What is Manic depressive psychosis and how to tackle it?

Bipolar artwork.
Bipolar artwork.

Manic depression, more commonly known as bipolar, is a mood disorder caused by a chemical imbalance in the brain. It has several different manifestations, ranging from mild to severe.

Bipolar I is the most intense, from what I have observed. Moods swing from highly manic to incredibly depressed, with a longer term for the depression than the mania. As I understand it, it was once thought that the depression caused the mania, but the commonly accepted opinion now is that the mania causes the depression. This is the version most likely to have psychosis within the depression or the mania.

Psychotic manifestation does not mean that the afflicted will always have psychotic symptoms. In those who have bipolar, the psychosis may evidence itself during particularly intense mood swings. Basically, a bipolar person may hear and see things that are not actually there, and believe things that they have no evidence for.

A close friend of mine and my mother both had bipolar I. Once, I was riding in the car with my friend, and she abruptly swerved into the oncoming lane. Luckily, we were on a road out in the middle of nowhere, and nothing came of it. I grabbed my seat and shouted, and she swerved back into her lane immediately, saying, "I didn't want to hit that rabbit." There had been no rabbit.

Back at her house, I mentioned the incident to her father, and he explained that when she stops taking her medication and rockets into a mania or depression, she will often suffer auditory and visual hallucinations.

My mother's form of psychosis was a little different, and more insidious. When my mother went into a severe depression or mania, she would become incredibly paranoid. She was convinced that the various women in our church were miserable in their marriages and determined to sleep with my father. She would lock the doors, terrified that an ex-boyfriend of mine who lived in California was going to return and kill her in her sleep. She stopped feeding the cat, because she was certain that it wanted to harm her.

However, if a person is diagnosed with any of the other bipolar types, they aren't necessarily protected from mood swings evidencing psychosis. Left untreated, a mild bipolar can progress to a more severe form.

The other forms of bipolar range from cyclothymic disorder, which is the mildest -- minor depressions and hypomanias.

Hypomania is similar to a mania, but manifests fewer of the manic symptoms and in less intensity.

Bipolar II is more intense than cyclothymic, but less so than Bipolar I. Bipolar II is characterized by shorter depressions than those of Bipolar I, and hypomanias.

Two other forms of bipolar are rapid-cycling disorder and mixed bipolar. These can manifest either in Bipolar I or Bipolar II, and are different in the way the mood swings present themselves.

Normally, bipolar moods can be charted. In fact, charting bipolar moods is one way to diagnose the illness. If someone's mood follow a cycle, with long periods of depression followed by short bursts of incredible energy and excitement, they most likely have some form of bipolar. To an extent, the mood cycles can be predicted according to past precedent.

Rapid-cycling disorder was once described to me by a psychiatrist as "russian roulette with your moods." In essence, while most bipolar moods are somewhat predictable in their time-frame occurance, rapid cycling is the essence of unpredictibility. In it's more severe forms, a rapid-cycler can swing from mania to depression in the course of a week, or a day -- and they cannot chart when it will occur, or what mood they can expect.

Mixed bipolar evidences both manic and depressive symptoms when in either a manic or depressive state. The afflicted may have the energy of a mania, but will also evidence irritability, pessimism, and other depressive symptoms. In a depression, they may have the lack of energy, the desire to stay in and sleep, but will be so full of restlessness that they prowl their house, their un-focused and unwanted energy manifesting in irritability and anger, even aggression.

Any one of these bipolar types can eventually shift into the most severe form of bipolar, Bipolar I. The most effective way to control any form of bipolar is medication and therapy.

Those who have bipolar often go off their medication once they're feeling better, thinking that it's no longer necessary. Either that, or they'll stop taking their medication due to side effects, or the fact that they don't like how it feels to have their moods damped down, fearing that it halts or ruins the creativity often present in the bipolar person.

