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Manic Depressive Psychosis (MDP) Depression: Psychological Implications, Symptoms, Diagnosis And Treatment

Updated on February 20, 2014

Manic Depressive psychosis

The symptoms of MDP depression are centered around the disturbances in mood. The mood is often sad. The face appears gloomy, with wrinkled forehead, drooping of the eyelids and sagging of the angles of the mouth. Sometimes the mood is agitated. The s
The symptoms of MDP depression are centered around the disturbances in mood. The mood is often sad. The face appears gloomy, with wrinkled forehead, drooping of the eyelids and sagging of the angles of the mouth. Sometimes the mood is agitated. The s | Source

Clinical Manifestations

Several terms such as psychosis depression, endogenous depression, agitated depression, involuntional melancholia, masked depression, etc. are all used to designate MDP depression. The symptoms of MDP depression are subject to diurnal variation, being worse in the morning hours.

Symptomatology

The symptoms of MDP depression are centered around the disturbances in mood. The mood is often sad. The face appears gloomy, with wrinkled forehead, drooping of the eyelids and sagging of the angles of the mouth. Sometimes the mood is agitated. The speech is slow, and the voice is low. They are pessimistic. They may retain ideas of delusions of guilt for imagined crimes and blames. Ideas of worthlessness and hopelessness may be evident in their talk. Out of such thoughts they develop suicidal ideas. Nihilistic and hypochondriacal delusions are common. Sometimes, they may not talk at all (depressive mutism).

Disorders of perception like auditory hallucinations of accusatory nature are sometimes observed. The motor activity is retarded. The movement is slow. The patient tends to stoop while walking or sitting. Depressed patients become self- centered and prefer to be left undisturbed. The routine work may be ignored as a result of feeling of general weakness. In the extreme form, the patient may develop depressive stupor where all the activities are minimal with least response to external stimuli. The slow mental activity of the patient may give an apparent impression of impairment of intelligence or memory (Pseudodementia). The insight and judement may be impaired.

Somatic symptoms: Bodily symptoms such as headache, chest pain, generalized aches, giddiness, amenorrhea, impotence, loss of appetite, constipation, insomnia etc, are common. Insomnia is most marked during the early morning hours. Loss of weight may occur.

Diagnosis: Diagnosis of depression is made on the basis of clinical features. The important clinical features of depression are the depressed mood, the retarded psychomotor activity, pessimistic attitude, feeling of worthlessness, guilt, suicidal tendencies, hypochondriacal delusions, etc. Some cases may present only with somatic symptoms (masked depression). Manic depressive psychosis is to be differentiated from secondary depression and schizophrenia. The causes of secondary depression are atherosclerosis, general paralysis of the insane, hypothyroidism, vitamin B12 deficiency etc.

Course: The illness follows the same course as mania, but the risk of suicide is high.

Depressive Stupor

where all the activities are minimal with least response to external stimuli. The slow mental activity of the patient may give an apparent impression of impairment of intelligence or memory (Pseudodementia). The insight and judement may be impaired.
where all the activities are minimal with least response to external stimuli. The slow mental activity of the patient may give an apparent impression of impairment of intelligence or memory (Pseudodementia). The insight and judement may be impaired. | Source

Treatment

Drugs and electroconvulsive therapy (ECT) are employed in the treatment of depression. As for the use of drugs:

  1. Antidepressants: Imipramine hydrochloride (25 to 50 mg thrice daily orally); Tri-imipramine hydrochloride (25 to 50 mg thrice daily orally); Amitriptyline hydrochloride (25 to 50 mg thrice daily orally) and Doxepin hydrochloride (25 to 50 mg thrice daily orally).
  2. Hypnotics such as nitrasepam can be used to induce sleep when insomnia is troublesome.

Electroconvulsive therapy in use is advantageous since the action is quick compared to drugs. This is the treatment of choice in cases of stupor, especially when there are suicidal tendencies.

© 2014 Funom Theophilus Makama

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    • lambservant profile image

      Lori Colbo 3 years ago from Pacific Northwest

      I am wondering who your intended audience is? The average layman won’t understand the medical terminology you use here.

      Why, also, do you recommend such old meds when so many newer ones with much fewer side effects are available?

      "Electroconvulsive therapy in use is advantageous since the action is quick compared to drugs. " This I find very concerning given the horrific damage ECT does to the memory. This is not done so readily, in fact very, very, rarely, here. European Psychiatry seems to still be practicing from an archaic model. I would never entrust myself nor anyone else to your care.

