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Manic depression

Manic Depression

Manic Depression is an illness that involves the body, thoughts and a person’s mood. It is not just a bad mood that will pass with time or something a person can just pull themselves together from and "get over it". Manic depression is a disorder suffered by many people and affects the way a person eats, sleeps, how they feel about themselves, and how they think. This disorder cannot be cured without a treatment because it has to do with a person’s chemical makeup and things that have happened in their life.

Symptoms of depression include persistent sadness,

anxiousness, emptiness, feelings of hopelessness, pessimism,

guilt, helplessness, and worthlessness. Also a loss of interest or

pleasure in hobbies and activities that were once enjoyed is a

common sign a person is depressed. They may be very tired and

feel a loss of energy to do everyday routines or could suffer the

opposite and not be able to sleep and become extremely restless.

Appetite changes and weight loss or weight gain is an example

of a physical change along with headaches and chronic pains.

Thoughts of death or suicide or suicide attempts are very

serious symptoms of depression and the person needs to seek

immediate help.

Depression is not something you can catch like the cold or the flu. It may run in families, suggesting it is biologically

inherited. Additional factors in a person’s life more likely

bring on the depression even if it had already been inherited.

Stresses in life with work, school, and home are typical causes.

In some families depression seems to occur generation after

generation and in others a person with no past family history of

the disorder could suffer from it. Whether inherited or not,

depression is often associated with changes in the brain

structure or brain function.

Manic depression, which is also known as bipolar disorder, is a certain type of depression. It is characterized by cycling mood changes; severe highs (mania) and severe lows (depression). Sometimes the mood changes dramatic and rapid but most of the time it changes gradually. When in the depressed cycle a person will have all or some of the typical depression symptoms. When in the manic cycle a person becomes overactive, over talkative, and has a great deal of energy. Mania often affects thinking, judgment and social behavior in ways that can cause serious problems and embarrassment. If mania is left untreated it could lead to a psychotic state.

Depression is treated by first getting a physical examination. Certain medications or medical conditions can be the cause of the same symptoms of depression. A patient will undergo the exam, an interview, and lab tests to rule out the possibility of a physical cause for the depression. If that is the case then a psychological evaluation will be done and the person will be referred to a psychologist or a psychiatrist. This doctor will ask about history the history of the symptoms, when they started, how long have they lasted and how severe they are. The doctor should also ask about alcohol or drug use and if the patient has ever had any thoughts about death or suicide. Another important factor is if anyone in the person’s family has ever been diagnosed with a depressive illness and if that is the case what treatments have they received. Lastly, a diagnostic evaluation will include a mental status examination to determine if speech or thought patterns or memory has been affected.

The treatment will depend on the final evaluation. There are numerous antidepressant medications and psychotherapies that can be used to treat these disorders. If it is a mild case psychotherapy may just be used alone, but people with a moderate to severe case benefit from antidepressants. The most effective treatment is the medication to relieve the patient from symptoms and the psychotherapy to learn more efficient ways to deal with life’s problems. A special type of therapy is called Electroconvulsive therapy (ECT), which is typically used for individuals whose depression is severe or life threatening or cannot take medication. It is most effective when the prescribed antidepressants do not provide enough relief of symptoms. Recently, ECT has been improved using a muscle relaxant before the treatment, which is done under short anesthesia. Electrodes are place at certain locations on the head to deliver electrical impulses. This stimulation causes a brief seizure within the brain. The person does not consciously experience the electrical stimulus so they are not aware at the time what is happening. For this treatment to work at least several sessions, three times a week are required.

There are many types of antidepressant medications that doctors use to treat these disorders. They include the selective serotonin reuptake inhibitors (SSRIs) and the monoamine oxidase inhibitors (MAOIs). Sometimes the doctor will try several different antidepressants because they may not be effective enough or have bad side effects for that particular patient. Also the dosage might be increased for the medication to be fully effective. These medications must be taken regularly for 3-4 weeks or sometimes as many as 8 weeks before they have a full therapeutic effect on the person. Patients may try and stop taking the medicine too early because they start to feel better. They don’t realize that it is important to take the antidepressant for the full prescribed amount of time in order for it to work and continue working. This may take as long as 4-9 months to prevent the recurrence of the depression or if the person suffers a chronic disorder may have to take their medication on a daily basis as long as they live.

Lithium is the main medication used for manic depression because it can be effective in controlling or eliminating mood swings. It must be used carefully and monitored consistently because the difference between a toxic dose and an effective dose is very small. If the person has a thyroid, kidney, or heart disorders or epilepsy, this medication may not be recommended. In this case other medications have been found to control mood swings. They are called carbamazepine (Tegretol) and valproate (Depakote).

Side effects with these antidepressants can vary from very minor and/or temporary to extremely severe and/or long lasting. Any type and degree of a side effect should always be reported to a doctor and if needed they will prescribe a new medication. Some of the most common side effects are dry mouth, constipation, bladder problems, sexual problems, blurred vision, dizziness, and drowsiness. Some of the newer antidepressants can cause headaches, nausea, nervousness, agitation, and sexual problems. All of these side effects will most likely pass after a week or so of being on the medications but if they persist or are a threat the medication will be changed.

The newest treatment is herbal therapy. St. John’s wort is an herb used for treatment of mild to moderate depression in Europe and has recently become known in the United States. It is an attractive bushy, low-growing plant covered with yellow flowers in the summer. The National Institute of Mental Health, the National Center for Complementary and Alternative Medicine and the Office of Dietary Supplements have sponsored a three year study on this herb to discover the effectiveness of this treatment opposed to a common antidepressant. The Food and Drug Administration has already issued a Public Health Advisory on February 10, 2000 stating that St. John’s wort appears to affect an important metabolic pathway. Many drugs prescribed that treat conditions such as heart disease, depression, seizures, certain cancers, and rejection of transplants use this pathway. This advises that any herbal supplements should be taken after the consultation with a doctor.

Therapy is also a major key in treating depression. It can be short term (10-20 week) or last longer. "Talking" therapy help patients gain insight into and help solve their problems through talking with a therapist. "Behavioral" therapists help patients learn how to reach more satisfaction and rewards through their own actions and how to unlearn the behavioral patterns that contribute to or come from their depression. Other therapies are called interpersonal and cognitive/behavioral therapies. Interpersonal therapists focus on the patient’s affected relationships that cause or increase depression. Cognitive/behavioral therapists help patients change their negative ways of thinking and behaving that is associated with depression. Psychodynamic therapies, which is only sometimes used to treat a depressed person, helps work on solving a patient’s conflicted feelings. These therapies are usually not started until the symptoms have been improved by the medications unless it is an extreme case of depression in which both the medication and therapy is begun at the same time.

There are many ways to get help and to treat manic depression. It is not a disease that someone can catch but a disorder that can be effectively treated. It is important for people to realize that these negative feelings are apart of this disorder and can be helped. Trying to identify and cope with these spurts of depression is the hardest part but can be done. People need to learn that it won’t all go away after taking one pill or going to one therapy session. They also have to realize that the second they are feeling "good" again does not mean that all medication should be stopped and doctor appointments should be canceled. Researchers are still trying to look for a possible gene or link in the body that causes these disorders along with improved more effective ways to treat them. As of now, there are many different options and possibilities for a person to try.

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