The fact of the matter is, side effects are better than exaggerated moods, and no medication can take away inherent talent and creativity (although it may need to be accessed in a new way). Furthermore, medication does not "cure" bipolar. It does not remove the bipolar moods -- it dampens them down to a manageable level. Nothing can remove bipolar. It is a life-long condition.

The only way to manage bipolar and the psychosis that may evidence itself is through regular medication and therapy. Therapy is essential because this is a disorder that manifests itself through your moods, and therefore impacts your interactions and perceptions of society. Therapy provides a sounding board that helps the bipolar person better assess social situations and personal relationships.

Medication is essential because without it, any form of bipolar will become more severe. Furthermore, it dampens moods to a manageable level, and increases well-being and the ability to become fairly steady, dependable, and reliable -- all essential qualities for maintaing work and family relationships.

If a bipolar person has stopped taking their medications, or their medications aren't working properly (which happens as the body adjusts to the drug, over long periods of time), then they may go into a depression or mania that requires they be hospitalized. If psychosis is evidencing, hospitalization is essential.

Electric Shock Therapy treatments, which consist of brief electric shocks to the brain, will help "reset" the bipolar person, bringing them out of the mood and creating a viable environment for treatment. This treatment has been highly demonized in the media, but is actually quite humane and safe. The worse side effect is a temporary loss of short-term memory.

Bipolar, in any of its forms and any of its symptoms, is not an illness to be taken lightly. Those who live with someone with bipolar need to be steady, understanding, and patient. They should understand that the bipolar person may say or do hurtful things that they don't really mean, but think they absolutely do at the time. They may swing from extreme anger to loving friendliness. The best thing to do is to educate yourself fully and completely about mental illness.

Two helpful websites are NIMH -- the national institute of mental health -- and WebMD. There are also many books available that address the illness and their symptoms in depth. I particularly like The Bipolar Handbook by Wes Burgess and Bipolar for Dummies by Candida Fink and Joe Kraynak, which both cover the information in an informative and friendly manner. To best understand what it's like inside the bipolar mind, read the memoir An Unquiet Mind, by Kay Redfield Jamison.




More by this Author


Comments 34 comments

Kulsum Mehmood profile image

Kulsum Mehmood 7 years ago from Nagpur, India

Just the info I was searching for. Thank you.


vrajavala profile image

vrajavala 7 years ago from Port St. Lucie

I never heard that one type of bipolar could change to the other. Most likely it was just an improper diagnosis in the beginning


that one girl profile image

that one girl 7 years ago from Washington state Author

Vrajavala -- actually, my psychiatrist gave me that piece of information. I wanted to know if it was some action on my part, or simply genetics or the course of the illness that had changed the way bipolar moods exhibited over the course of the years. He explained that bipolar will, like any illness, worsen over time if left untreated. He also admitted that even with treatment, bipolar worsens over time -- the treatment slows it, but does not stop the progression of the illness. Bipolar does get more severe as the years go by.


nancydodds1 profile image

nancydodds1 7 years ago from Houston, Texas

Nice hub!


download-peace profile image

download-peace 7 years ago from MN

Thank you for the information on Bipolar Disorder. I have a 20 year old son, who has rapid cycling Bipolar. He wasn't officially diagnosed until last year, but looking back, he had signs and symptoms from the age of 5. Bipolar does present differently in children than in adults. Puberty seems to accelerate the illness by leaps and bounds! And then add in high school and dating, stress, and self medicating, and you have a recipe for disaster.

I almost wish my son's manic phases were high, happy and creative! But, instead, his manic phases are mixed--he becomes highly voilatle, and will snap into a rage over the slightest thing. He can be very destructive, and mean horrible things can fly out of his mouth as fast as he can think them. Then he dives into a depressive phase--sometime suicidal thoughts. Give him an hour or two, and he will be the kind gentle son I recognize again. But wait!! Another hour or two may go by, and he gets a phone call from his girlfriend who wants to fight about something...and the whole cyclebegins again!

Yes, my son suffers greatly from this "Monster", but so do we all as a family.

