Manic-depressive psychosis, also known as bipolar disorder, is a serious psychiatric illness characterized by mood swings, delusions, and hallucinations. It can be triggered by genetic predisposition, environmental factors, addiction, or trauma. Diagnosis requires a history of documented or cyclical behaviors, and treatment often involves hospitalization, medication, and psychotherapy. Symptoms vary between individuals and can be debilitating, requiring long-term treatment.
Manic-depressive psychosis is a serious psychiatric illness characterized by pronounced mood swings and the presence of delusions and hallucinations. Individuals with this presentation of manic depression, also known as bipolar disorder, often have difficulty with daily functioning, such as maintaining relationships and jobs, due to the pronounced nature of their psychosis, which clouds their perception of reality. Treatment for this potentially debilitating condition often requires hospitalization and medication to stabilize mood and long-term treatment, including psychotherapy.
While there is no known single cause for the development of manic depression, it has been argued that several factors may contribute to its gradual development or acute onset. Some studies have suggested that bipolar individuals may possess a genetic predisposition for the disorder due to the presence of biological variance or chemical imbalance. The presentation of manic depression appears to be more evident in individuals with a family history of the disorder. Other factors that can trigger the onset of the disease may include environmental factors, chemical addiction and abuse, and trauma.
The presentation of bipolar symptoms generally varies between individuals and can manifest in varying degrees depending on the severity of the mood swing. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), there are three distinct classifications of bipolar disorder: bipolar I, bipolar II, and cyclothymia, which is considered a milder presentation of the disease. Manic-depressive psychosis can be triggered by a severe episode of depression or mania.
Those who develop manic depressive psychosis develop an altered perception of reality that presents itself as very real to the symptomatic individual. In essence, the intensity of a triggering event or transition from depression to mania causes the affected individual to detach from reality. He or she may experience auditory and visual hallucinations, such as hearing voices or seeing people or things that aren’t there. Some psychotic individuals may hold unrealistic beliefs or harbor feelings of persecution, such as believing they are a religious figure or are being watched or hunted down. An individual’s psychosis can quickly become a debilitating condition that prevents them from functioning normally and may require hospitalization.
A diagnosis of manic-depressive psychosis is generally made with an assessment of the individual’s psychiatric history and the administration of a variety of diagnostic tests. Manic depression can be difficult to diagnose without a history of documented or cyclical behaviors. For a diagnosis of manic depression, an individual must meet the established criteria as presented in the DSM for a specific amount of time.
The criterion includes markers for the depressive and manic ends of the spectrum, as well as those that may occur in the middle of a mixed episode. The number of criteria required and episode duration for a diagnosis varies with the presentation of symptoms; which means that the criteria for a major depressive episode will generally be different from those established for a mania-induced psychotic break. Once an assessment is made and established criteria are met, a clear diagnosis of bipolar I, II, or cyclothymic disorder can be made. Psychosis itself is classified as a presentation of symptoms, not part of the diagnosis of the disorder.
Individuals suffering from depression may exhibit the hallmarks of persistently low mood, such as tiredness, loss of interest, and feelings of guilt. Those experiencing a depressive episode may also develop suicidal ideation, demonstrate impaired concentration, and avoid social and professional situations. Manic individuals often require little or no sleep, are extremely physically active, and demonstrate impaired judgment. Some may participate in risky behaviors they would not normally pursue, such as promiscuity, substance use and abuse, or situations that could put them at risk for injury or death. In some cases, mania can also drive an individual to set lofty, unattainable goals that could put them at risk of financial, personal, social, or professional ruin.
Manic-depressive psychosis generally requires hospitalization to prevent the individual from causing harm to themselves or others. Hospitalization also allows for the opportunity to bring the individual back to reality with the aid of medication and psychotherapy. Medications such as antidepressants, anticonvulsants, and antipsychotics can be administered individually or in combination to stabilize the affected individual’s mood. Psychotherapy is often viewed as a necessary part of long-term treatment, incorporating individual, family, and group therapy sessions to promote education, understanding, and healthy coping skills.
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