2 Varieties Of Manic Depression - Learn More To Help Yourself And Others

When a person has experienced their first manic episode were particularly thought to be suffering from bipolar depression. This is known as a chronic disease like most people who have had one episode generally have more episodes to follow. According to statistics, at least four episodes must occur in one year, where it has been given preventive treatment.

Every individual is unique in the forms of depression, manic episodes and mood cycles are shown in combinations. Once these patterns have been identified, it becomes easier to identify upcoming episodes. Bipolar Depression, according to some studies indicate that the chance of developing bipolar depression is related to genetikom.Poremećaj is usually detected in adolescence or in young adults. As a condition of continuous episodes, those affected will find it can last a lifetime.

There are many who are informed enough about bipolar disorder, as well as the company is usually pretty blase about tome.Dvije main types are the bipolar I and II. What distinguishes the two different types is the presence of manic episodes in one. To understand the differences you need to learn about depressive and manic episodes that may occur.

There are various symptoms that are characteristic of depressive episodes. Luckily it was reduced or not present, persistent depression, loss of interest in daily activities and social ones, fatigue, feeling worthless, deep feelings of guilt, lack of concentration, sleep disturbance, restless, moving slowly, constantly thinks about death and suicide.

When five of these symptoms of depression are present in a person for at least two weeks, such as lack of pleasure in daily activities and feelings of depression, it will manifest itself in depression epizode.Simptomi occur around without using drugs or alcohol or any contributions to health conditions, and more to do with great distress or when the mind is in turmoil.

Manic episodes show different symptoms, such as talking constantly, so that more energy is needed less sleep, grandiose ideas, racing thoughts, easily distracted, and his confidence becomes veliča.Osoba can participate in tours ridiculous spending, adverse sexual behavior and increase the achievement of goals or objectives.

DSM IV (Diagnostic and Statistical Manual), which belongs to the APA (American Psychiatric Association), says that when a person experiences a mood disorder that can be persistent, unexplained euphoria along with three or more symptoms for at least a week, so that a person loses ability to function normally, but it is productive, this is a manic episode. The criteria for a manic episode is that it is not due to alcohol or drugs or underlying medical condition.

notice small differences in relation to the bipolar I and bipolar II disorders. In bipolar I individuals will have one manic and depressive episodes epizoda.Osoba with bipolar disorder II will experience at least one episode of hypomania episode without the presence of manic episodes. Do not confuse the two -. The difference between the two is that in bipolar disorder I would have had the experience of manic episodes

Bipolar disorder is classified as two types, because the symptoms mentioned above, which assessed the severity. This is because we can distinguish how manic episode occurs in a person, but that it reduces the disorder. Depending on the degree of occurrence of mania, and not at the level of impairment that causes a disorder, that classification is determined in these disorders.

Any person who has bipolar disorder is unique in the symptoms they experience. Those who are diagnosed with bipolar I all have different degrees of adaptation, distress and impairment. Each level is a variable on a wide range which can all vary. Those who are diagnosed with bipolar II have also been affected in similar proportions.

This type of mental disorder should be aware of, so that people can recognize the symptoms before someone is diagnosed. It is also useful to know if people know or need to develop the disorder. Useful information and appropriate treatment can be obtained by asking your doctor or other healthcare professional. Education in itself, it is useful to know bipolar disorder to family, friends or other important that you come across in your life. This is a huge learning curve and valuable step toward recovery and a better, healthier life.

Agitated Depressive Disorder

Agitated Depression a state of clinical depression in which the person exhibits irritability and restlessness. This term is applied to depressive disorders in which agitation is prominent. Agitation occurs in many severe depressive disorders but in agitated depression, it is particularly severe. Agitated depression is seen more commonly among the middle aged and elderly than among younger patients. However, there is no reason to suppose that agitated depression differs in other impotent ways from the other depressive disorders.

Definition of Agitated Depression

A major depression with agitation that may be driven by hypomania.

Although many people experience symptoms such as feeling slowed down and lethargic when they are depressed, others may experience just the opposite. They may feel anger, agitation and irritability. This is what "agitated depression" refers to.

Agitated depression was once called melancholia agitata. It is now also known as mixed mania.

Agitation occurs in many severe depressive disorders, but in agitated depression it is particularly severe. There is no reason to suppose that agitated depression differs in other important respects from other depressive disorders.

Diagnostic Criteria for Agitated Depression

• Major Depressive Episode


• At least two of the following symptoms:


• Motor agitation


• Psychic agitation or intense inner tension


• Racing or crowded thoughts

Agitated depression meets the criteria for major depressive episode but not those of a mixed bipolar disorder according to the DSM-III-R.