If you are a parent of a child with bipolar, or another mental illness, I created a private membership site just for us. Because, just like no one can imagine how it feels to be bipolar unless you have it yourself, no one but another parent raising a child with a mental illness can know what it's like unless they are living it also.

If you, a parent, need support, go to http://bipolarmonster.rsitez.com

We are just a family of parents who truly understand!


ahpoetic profile image

ahpoetic 7 years ago

I've known a person that grew depressed and sighed a lot when he got divorced. I believe anyone can suffer depression if they allow themselves to be overwhelmed by situations in their lives.


that one girl profile image

that one girl 7 years ago from Washington state Author

Ahpoetic~

Your comment that: "I've known a person that grew depressed and sighed a lot when he got divorced. I believe anyone can suffer depression if they allow themselves to be overwhelmed by situations in their lives," seems to evidence an ignorance of the difference between unhappiness and true depression. The mental illness community often laments the term "depression," because it's so casually used that it doesn't truly connotate the intenseness of the emotion. To say that someone is depressed over a divorce, or their dog dying is not correlative to saying that someone is depressed due to a mental illness.

Depression to the mentally ill person is all-encompassing. It touches every aspect of their lives. "Sighing a lot" and "staying inside in a dark room without ever picking up, rarely eating (or eating too much), and hiding under the covers to pretend to sleep when people come over," are two entirely different things.

Furthermore, it's somewhat insulting for you to insinuate (as your comment seems to) that depression (ergo mental illness) is a choice. That is a stereotype that damages those who truly have a mental illness and would give anything to dispose of mood cycles that alter and even destroy their interpersonal relationships.


DynamicS profile image

DynamicS 7 years ago from Toronto, Canada

that one girl, this is a very informative and well researched hub. I thank you for educating us about mental illness. I was not fully aware that there are different types of bipolar.

I work with adults with physical disabilities, but find that due to disease progression or perhaps aging process, some of our clients have underlining mental illness that are not being addressed. These are the clients that staff find most challenging to work with. This is due because of lack of understanding of mental illness. As a result, several years ago I organized seveeral training sessions for the staff to address some of these challenges. I must say I lean so much about mental illness and approached my work with a different more positive and reactive apporach.

Again, thanks for educating us. I look forward to read mor hubs from you...


Sara Tonyn profile image

Sara Tonyn 7 years ago from Ohio, the Buckeye State

I'm afraid this is going to sound like I'm splitting hairs but I think it's important to clarify a few things if I may.

Based on the title of your hub, I hope people aren't getting the impression that bipolar disorder is a PSYCHOSIS because it's NOT. As you noted, it's a mood disorder. The diagnosis is not manic-depressive PSYCHOSIS, it's manic-depressive DISORDER or bipolar DISORDER. Like many other mental illnesses, a bipolar disorder may or may NOT include psychosis. That said, maybe the title of your hub should be revised so as not to be misleading.

Also, you state "Basically, a bipolar person will hear and see things that are not actually there, and believe things that they have no evidence for" -- and that is NOT true. It's incorrect to say bipolar individuals WILL suffer from hallucinations. Some may, but others never will.

I swear I'm not trying to be picky but since mental illness still has a bad stigma attached to it, I feel it's very important to be precise when explaining or describing a disorder. "Psychosis" and "hallucinations" are powerful terms that need to be used extremely carefully in my opinion.

Finally, like Vrajavala, I've never heard of one type of bipolar disorder "changing" to another. The disorder may progress but I'm not sure that saying it "changes" to another is really an accurate description.

I sincerely hope I haven't offended you with my comments. There were only meant as constructive criticism, not plain ol' criticism from some smarty pants!

And yes, as you may have guessed, I suffer from bipolar disorder; bipolar II WITHOUT psychosis. :)


that one girl profile image

that one girl 7 years ago from Washington state Author

The name of the hub was b/c I was responding to a question someone asked. That's how most of the (admittedly few) hubs I've written come to pass. I scroll along the questions, find one that catches my eye, and answer it.

