Mania In Bipolar Depression Essay, Research Paper
Bipolar depression, also known as bipolar disorder, manic depression and manic-depressive illness, is a form of a depressive illness in which mania and depression alternate. It is a disorder that affects over 2 million (1.2 percent) Americans and usually begins during adolescence (American Medical Association [AMA], 1998). It is often not recognized as a serious disorder, but in many cases it causes difficulty in occupational, educational, social life, and other important functioning.
A person who has bipolar disorder swings between two extreme emotional poles- depression and mania. During the depression phase, the person will have the same symptoms as people with severe depression (AMA, 1998). Although the shifts of mood have nothing to do with daily activities, the symptoms may prevent the person from functioning normally. However, the All About Bipolar Disorder webpage (1995-2000), says that “increased stress and inadequate coping mechanisms to deal with that stress may also contribute to the disorder’s manifestation.” The cycles of mood shifts vary greatly in frequency and length. Some people may have several bouts of mania or depression in a row, some have them simultaneously and some have mania without depression (AMA, 1998). In some cases people never experience euphoria during mania, but go directly to a dysphoric state where their energy is boosted so they feel pressured in an uncomfortable state of mind. In other cases bipolar can have a triphasic characteristic, where there is a brief period of depression, then a sudden swing into mania, then depression will set in again for a few weeks (Mondimore, 1995). Some may have mixed mood states. “In mixed mood states (also referred to as dysphoric mania) pronounced symptoms of both depression and mania either co-exist or alternate during different periods of the day.” (Daly, p.1157, 1997). However, typical bipolar patients alternate mania and depression with euthymania (normal mood) in between the two (Gorman, 1998).
During the manic phase of bipolar depression a person undergoes changes in mood, distorted thinking and behavior. Euphoria is extremely common early in a manic episode. During mania, irritability is common, and any form of frustration becomes unbearable. Rage may be overwhelming if other try to restrain the manic behaviors. For example, “When you try to inhibit or criticize him, he will get angry, perhaps violent.” (Cammer, 1969, p.45). Also, the person may experience a pressure to socialize or a sudden preoccupation with success, wealth, power, and fame (Mondimore, 1995). The person will have an inflated self-esteem thinking they are uniquely talented and attractive and “nothing can dent your self confidence,” explains the AMA (1998, p.48). Along with this, this overconfidence may become the basis for delusional thinking.
The way overconfidence can be linked with delusional thinking is commonly by way of paranoia. For example, the maniac believes that their phone calls are so important that their phone is tapped. 75 percent of maniacs have delusions (AMA, 1998). During the delusional state, people may feel immune to any kind of restraint. According to the AMA, “if you are manic, you truly believe nothing can stop you” (p.49). In severe cases people can hear voices inside their head. They may also believe they are God, that they have been elected to a high political office or they have solved a universal mystery. Some people even believe that they have magical powers.
“Mania is a time for energy,” stated the AMA (1998, p.49). During the manic phase the person may feel rested after a few hours of sleep or need no sleep at all. There is a possible appetite disturbance and “your sex drive might increase and everything seems interesting and enjoyable.” (Dewan, 1999.) During mania it may be hard for a person to concentrate on one line of thought, for their mind is racing with thoughts and ideas. This often affects speech. According to Mondimore (1995, p.89), “Their thoughts race, their minds so speeded up that they can’t talk fast enough to express them and speech can become incoherent.” Along with this, there could be a pressure of speech. This is speaking without pause, raising voice if interrupted, and forcing oneself into conversation. The speech also becomes louder and faster. During mania it is also not uncommon to forget small details of an ordinary behavior such as hanging up the telephone. Yet, trivial things easily distract people. Someone experiencing mania may make many different plans for one day, but has full intention of accomplishing all of them (and probably will.) However, during mania, one may have an extreme desire to do something random that may seem odd, such as paint their house pink. And as mania progresses the moods become wilder and less predictable. They also often indulge in harmful activities because they simply seem fun, and do not think about the consequences. Activities such as running up a large credit card bill or having promiscuous sex with random people married or not are not uncommon. Unfortunately, mania makes it hard to distinguish fact and fantasy; therefore it may result in lies and deceit.
Although all mania has the same characteristics and symptoms, there is also hypomania. This is the same, yet not nearly as severely impulsive. A person who experiences mania and sever depression have Bipolar I, whereas those who have depression and hypomania have Bipolar II (Gorman, 1998). “Hypomania does not involve losing touch with reality or cause as much disruption in your life.” (Dewan, 1999). When a doctor is determining if someone has bipolar depression, they look for very specific patterns of symptoms of mania and depression, for doctors do not fully understand the cause (AMA, 1998). However, according to the All About Bipolar Disorder webpage (1995-2000), doctors do know family history and genetics play a role in likelihood, but it is not a purely biochemical or mental disorder and it can be treated by a combination of medication and psychotherapy.
ReferencesAmerican Medical Association. (1998). Essential guide to depression. New York: Pocket Books.
Cammer, L. (1969). Up from depression. New York: Simon and Schuster.
Daly, I. (1997) Mania. The lancet, 4 , 1157.
Dewan, N. (1999, July 1). What is bipolar disorder? Clinical Reference Systems. (Infotrac No. 55838862).
Gorman, J. (1998). The Essential guide to mental health. New York: St. Martin’s Griffin.
Mondimore, F. (1995). Depression, The mood disease. Baltimore:
The Johns Hopkins University Press. (1995-2000). All About Bipolar Disorder [Online]. Mental Health Net and CMHC Systems. Available: http://bipolar.mentalhelp.net/ [2000.April 10].