Agitated Major Depressive Disorder Symptoms

It is not tough to identify the symptoms of agitated depression. People that suffer from this type of depression are not able to sit still and keep on restlessly moving here and there all the time. It is due to the outburst of emotional energy caused because of agitated depression. Those that suffer from this type of depression tend to complain a lot and develop the feelings of being misunderstood by others. At least 2 of the following manifestations of psychomotor retardation (not more subjective anxiety) are required for several days during the current episode:

• Tearing of cloths

• Motor agitation

• Intense inner tension

• Racing thoughts

• Never ending baseless thoughts

• Continuous talking

• Hand wringing


• Pacing


• Pulling or rubbing on hair, skin, or clothing


• Outbursts of complaining or shouting


• Difficulty in explaining problem

Agitated depression in bipolar I disorder

The occurrence of agitated depression in bipolar I disorder is not rare and has significant prognostic and therapeutic implications. Whether the co-occurrence of a major depressive syndrome with one or two of these symptomatic clusters makes up a "mixed state" remains unclear.

Clinical Forms of Agitated Depression

1. Psychotic agitated depression
   
   Proposed name: Melancholia


2. Non-psychotic agitated depression
   
   Meets the RDC criteria


3. Excites anxious depression
   
   Provisional name: Psychic agitation and racing or crowded thoughts.

Complications for Agitated depression

The complications that have been mentioned in various sources for Agitated depression includes getting involved in risky activities, dysfunction in family and work, and even suicide or homicide.

Treatment

Agitated depression can be difficult to treat because the behavior patterns associated with this form of depression lend to the inability to consistently take medication. It is important to get properly diagnosed by a mental health care professional who can supervise your treatment closely. Psychotherapy is also useful in treating agitated depression. It is usually necessary to have long term treatment as a combination drug and psychotherapy. The drug therapy has to be fine tuned to your specific needs. This can take up to a month to see results and a cessation of side effects in most people but it is highly effective.

The common treatment approaches are:

1. Medicines - Antidepressants and anticonvulsant like divalproex, aripiprazole, clozapine or olanzapine is largely used in treatment of agitated depression.


2. Psychotherapy - In most of the cases psychotherapy is preferred to treat agitated depression.


3. Combination of medicines and psychotherapy - When drug therapy and psychotherapy is used in combination then effect is much better for curing agitated depression.


4. Electroconvulsive therapy - Electricity is passed to the brain through electrodes to overcome from agitated depression.

Sources and Additional Information:

http://www.depression-guide.com/agitated-depression.htm

http://www.happymoods.info/what-is-agitated-depression

http://www.survivingdepression.net/types/agitated.html

http://www.total-health-care.com/depression/agitated-depression.htm

http://www.wrongdiagnosis.com/a/agitated_depression/complic.htm

Lithium as Mood Stabilizer for Major Depression

The oldest and best mood stabilizer for depression is lithium carbonate (lithium). Although this medication is primarily used to treat bipolar disorders, lithium can also be effective in alleviating unipolar depressive symptoms. Sometimes, lithium is added on to an antidepressant medication regimen for Major Depression when antidepressants alone are not working out.

What is lithium used for?

There are different ways in which lithium is used.

1. To treat mania (high mood with over-activity, racing thoughts and agitation)

Lithium needs to be taken in doses that keep its level in the blood relatively high. Often, other medicines are used initially to treat mania because of the increased risk of side effects with high levels of lithium, and because it takes a number of days to work. Lithium is then introduced a little later to stabilize mood.

2. As a mood stabilizer

To help prevent the recurrence of severe swings in mood, after an acute episode of bipolar illness has settled. Lithium may take several weeks, months and probably up to two years to reach its full potential effect as a mood stabilizer. Even if lithium does not completely stop the mood swings, it usually reduces their severity.

3. To boost the effect of antidepressants

When antidepressant medications have not worked fully in treating depression, adding lithium can be a very good way of increasing their effectiveness and getting the symptoms to improve.

How does lithium work?

It is not really known how lithium works. Lithium may alter the way that nerve cells respond to some of the chemicals that pass messages between them. However, it is known that it is a very effective medicine.

How often is lithium taken?

Mostly, it is taken as a single dose at night - this is more convenient and reduces the problems with some of the side effects. A few people may find it is better to split the total amount into more than one dose - follow your doctor's advice.

Is lithium addictive?

Lithium is not addictive. But when it is stopped, it should be reduced gradually to minimize the chances of the illness coming back.

Is lithium a safe medicine?

Lithium is safe if used correctly, according you your specialist's or family doctor's instructions.

• Before you are started on lithium, your doctor will need to know your medical history - including any psychiatric illnesses you have had in the past.