You're absolutely correct about the poor word choice in "will/may." Correction has been made.

As far as the disorder changing to another, it is a hypothesis strongly supported by most health professionals and backed up by a 2003 study that bipolar is a progressive illness. I included the following links in the revisions I made to the article as well.

I've also dealt with bipolar my entire life -- through my grandmother, mother, one of my sisters, and myself. I know it on every level and through every incarnation and I've watched it through it's various progressions, as well as experienced it. I respectfully disagree that Bipolar does not progress.

http://www.eurekalert.org/pub_releases/2003-05/uoc...

http://www.associatedcontent.com/article/2021430/i...


Sara Tonyn profile image

Sara Tonyn 7 years ago from Ohio, the Buckeye State

that one girl --

Thanks for the prompt response. :) And special thanks for not thinking I was just being a jerk!

Thanks also for making the correction and for providing the new links. Interesting stuff for sure!

For the record, I do agree the disorder progresses. (Lucky us.) It was only the possible "change to another disorder" that I was questioning.

Please continue doing a great job of educating people about bipolar disorder. At some point I may create a hub of my own concerning our illness and I fully expect you to proofread my effort and catch any errors I make. :)

Take care!

-- Sara


that one girl profile image

that one girl 7 years ago from Washington state Author

No problem. I look forward to reading any hubs by you. I don't know if you want me proof-reading, though, considering how awkwardly the final sentence in my last comment was written. :)

To phrase that sentence in a more clarified manner: I respectfully disagree with the idea that Bipolar does not progress through the different types.

I look forward to your educational hubs. The more people fighting the social stigmatization of mental illnesses, the better!


loveofnight profile image

loveofnight 7 years ago from Baltimore, Maryland

i was married to a viet nam vet who was manic depressed and went through a lot to try and help get and keep him well.this is good info worthy of passing on.


sarena 6 years ago

I found your info very informative. A question for you...Any ideas on how to support/bring down someone having manic episode? He has stopped taking medication, and now to far gone to help. Just spinning round like a tornado, distrubing anything in his path. I basically tell all to try and buffer him, treat him gently and support him. Anything else and he flies off, almost stepping up to the next level, that eventually will be so distructive for him.

Any suggestions most welcome.


that one girl profile image

that one girl 6 years ago from Washington state Author

My best advice is to find him a therapist. If he refuses/ doesn't want to take meds, a therapist can at least help him anticipate and deal with his moods in a healthy manner. Bringing him down (or up) from a mood is nearly impossible, in my experience -- you just kind of have to ride it out.

You could hospitalize him, but I don't recommend that unless you know the condition and quality of the psychiatric wards in your area, or at least until you research them. Some of those places unfortunately do more harm than good. (Not all, I've been in some lovely psychiatric wards).


christalluna1124 profile image

christalluna1124 6 years ago from Dallas Texas

One girl,

As your new fan I want to thank you for this very informative hub. You are correct in saying that the depression suffered by those of us with bipolar disorder make depression caused by life events pale in comparison. When I suffer depressive episodes, I am completely imobilized. I can not bathe, dress or even comb my hair. I have home healthcare who attends to these needs and cooks so I am made to eat. I rarely talk in this stage and prefer to be left alone. I was diagnosed after my 4th suicide attempt. I applaud you for your attempt to educate the general public about this disorder. My son is 8 and bipolar. While I am more in mixed states most of the time he is more super-hyper and rage filled. I will be sure to join your website. Feel free to browse my hubs on bipolar. Believe me with two of us in the same house it makes for an interesting life.

Warmest regards,

Christal


jitu66 profile image

jitu66 6 years ago from New Delhi

Nice hub. I was finding some information on Manic Depression


andybond profile image

andybond 6 years ago

Hi,

This was very interseting to read. I knew about Bipolar and read a little about it but never real went too in-depth.

