Relationship Between Mania And Melancholia
The idea of a relationship between mania and melancholia can be traced back to at least the 2nd century AD. Soranus of Ephesus described mania and melancholia as distinct diseases with separate etiologies however, he acknowledged that “many others consider melancholia a form of the disease of mania”.
The earliest written descriptions of a relationship between mania and melancholia are attributed to Aretaeus of Cappadocia. Aretaeus was an eclectic medical philosopher who lived in Alexandria somewhere between 30 and 150 AD. Aretaeus is recognized as having authored most of the surviving texts referring to a unified concept of manic-depressive illness, viewing both melancholia and mania as having a common origin in “black bile”.
What Does A Doctor Need To Know To Diagnose Bipolar Disorder
A bipolar disorder diagnosis is made only by taking careful note of symptoms, including their severity, length, and frequency. “Mood swings” from day to day or moment to moment do not necessarily indicate a diagnosis of bipolar disorder. Rather, the diagnosis hinges on having periods of unusual elevation or irritability in mood that are coupled with increases in energy, sleeplessness, and fast thinking or speech. The patientâs symptoms are fully assessed using specific criteria from the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders or DSM-5.
In making the diagnosis of bipolar disorder, the psychiatrist or other mental health expert will ask you questions about your personal and family history of mental illness and bipolar disorder or other mood disorders. Because bipolar disorder sometimes has a genetic component, family history can be helpful in making a diagnosis.
Also, the doctor will ask detailed questions about your bipolar symptoms. Other questions may focus on reasoning, memory, ability to express yourself, and ability to maintain relationships.
Symptoms That Lead To A Diagnosis
If youre suffering from any kind of mental health disorder, its important that you identify and understand your symptoms in order for our doctors to correctly diagnose you. Bipolar disorder consists of both manic and depressive episodes that create an unstable mood.
Mania can be extreme changes in mood, or you can have hypomania which is typically less severe. Symptoms of mania include:
Difficulty sleeping Extreme energy Increased self-esteem Difficulty concentrating Racing thoughts
On the opposite end of the spectrum, depression can change your emotional highs to hopeless lows. If you have bipolar disorder with depression, symptoms you may experience include:
Fatigue Sadness Decreased energy Overeating or loss of appetite Suicidal thoughts
Our team at Boston MindCare take a detailed history to decipher your symptoms and give you a definitive diagnosis. With that, we can also form a customized treatment plan for you.
Read Also: Acute Phase Of Schizophrenia
How Does It Affect People
Bipolar disorder affects both men and women. For many people, the first symptoms show up in their early twenties. However, research has shown that the first episode of bipolar disorder is occurring earlier: It often shows up in adolescence, and even children can have the disorder.
Recent research suggests that kids and teens with bipolar disorder don’t always have the same behavioral patterns that adults with bipolar disorder do. For example, kids who have bipolar disorder may experience particularly rapid mood changes and may have some of the other mood-related symptoms listed below, such as irritability and high levels of anxiety. But they may not show other symptoms that are more commonly seen in adults.
Because brain function is involved, the ways people with bipolar disorder think, act, and feel are all affected. This can make it especially difficult for other people to understand their condition. It can be incredibly frustrating if other people act as though someone with bipolar disorder should just “snap out of it,” as if a person who is sick can become well simply by wanting to.
Bipolar disorder isn’t a sign of weakness or a character flaw it’s a serious medical condition that requires treatment, just like any other condition.
Brain Structure And Function
Researchers are learning that the brain structure and function of people with bipolar disorder may be different from the brain structure and function of people who do not have bipolar disorder or other psychiatric disorders. Learning about the nature of these brain changes helps doctors better understand bipolar disorder and may in the future help predict which types of treatment will work best for a person with bipolar disorder. At this time, diagnosis is based on symptoms rather than brain imaging or other diagnostic tests.
Read Also: Can You Go To Urgent Care For Panic Attacks
What Are The Symptoms
The symptoms depend on your mood swings, or “highs” and “lows.” During a manic high, you may feel:
- Very happy, energetic, or on edge.
- Like you need very little sleep.
- Overly self-confident.
Some people spend a lot of money or get involved in dangerous activities when they are manic. After a manic episode, you may return to normal. Or your mood may swing in the opposite direction to feelings of sadness, depression, and hopelessness. During a depressive episode, or low, you may have:
- Trouble thinking and making decisions.
- Memory problems.
- Less interest in things you have enjoyed in the past.
- Thoughts about killing yourself.
The mood swings of bipolar disorder can be mild or extreme. They may come on slowly over several days or weeks or suddenly over a few minutes or hours. These mood swings may last for a few hours or for several months.
A Story Of Misdiagnosis
“Home from a weeks vacation in Costa Rica, I was at the office of my general practitioner to get a prescription for a different medication for my depression. I told the doctor that I had spent my vacation entirely in my hotel room ‘maniacally writing.’ While my wife went to the beach, explored neighborhoods, and visited my family who lived there, I just wrote. And wrote. And wrote. I wrote so much that I came home with seven chapters of what would become my first book.