• Your doctor will examine you physically and take a blood sample to check your blood count, your kidney function and your thyroid gland.


• Depending on your medical history your doctor may also ask you to collect urine for 24 hours and arrange for you to have an ECG heart tracing done. These tests are simply to make sure that it safe for you to start taking lithium.

The problem with lithium is that a certain level of the drug has to be produced in the blood for it to be effective, but if the level rises too much, unpleasant and potentially serious side effects can occur.

What are the side effects of lithium?

The commonest side effects that people may notice when they start lithium are:

• dry mouth


• a metallic taste


• a slight shakiness


• a feeling of mild weakness


• some bowel looseness (diarrhea).

These usually settle as your body adapts to the medication. After taking lithium for some time, the following may be noticed:

• weight gain.


• passing urine more often and needing to drink more than usual. If this happens, you should tell your doctor.


• swollen ankles due to water retention.


• the thyroid gland may become underactive.

Occasionally, some people feel that they get mild memory problems due to lithium. It is possible that this is due to the mental illness itself, but the lithium may sometimes be responsible.

These problems generally disappear if lithium is reduced or stopped. If they occur, your doctor will be able to advise how they should be handled.

Less commonly, when a person has been taking lithium for some time it can cause the thyroid gland to become underactive. This can lead to symptoms such as:

• a lack of energy


• feeling the cold more


• weight gain


• feeling depressed.

Lithium is also a potentially dangerous drug in that its therapeutic dose (the dose necessary for it to offer antidepressant effects) is uncomfortably close to its toxic dose.

Toxic levels of lithium in the blood can cause slowed or stopped breathing, seizures, coma and even death. Before taking lithium, a person will undergo a battery of laboratory tests including a complete blood count, tests for serum creatinine, electrolytes, and hormones, and a urinalysis. A complete blood count measures the number of red and white blood cells and platelets to ensure that these cells are at normal levels, there are no known infections, and that the body can function normally in case of an injury.

Measuring creatinine in blood serum is a test for kidney function. Since adequate kidney function is essential to clearing lithium from the system, this test is particularly important. Tests for electrolytes, hormones, (thyroid, in particular) and urine components indicate the basic health of an individual and provide baseline levels for comparison during lithium treatment. To avoid lithium toxicity, people must have regular monitoring of their blood levels of lithium to make sure that they remain within an acceptable therapeutic range. Blood lithium levels need to be monitored more frequently during the early stages of treatment, but as treatment stabilizes, monitoring can occur every three to six months.

Pregnancy and Breast Feeding

Lithium crosses the placenta and has been associated with toxicity in the fetus. Children born to women taking lithium during pregnancy have an increased risk of goiter and cardiac anomalies. If possible, lithium should be withheld during the first trimester. Women of childbearing age who may require lithium should be counseled about becoming pregnant.

Lithium is secreted into breast milk. Symptoms of lithium toxicity, including changes in the electrocardiogram, have been seen in some breast-fed infants, whose mothers were taking lithium. If possible, women taking lithium should not breast-feed their infants.

How can I be sure that the lithium level is right?

The body gets rid of lithium through the kidneys in the urine, and it is easy to test the lithium level in the blood.

• After starting lithium, it takes about five days for the lithium to build up to a steady level in the blood. For this reason your doctor will take a blood sample to check the level about five days after you first start to take the lithium. If the level is not quite right, the doctor can easily work out from the blood test what the dose should be.


• Lithium blood tests need to be taken at least 12 hours after the last dose of lithium to make sure the test is reliable.


• Any time a change is made in the dose, the level has to be checked about five days later.


• The lithium level will be checked quite frequently to begin with until it is certain that the level is stable and correct. Once this has been achieved, the frequency of blood tests will be less, but a test should still be carried out about every two to three months.


• Lithium is one of the medicines where it is important to always take the same brand. Even at the same doses, different brands will give different blood levels. If the brand has to be changed, a close eye will have to be kept on the level until it is steady again.

What can I do to avoid high lithium levels developing?

• Make sure that you go for the blood tests whenever they are needed.


• Don't suddenly change the amount of salt in your diet; it is especially important not to suddenly reduce your salt intake.


• Make sure that you drink enough fluids, especially if you are exercising heavily or in hot weather when you will sweat more.


• Remember that alcoholic drinks can make you lose water overall. This is particularly important to bear in mind if you are on holiday abroad: you may feel like drinking more alcohol, and the weather may be hot so you sweat more.


• See a doctor straight away if you get any of the physical illnesses or symptoms listed above. Always tell any doctor or pharmacist that you are taking lithium before you are prescribed, or buy, any new medicines.