My mum suffers from depression but after reading this hub closley I realise it isn't a form of Bipolar. I can scratch that out.


brenren57 profile image

brenren57 6 years ago from Williamsburg, VA

Hmmph. I have severe rapid-cycling Bipolar I Disorder. I have psychotic manifestations, and I have desperately wanted to be dead - even recently, but I have never been hospitalized (yet) and just TRY to get near me with brain buzzers. Humane? You apparently don't have the disorder. How would you like the idea of someone running voltage through your skull?


that one girl profile image

that one girl 6 years ago from Washington state Author

Robert: In the case of an adult, if they refuse to get diagnoses and treatment, it's almost impossible to force it unless they get to the point of causing harm to themselves or others.

Brenren57: Actually, I am bipolar, as was my mom. I have bipolar 1, manifesting with mixed-state and rapid-cycling My mother had atypical bipolar 1, long depressions and rare manic states.

My mom had ETC twice. The first time, it reset her from a suicidal depression. The second time, 23 years later, she begged the doctor to do it to help her out of a debilitating depression. The doctor refused, saying it was a last resort. By the time he agreed to do it, she'd progressed to the point that even the ETC couldn't reset her depression.

I've observed modern ETC treatments and interviewed the patients, family members of patients and doctors of patients. It's humane, but it does suffer under a stigma of fear and misinformation.

Much like mental illness, come to think of it.


schoolgirlforreal profile image

schoolgirlforreal 6 years ago from USA

Hi, good hub but I agree with Sara Tonyn that I've never heard a bipolar person have visual or auditory hallucinations....though it may be possible,,as Sara said some NEVER do...which should be made clear.

Thanks for writing on this subject though. It's good to have firsthand feedback.

SG


that one girl profile image

that one girl 6 years ago from Washington state Author

Schoolgirlforreal --

Thanks for reading. The information for this hub was gained from personal experience and years of research (I've been interested in mental illness since I was 15, and regularly read medical literature on the subject).

I seem to have phrased the disputed section of the article badly. Depending on the type of bipolar and the intensity of the mood swing, psychosis evidencing in the form of visual, auditory or tactile hallucinations is possible. This is most frequent with the intense manias experienced in type 1 bipolar.

That said, not everyone experiences said hallucinations. In my personal life, those people I associate with who have/ had (while living) bipolar did indeed suffer from occasional hallucinations. It's true, not every mood swing was tainted by the hallucinations, but it does occur.

This January, I suffered from visual hallucinations during a particularly bad manic episode. I hadn't been able to contact my psychiatrist on a regular basis, due to her being in the middle of an office move. Just before she started the move, we'd altered some of my medications, because I'd been experiencing frighteningly deep depressions. While adjusting my meds, I started rocketing into extreme manic states, and at one point I spent an entire day afraid to sleep or blink, because every time I closed my eyes I would see horrible things blazoned across my internal vision -- things like Jesus melting on the cross, then opening demon-crazed eyes to glare at me, or Hitler's face morphing into an anime samurai. Then I started seeing things like Transformers and Autobots sneaking around the house, even with my eyes wide open.

I don't like to tell people about this because they tend to have two reactions: 1) I'm making it up for attention or 2) Wow, how cool would that be to see Transformers in the bathroom!

My response is 1) This is not the attention any reasonable person would like to have and 2) Hallucinations are only fun when you go looking for them. They're never fun when they show up unexpectedly.


Brummlin profile image

Brummlin 6 years ago from Central Florida

Absolutely brilliant. You have described this better than most people ever could in simple, but not simplistic terms.

Someone close to me suffers from Bipolar I, but fortunately is a rapid cycler. More "mild" psychosis (horrible term for any psychosis,) can happen during a lot of people's manic episodes. But when it gets serious, is when the mania causes chronic insomnia.

Both of these will cause psychosis alone. I met someone once who had manic psychosis so bad at times... Let's just say it's by the grace of God she was around.


wander1 profile image

wander1 6 years ago

Good to know I'm not alone - thanks! It's really a struggle for life, and sometimes it's tempting to give it all up.


