to tackle the daily tasks and problems of living. Someone with this sort of depression will be more likely to have the physical symptoms listed below. Not everyone who becomes depressed will have all these symptoms, but they will usually have several of them.
MENTAL SYMPTOMS
- Feelings of unhappiness that don''t go away
- Losing interest in things
- Being unable to enjoy things
- Finding it hard to make even simple decisions
- Feeling utterly tired
- Feeling restless and agitated
- Losing self-confidence
- Feeling useless, inadequate and hopeless
- Feeling more irritable than usual
- Thinking of suicide
PHYSICAL SYMPTOMS
- Losing appetite and weight
- Difficulty in getting to sleep
- Waking earlier than usual
- Constipation
- Going off sex
MANIA
Mania is an exaggeration of feelings that we all experience from time to time. It is the opposite of depression - a feeling of well-being, energy and optimism. Surely this can''t be a problem? Well, actually it can. These feelings can be so intense that you can lose contact with reality. When this happens you may find yourself believing strange things about yourself, making bad judgements and behaving in embarrassing, harmful and sometimes even dangerous ways. Like depression, it can make it difficult or impossible to deal with life in an effective way. A period of mania can, if untreated, destroy your relationships and work. When it isn''t so extreme, doctors may use the word ''hypomania'' to describe it. In an episode of mania, you may feel:
- Very happy and excited
- Irritated with other people who don''t share your optimistic outlook
- Full of energy
- Unable or unwilling to sleep
- Full of new and exciting ideas
- More important than usual
- That you are hearing voices that other people can''t hear
- Other people may notice that you are:
- Jumping very quickly from one idea to another
- Making plans that are grandiose and unrealistic
- Very active and moving very quickly
- Behaving in a bizarre way
- Speaking very quickly - if your mood is very high, it can be difficult for other people to understand what you are talking about
- Making odd decisions on the spur of the moment, sometimes with disastrous consequences
- Recklessly spending your money
- Less inhibited about your sexual behaviour
HELPING A DEPRESSED RELATIVE OR FRIEND
It is often difficult to know what to say to someone who is very depressed - it may seem that you can''t say anything right because they interpret everything in a very pessimistic way. It can be very difficult to know what they want - this is hardly surprising because often the depressed person does not know themselves what they want. They may be very withdrawn and irritable but at the same time unable to do without your help and support. They may be very worried but unwilling or unable to accept advice. So try to be as patient and understanding as possible.
Practical help may be easier to offer and is very important. Make sure that your relative or friend is able to look after themselves properly. If you find that they are seriously neglecting themselves by not eating or drinking, seek medical help immediately.
If they talk of harming or killing themselves, this should be taken seriously and professional help should be obtained.
It is important that you give yourself space and time to recharge your batteries. Make sure that you are able to spend some time on your own or with trusted friends who will give you the support you need at this time. If your relative or friend has to go into hospital, make sure that you share the visiting with someone else. You will be better able to support your friend or relative if you yourself have had some time to rest.
HELPING A MANIC FRIEND OR RELATIVE
At the start of a manic mood swing, the person will appear to be happy, energetic and outward-going, the ''life and soul of the party''. They will relish being the centre of attention and will enjoy social occasions such as parties or heated discussions. However, these will tend to increase the sufferer''s level of excitement and will tend to make their mood even higher. So, it is a good idea to keep them away from such situations if possible while you try to persuade them to seek help. They will benefit from information about the illness, advice about how to help, and practical support.
If a manic swing has become severe, the person may become hostile, suspicious and verbally or physically explosive. Don''t get into arguments but get professional help immediately. You should keep a contact telephone number and the name of a trusted professional handy for any such emergency. There may be times when it is necessary for the manic person to have a short admission to hospital to protect them from getting into trouble.