How long will I have to take lithium for?

Lithium has a preventative effect when taken in the medium to long term.

• Lithium is mostly taken for at least one to two years to derive full benefit from its use. Many people need to stay on it long-term to prevent the illness relapsing.


• When lithium is stopped, it should be tailed off gradually over a number of weeks or months to avoid a period of mania that can occur if it is stopped suddenly.

How effective is lithium?

Despite the potential difficulties with lithium treatment, it remains the best medication for stabilizing mood in most people. It is the mood-stabilizing drug that has the best-proven results in boosting the effect of antidepressants. Many people find it an effective medicine that helps to control their mood disorder and greatly improve their quality of life.

Sources and Additional Information:

http://www.mayoclinic.com/health/lithium-medication/MY00639

http://www.netdoctor.co.uk/diseases/depression/lithium_000290.htm

http://www.medicinenet.com/lithium/article.htm

http://en.wikipedia.org/wiki/Lithium_pharmacology

Historical retrospectives of depressive disorder

Depressive disorders have been with mankind since the beginning of recorded history. In the Bible, King David, as well as Job, suffered from this affliction. Hippocrates referred to depression as melancholia, which literally means black bile. Black bile, along with blood, phlegm, and yellow bile were the four humors (fluids) that described the basic medical physiology theory of that time.

Depression, also referred to as clinical depression, has been portrayed in literature and the arts for hundreds of years, but what do we mean today when we refer to a depressive disorder? In the 19th century, depression was seen as an inherited weakness of temperament. In the first half of the 20th century, Freud linked the development of depression to guilt and conflict. John Cheever, the author and a modern sufferer of depressive disorder, wrote of conflict and experiences with his parents as influencing his development of depression.

In the 1950s and 60s, depression was divided into two types, endogenous and neurotic. Endogenous means that the depression comes from within the body, perhaps of genetic origin, or comes out of nowhere. Neurotic or reactive depression has a clear environmental precipitating factor, such as the death of a spouse, or other significant loss, such as the loss of a job.

The term "major depressive disorder" was selected by the American Psychiatric Association to designate this symptom cluster as a mood disorder in the 1980 version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) classification, and has become widely used since. The general term depression is often used to describe the disorder, but as it can also be used to describe other types of psychological depression, more precise terminology is preferred for the disorder in clinical and research use. Major depression is a disabling condition which adversely affects a person's family, work or school life, sleeping and eating habits, and general health. In the United States, approximately 3.4% of people with major depression commit suicide, and up to 60% of people who commit suicide have depression or another mood disorder.

Major Depressive Disorder

In the 1970s and 80s, the focus of attention shifted from the cause of depression to its effects on the afflicted people. That is to say, whatever the cause in a particular case, what are the symptoms and impaired functions that experts can agree make up a depressive disorder? Although there is some argument even today (as in all branches of medicines), most experts agree that:

1. A depressive disorder is a syndrome (group of symptoms) that reflects a sad and/or irritable mood exceeding normal sadness or grief. More specifically, the sadness of depression is characterized by a greater intensity and duration and by more severe symptoms and functional disabilities than is normal.


2. Depressive signs and symptoms are characterized not only by negative thoughts, moods, and behaviors but also by specific changes in bodily functions (for example, crying spells, body aches, low energy or libido, as well as problems with eating, weight, or sleeping). The functional changes of clinical depression are often called neurovegetative signs. This means that the nervous system changes in the brain cause many physical symptoms that result in diminished activity and participation.


3. Certain people with depressive disorder, especially bipolar depression (manic depression), seem to have an inherited vulnerability to this condition.


4. Depressive disorders are a huge public-health problem, due to its affecting millions of people.

·         The statistics on the costs due to depression in the United States include huge amounts of direct costs, which are for treatment, and indirect costs, such as lost productivity and absenteeism.

·         In a major medical study, depression caused significant problems in the functioning of those affected more often than did arthritis, hypertension, chronic lung disease, and diabetes, and in two categories of problems, as often as coronary artery disease.

·         Depression can increase the risks for developing coronary artery disease, HIV, asthma, and some other medical illnesses. Furthermore, it can increase the morbidity (illness/negative health effects) and mortality (death) from these conditions.

5. Depression is usually first identified in a primary-care setting, not in a mental health practitioner's office. Moreover, it often assumes various disguises, which causes depression to be frequently under-diagnosed.


6. In spite of clear research evidence and clinical guidelines regarding therapy, depression is often undertreated. Hopefully, this situation can change for the better.

Major Depressive Disorder

Sources and Additional Information:

http://www.medicinenet.com/

http://en.wikipedia.org/wiki/Major_depressive_disorder