Emil Kraepelin, in the beginning of 20th
century has classified mental disorders into dementia praecox (Schizophrenia) and
manic-depressive psychosis. Even today this broad classification is true, though finer sub
classifications have appeared with newer research, particularly in field of genetics and
Few cases of Depressive Disorders also
suffer from episodes of mania, in which the symptoms are opposite to those of Depressive disorder. When the same patient suffers from the both these, that is, manic as well as
depressive episodes, the illness is diagnosed as manic-depressive disorder.
Elated Mood: Patients become
overconfident, feel they can do everything, nothing is impossible, laugh excessively and
make others laugh, feel they have contacts with VIPs and can get any work done
Excessive Talk: Patients talk more
than usual, shifting from one subject to another. Patients talk with unknown people as if
they have known them for years. Patients talk about confidential matters to every one.
Excessive Activities: Patients are on
the move all the time, meeting relatives whom they have not met for months together, visit
relatives and friends very frequently and for trivial reasons, makes lots of plans for
activities (at work, socially etc) doing things that feel good but have bad effects
(spending too much money, foolish business investments, inappropriate sexual activities).
Excessive Spending: Patients purchase
things, which are not required, purchase things in bulk many times more than what is
actually needed, travel in taxis although they may not have money or are not able to
Excessive Energy: Patients do not
get tired in spite of over activity.
Irritability: Whenever the patients
are opposed or obstructed they get irritated and angry.
Sleep is reduced: 2 to 4 hours sleep
appears sufficient during this phase. Patients get up around 4.00 am and will wake up
other family members and force them to work.
Drug Therapy: there are specific
drugs that are effective in management of manic episode.
ECT: May be necessary if the patient
is not co-operative and unmanageable. ECT is also indicated if drug therapy does not
produce desirable results.
Psychotherapy: Drug therapy is of
prime importance. Once the patients have become normal, then psychotherapy and counseling
is initiated, the purpose of psychotherapy is to prevent relapses and recurrences.