|
In bipolar affective disorder, otherwise known as manic-depressive disorder, person suffers bouts of both depression and mania. Whereas everyone will at sometime or other feel cheesed off, fed up or euphoria, it is when such symptoms become qualitatively different, pervasive or interfere with normal functioning that a bipolar disorder has occurred. It is characterized by disturbances of mood, speech, energy and ideas. At times, the person may be excessively depressed while at other times he may be even euphoric.
When the individual is in the depressive phase his mood is depressed, miserable or irritable. The talk is impoverished, slow and monotonous. He has reduced energy and is lethargic. His feelings are of futility, guilt, self reproach, unworthiness. He has hypochondrial preoccupations and suicidal thought he may even have delusions of guilt, nihilism and persecution. The individual shows impaired learning and even dementia. The physical signs that are evident are early waking, poor appetite and weight loss, constipation fatigues, body aches and pains. Such an individual may also show agitation with poverty of movement and expression, sometimes having hallucinations which are auditory but often hostile and critical. These individuals describe the world as looking grey themselves as lacking a zest for living and devoid of pleasure and interest in life. Anxiety and panic attacks are common, secondary phobic symptoms may emerge. These also cause significant incapacity. Marked headache and fatigue are the most common physical signs. Depressed persons with any other physical disorder view themselves as more sick and visit their doctors more often and comply less. On the other hand, when the person suffering from bipolar disorder goes into manic phase then there is marked elevation of mood characterized by euphoria, over activity disability. The social disability of mania can be severe leading to significant debits from over spending and over-generosity, lost relationship and lost employment from and disinhibition. It can be distinguish from normal happiness by its persistence, non-reactivity that is it’s not provoked by good news and not affected by bad news and social reckless behavior. These individuals than have a elevated or irritable mood. Their talk is fast, pressurized with flight of ideas showing excessive energy. Their ideas are of grandiose and they are self confident with delusion of wealth, power, influenced or of religious significant which are sometimes even persecutory. They also show disturbance of registration of memories. Their behavior shows disinhibition with excessive drinking or spending. Such people also have insomnia and mild to moderate with loss.
In severe cases, manic person may have fleeting auditory or more rarely visual hallucinations. He is also full of optimistic and unrealistic plans for the future. However, his concentration is poor and tries to do several things at once. He dresses flamboyantly and may behave in an outrageous and promiscuous manner. Outbursts of irritably aggression are common. He tends to speak rapidly and incoherently although he is often humorous in an irreverent and infectious way. The person may laugh and cry simultaneously manic episodes like depression may be triggered by a painful rejection or loss. This has led to the concept of manic difference where by the person escapes into mania as a way of avoiding unhappy or sad feelings.
People suffering from bipolar disorder have following factors affecting their lives. There may be a physical disease particularly if chronic, stigmatizing or painful.
There’s excessive and chronic alcohol use. Social stresses are also present especially loss events such as separation and bereavement. They also show interpersonal difficulties with these close to the individual especially when socially humiliated. There’s also lack of social support with no confiding relationship.
|