Emil Kraepelin, in the beginning of 20^th 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 biochemistry.

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 VIP’s and can get any work done through them.

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 afford it.

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.

TREATMENT

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.