“I needed a new prescription because my first prescription for depression, Prozac, had made me irritable. I also could not concentrate, couldn’t sleep, and my language was coarse. These symptoms had been taken by the doctor to indicate a deeper depression, and so she had originally increased the dosage. But a new problem, a side effect of diarrhea, pushed me to noncompliance. I quit taking the medication, and went to Costa Rica during the period needed to wash it out of my system before getting a different medication.
“But now, at this appointment, my use of the word ‘maniacally’ caused my doctor to pause. Antidepressants can cause people with bipolar disorder to ‘flip’ into mania or hypomania. So she screened me by asking just one question, ‘Are you manic?’
“I answered, ‘No. I’m not manic, I’m excited!’ With that, she gave me the next antidepressant.
Read Also: What Is The Meaning Of Phobia
How Do I Get Help If I Think I Have Bipolar Disorder
The usual first step to getting help is to speak to your GP.
It can help to keep a record of your moods. This can help you and your GP to understand your mood swings. Bipolar UK have a mood diary and a mood scale on their website. You can find their details in the Useful contacts section at the bottom of this page.
Your GP cant diagnose bipolar disorder. Only a psychiatrist can make a formal diagnosis. Your GP may arrange an appointment with a psychiatrist if you have:
- depression, and
- ever felt very excited or not in control of your mood or behaviour for at least 4 days in a row.
They might refer you to a psychiatrist at your local NHS community mental health team .
Your GP should make an urgent referral to the CMHT if they think that you might have mania or severe depression. Or there is a chance that you are a danger to yourself or someone else.
Your GP should refer you to your local NHS early intervention team if you have an episode of psychosis and its your first one.
Bipolar disorder can be difficult to diagnose because it affects everyone differently. Also, the symptoms of bipolar disorder can be experienced by people who have other mental illness diagnoses. It can take a long time to get a diagnosis of bipolar disorder.
You can find more information about:
- NHS mental health teams by clicking here.
History Of Bipolar Disorder
Cyclical variations in moods and energy levels have been recorded at least as far back as several thousand years. The words “melancholia” ” rel=”nofollow”> depression) and “mania” have their etymologies in Ancient Greek. The word melancholia is derived from melas/, meaning “black”, and chole/, meaning “bile” or “gall”, indicative of the term’s origins in pre-Hippocratichumoral theories. A man known as Aretaeus of Cappadocia has the first records of analyzing the symptoms of depression and mania in the 1st century of Greece. There is documentation that explains how bath salts were used to calm those with manic symptoms and also help those who are dealing with depression. Even today, lithium is used as a treatment to bipolar disorder which is significant because lithium could have been an ingredient in the Greek bath salt. Centuries passed and very little was studied or discovered. It wasn’t until the mid-19th century that a French psychiatrist by the name of Jean-Pierre Falret wrote an article describing “circular insanity” and this is believed to be the first recorded diagnosis of bipolar disorder. Years later, in the early 1900s, Emil Kraepelin, a German psychiatrist, analyzed the influence of biology on mental disorders, including bipolar disorder. His studies are still used as the basis of classification of mental disorders today.
You May Like: Does Celine Dion Have An Eating Disorder
Living With Bipolar Disorder
Teens normally face ups and downs with school, family, work, and friends. Dealing with bipolar disorder at the same time is a very difficult challenge. One 16-year-old reader who was diagnosed with bipolar disorder at 14 wrote to us about the experience:
“I had mood swings that were the worst anyone could have ever seen. My poor parents thought I hated them, but really I was sick and didn’t even realize it. But now I am on medications for my disorder and I live a pretty normal life. My family and friends support me, and they, along with my therapist, have helped me get to the point where I am today. I just want other teens to know that even though it is hard at times to be bipolar, things will get better.”
If you’ve been diagnosed with bipolar disorder, taking your medications as prescribed, reporting any changes in how you feel or function, and participating in therapy will be key to living a successful life. In addition to treatment, making a few lifestyle changes, such as reducing stress, eating well, and getting enough sleep and exercise can help someone who is living with the condition. And many teens find it helps to join a support network such as a local support group for people with bipolar disorder.
What Are Your Treatment Options
Treatment will depend on which type of bipolar disorder you have, and what your symptoms are. Most of the time, youll need medication to manage your symptoms, along with therapy. Medications that may be used include:
Antidepressants Antipsychotics Mood stabilizers Anti-anxiety medications
Sometimes traditional medication therapy isnt enough. At Boston MindCare, our doctors offer a unique treatment option when nothing else has worked. Ketamine infusion therapy can help the symptoms of depressive episodes associated with bipolar disorder. It works by inhibiting glutamate in your brain to stabilize your mood.
Like many of the other medications used to treat this disorder, ketamine comes with some side effects, so its important to talk to our doctors to see if this treatment is right for you.
