Manic Depression (Bipolar Disorder)

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Manic depression (manic depressive illness) or bipolar mood disorder is a mood disturbance characterised by alternating periods of depression and mania. Moving from one mood to another is referred to as a mood swing which can be mild, moderate or quite severe and are accompanied by changes in thinking and behaviour. It typically begins during the teens, twenties or thirties and continues throughout life. The course of the illness will vary from patient to patient and without treatment, the frequency and severity of this recurring illness can increase over time.

It is believed that Manic Depression (or Bipolar Disorder) affects 1 in 100 people in Australia and whilst it is a serious condition it is treatable.

It is important to note that there are a range of depressive illnesses briefly described below.

Major Depression

Major depression is characterised by a combination of symptoms, including sad moods that interfere with the ability to work, sleep, eat and generally function ‘normally’ such as enjoying once pleasurable activities. Disabling episodes of depression can occur once, twice, or several times in a lifetime.

Dysthymia

Dysthymia is a less severe type of depression. It involves long-term (chronic) symptoms that do not totally disable the sufferer but do prevent the affected person from functioning at full capacity or from feeling good about themselves. It is not uncommon for people with dysthymia to also experience episodes of major depression; the combination of these two types of depression being known as double-depression.

Bipolar Disorder (Manic Depression)

Another type of depression is bipolar disorder, which was formerly called manic-depressive illness or manic depression. This condition shows a particular pattern of inheritance. Not nearly as common as the other types of depressive disorders, bipolar disorder involves cycles of depression and mania, or elation. Bipolar disorder is often a chronic, recurring condition. Sometimes, the mood switches are dramatic and rapid, but most often they are gradual.

Manic depression is diagnosed if a person demonstrates a certain number of symptoms however it should be noted that a mood change is not necessarily a symptom for the diagnosis of depression or mania. Manic depression is also known as Bipolar disorder because a person’s mood can alternate between the "poles" of highs and depressive lows. Changes in mood (or mood swing) can last for hours, days, weeks or even months.

The first step in getting treatment for manic depression is obtaining an accurate and correct diagnosis. This can be more difficult than it might seem because the symptoms of manic depression are often very similar at times to other major brain disorders, such as schizophrenia or bipolar disorder. Many General Practitioners don’t have a lot of experience with manic depressive illness and therefore it is important that someone exhibiting depressive illness symptoms see a psychiatrist that is experienced in the diagnosis and treatment of maniac depression.

Treatments

There are things a sufferer can do themselves to control mood swings so that they stop short of becoming full-blown episodes of mania or depression however medication is typically needed to keep the mood stable (prophylaxis) and treat a manic or depressive episode.

Medication - Mood Stabilisers

There are several mood stabilisers however, Lithium (a naturally occurring salt) was the first medication that was found to be helpful in stabilising moods. Lithium has been used as a mood stabiliser for an extended period however its exact workings are still not clear. It can be used to treat both manic and depressive episodes; the main issue is getting the level of lithium in the body right noting that if it is too low it will not work however if it is too high it will become toxic.

Treatment with Lithium will be started by a psychiatrist with blood tests undertaken in the weeks following the start of treatment with Lithium to ensure the patient is receiving the appropriate dose. Once the dose is stabilised, the prescribing and monitoring of lithium treatment will most likely be taken over by the patient’s personal General Practitioner.

The amount of lithium in the blood is very sensitive to how much, or how little, water there is in your body. If you become dehydrated, the level of lithium in your blood will rise and increase the chances of suffering from side-effects or potentially toxic effects. It is very important to drink plenty of water or for the more active to use coffee and tea in moderation because as diuretics they increase the amount of water you pass in your urine. It can take up to 3-months or even longer for Lithium to work properly so it may be necessary to carry on taking the Lithium tablets during this time.

Side-effects:

These can happen in the first few weeks after starting Lithium treatment and can be irritating and unpleasant but often disappear or improve over time.

Most common side-effects include feeling thirsty, passing more urine than usual or gaining weight.

Less common side effects include blurred vision, muscle weakness, diarrhoea, trembling of the hands and a feeling of nausea. If the level of Lithium in the blood is too high, the patient may experience vomiting, staggering and slurred speech.

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If you are concerned about a family member, colleague or friend seek help and assistance from a trained mental health specialist or service provider in your state or territory.