HELLOWORLD 5 years ago

I have this......really sucks, and the worst part about it is that im only 19, actually that's not the worst part. there are a lot more worse things about it than that AHHHHHHHHHH I CANT THINK STRAIGHT WHAT THE FUCK I CANT EVEN WRITE A SIMPLE PARAGRAPH. FML. i took medication but it seemed to only be making it worse, and now im off it and im still getting worse.. ITS NOT GETTING ANY BETTER! im only 18 and i cant even concentrate in school anymore or focus because when i try to logically understand things that i'm learning it all comes out like BLAHHHHH MUSH.. Can't talk to people anymore because not only to others not understand what i say but i don't either when i rethink what i just said.. so i don't even try anymore. My life is going down a fucking SHIT HOLE.FUCK MY BRAIN.I-HATE-IT, AND I HATE MYSELF FOR CHOOSING THE PATH I DID THAT MADE THIS HAPPEN. I USE CAPITAL LETTER BECAUSE IM SCREAMING IN MY HEAD JUST SO YOU KNOW. this is a warning for all of you that may wanna do drugs in the future..DON'T..


mimo 5 years ago

can manic depressive pschois be cured

how do i go about it

what is the treatment


that one girl profile image

that one girl 5 years ago from Washington state Author

No, I'm sorry. There are many modern illnesses, both physical and mental, that we don't actually know the exact, precise cause of. Diabetes, schizophrenia, etc. Like diabetes (no cure, but managed through insulin), mentally ill people can manage their illness through medication and therapy. It's important to realize that both of these components are key -- mental illness manifests itself through your emotions and interactions, so a good therapist will help immensely. The key there is a GOOD therapist. Don't just go to the first doctor you see; find someone you click with. This is important.


Mental Illness sucks 5 years ago

I'm curious to whether I may have a spectrum of bipolar disorder.

Celexa and Effexor on the first day gave me incredible energy and rage. I just started effexor last night, tired today but based on the short term anger I had experienced and energy - this worried me.

My doctor diagnosed me Major Depressive, ADD, and PTSD. I'm noticing strange things occuring in my brain on the Effexor. It seems my perception of time has slowed down and I'm able to make out and intrepret lyrics in music. Don't know if the effexor is treating the ADD or the depression as depression can cause a lapse in time perception as can ADD...

Anyways, I've digressed. I must say the article was good, however, there were some grossly misused statements that as the other poster said - in a society where mental illness is surrounded by stigma, wording in these articles must be used carefully as to not exaggerate the truth or speculate.


Escobana profile image

Escobana 5 years ago from Valencia

Well done! Very informative and I like the way I can recognize myself in your Hub. Charting my Bipolar Disorder and intensive therapy has made life very great for me.

Voted you up, useful and interesting!


naturalsolutions 5 years ago

It's my very first time to know that chemical imbalance could change the mood of a person. Now i know why there's a lot of people feel that undefined feelings.


Monica Ganvir 5 years ago

This article was really good,, a lot of learning.


chamannigam 4 years ago

i have heard that thesr phases do not occur after-the age 60- 65but in my husbands case with the mood regulaters ho is having them .he is 78 for him depressive phases are very painful even for us also .during maniac phases he is happy but i am very disturbed as he will do things that will cause problems for the whole family .for the last 43 years he and the whole family is suffering .


stylezink profile image

stylezink 4 years ago from Atlanta, GA.

GREAT HUB! There's so much information on bipolar disorder and what I was looking for. Thanks for sharing your knowledge!


Hendrika profile image

Hendrika 4 years ago from Pretoria, South Africa

I suffer from bipolar that took years before it was diagnosed and my family suffer a lot because of that. I did not know where the bouts of irritability and uncontrollable anger and shouting came from until I was properly diagnosed. So, I agree, get help as fast as possible!

    Sign in or sign up and post using a HubPages Network account.

    0 of 8192 characters used
    Post Comment

    No HTML is allowed in comments, but URLs will be hyperlinked. Comments are not for promoting your articles or other sites.


    Click to Rate This Article
    working