You dont need to deal with bipolar disorder on your own. If youre looking for help, call our office at 701-207-9841 or book an appointment online today.
Also Check: What Is The Phobia For Bees
When Youre Married To Someone With Bipolar Disorder
Error! You must specify a value for the Video ID, Width, Height and Anchor parameters to use this shortcode!
Learn more about bipolar disorder and relationships by reading our relationship blogs.
Bipolar disorder wears many faces. There are as many experiences with bipolar disorder as there are people with bipolar. These experiences run the gamut from wonderful and exciting to confusing, disappointing and devastating. This article addresses some of the issues that can arise when dealing with a spouse with bipolar disorder.
Like all individuals, people with bipolar disorder have many good attributes, but at times, they also display less desirable qualities, such as being withdrawn, irritable, moody, and depressed. They may be affectionate and loving sometimes and then cold and distant at other times. The person may welcome and enjoy sex one day, while rejecting affection the next day. These erratic behaviors can be quite challenging for all concerned, especially spouses.
At times the person with bipolar disorder may experience manic or hypomanic episodes during which they can be fun, interesting, talkative, upbeat and full of energy. At other times, the person may experience depression that effects them physically, spiritually and soulfully. The spouse might feel confused, not knowing how to deal with certain behaviors.
- Academic struggles
- Reckless behavior
- Extreme defiance
- Controlling behaviors
- Suicidal thoughts or attempts
How To Diagnose Bipolar Disorder: Dsm
Medically Reviewed By: Lauren Fawley
Bipolar disorder affects millions of people around the world, and its extreme ups and downs can make living life challenging at times. This article will discuss the DSM-5 bipolar disorder criteria, which is the most up-to-date information on how the condition is diagnosed. Additionally, you will learn how a diagnosis can influence a course of treatment and what methods are effective.
What Is Bipolar Disorder?
Bipolar disorder is characterized by shifts in mood, and those who have it can experience high energy, euphoria, and become overactive. This is known as mania, and it can also include irritability, and some people can become easily agitated in a manic state. Manic episodes also associated with risk-taking behaviors and increased impulsivity
On the other end of the spectrum, people with bipolar disorder can have very low moods, and this is the depressive side of the condition. Just like with major depression, bipolar sufferers who are having a depressive episode can feel down on themselves, have low energy and motivation, and think about death and suicide.
Nonetheless, these mood swings are not typically short and temporary. Instead, these episodes must last at least a week for mania and two weeks for depression for the person to have Bipolar I disorder. This is not only important for diagnosing bipolar disorder, in general, but it can also determine what type a person has, which you will learn more about in the next section.
Don’t Miss: Pristiq Drug Interactions
Getting A Psychiatric Referral
Because people cannot diagnose themselves, you will need to speak to a psychiatrist or other mental health professional in order to receive a proper diagnosis of bipolar disorder. However, this can be a tricky situation in itself. In some areas and if you are wealthy enough, you may be able to simply walk into a psychiatrists or therapists office office and pay for an assessment. In other areas and for many people, it will require a referral from another medical specialist. In this article, I will discuss the process of getting referred to a psychiatrist for a diagnosis.
There are a few things that you should bring up when speaking to your family physician:
- Explain to them exactly the symptoms that you have.
- Be clear that you would like to have an assessment for the possibility of bipolar disorder or other, related mental illnesses.
- If you have a history of bipolar disorder or other mental health problems in your family, let your physician know this as well.
- Discuss with them the effects that antidepressants have had on you.
- Be sure to include any cases where you have been suicidal or harmed yourself or others .
In these cases, youre not really seeking a diagnosis. Youre seeking immediate help. However, the result is ultimately the same. You or another person will receive an assessment for bipolar disorder and other mental illnesses.
Filing For Social Security Disability Or Ssi With Bipolar Disorder
- Sleep disturbance
- Paranoid thinking
- Involvement in activities that are likely to cause painful consequences without realizing it
a significant restriction of daily activities or severe difficulties maintaining social functioning or repeated instances of decompensation that last for extended periods of time or significant difficulties with persistence, concentration, or pace
- Repeated decompensation episodes of extended duration
- A residual disease process that has resulted in such marginal adjustment that even a small change in environment or increase in mental demands could be predicted to cause the person to decompensate, or a current one year or more history of a failure to function outside of a very supportive living environment with a projected continued need for the supportive living arrangement
impairment listing 12.04 A3, B, or CMost popular topics on SSDRC.com
Donât Miss: How To Increase Your Va Disability Rating
Also Check: What Are The Three Stages Of Schizophrenia
Diagnosis Guide For Bipolar Disorder
Testing for bipolar disorder
People with bipolar disorder go through intense emotional changes that are very different from their usual mood and behavior. These changes affect their lives on a day-to-day basis.
Testing for bipolar disorder isnt as simple as taking a multiple choice test or sending blood to the lab. While bipolar disorder does show distinct symptoms, theres no single test to confirm the condition. Often, a combination of methods is used to make a diagnosis.