    • Patty Inglish, MS profile image

      Patty Inglish 3 years ago from North America

      Unfortunately, in Ohio, ECT is being used more extensively in recent years and I don't like the number of patients that seem to have memory loss longer than the few weeks they "should" have it.

      OSU Hospital says on its website: "CT is a safe and effective clinical procedure for conditions that do not respond as well to other forms of treatment."

      ECT may be effective, but I don't like its use. Others do like its use.

      in America, MDP became BiPolar Disorder, which is a mood disorder. Knowing patients who have had the condition, it is difficult for me to not think of it still as a psychosis, based on their behaviors and expressed thoughts.

    • raymondphilippe profile image

      Raymond Philippe 3 years ago from The Netherlands

      Lambservant, i think your statement "European Psychiatry seems to still be practicing from an archaic model. " is a bit of an over generalization. ECT is practiced in my country (netherlands) if therapy and/or medication doesn't work and the patient is desperate. It can also be used as a last resort when patients have a very strong suicidal wish and there simply isn't enough time to wait for the right medicine /therapy to kick in.

    • married2medicine profile image
      Author

      Funom Theophilus Makama 3 years ago from Europe

      Thank you all for your comment.... As for Lambservant, I suggest you give your point and if there is any conflicting issue, you can explain in details and give reasons why my point here isn't appropriate, but condemning European medicine in general is very arrogant and wrong... You wouldn't recommend anyone to me? It's okay my dear, but millions will read all the articles pasted here...

      As for the drugs, I will do a little bit of research to compare and contrast and then, if there is a need to update this hub, I will. You Americans will never change.... Just too proud (as always). And what makes you think these archaic methods aren't helping a lot in other countries? Psychiatric conditions are fast evolving in the USA, maybe that's why you need to adapt with its evolution, but over here, these methods work effectively and just as raymondphilippe has said ECT is always a treatment of choice if the drugs do not seem to work or if in a relatively emergency situation.

      I respect your views lamservant and I appreciate your comments, but there is no need to be arrogant. Even if this hub is TOTALLY wrong, just simply say so without making any negative generalizations!

      As for the other, comments.... Thank you all!

    • tsmog profile image

      Tim Mitchell 3 years ago from Escondido, CA

      An interesting article. Sharing from the perspective of one who has a diagnosis (dxd) since '86 beginning with cyclothymia then progressing to BP-1 ('93), then BP-1 ('98) with psychotic episodes, and recently ('12) with BP-1 most recent episodes of dysphoric mania with psychotic episodes lasting near a year I think what may be lost is it is lifelong.

      In '98 I was hospitalized. The trauma of that process was not the diagnosis and crisis treatment . . . it was the perceived stigma both socially and importantly of self imposed guilt and possibly shame with those ramifications affecting esteem and identity. Or, maybe an 'and', the stigma perceived as real while socially may or may not have been real. The work of Howard Becker's labeling theory prompts a light of understanding regarding social interactions with both positive and negative consequences.

      Ex: Standing in a checkout line or having a conversation the diagnosed knows at that moment they are experiencing symptoms and the only thought is "They know (they being who the social interaction is occurring with actually or perceived, which may be lacking perspective) . . . I am this or that" when in fact 'they' do not. Yet, that negative thought process most likely an automatic process acts as a stimuli or trigger event producing a negative effect of generality with symptomology thusly exasperating real symptoms with specificity at times. Thus a time of crisis.

      A solution set with the greatest success from my knowledge is the cognitive behavioral approach. That approach is not a one day process, a one week process, a one seminar process, a one month process . . . it is lifelong with bipolar disorder.

      That being said from the perspective of treating the patient with the goal of becoming functional in a time of shall we say 'crisis' those mentioned (specific to ECT and extreme medication dosages) in the article may have a positive effect, yet efficacy may be left to wonder without subsequent treatment(s) with medications, followup specifically verbal therapy, and monitoring, of which self monitoring via mood/med charting, journaling, and of course education or of the least familiarizing the 'self' with what the diagnosis or bipolar (Manic Depression) is. For the patient/client learning abilities does play significantly on that outcome.

      Essentially success of the patient/client after the crisis episode is an enduring process requiring much of that individual and too, dedicated professionals. The treatment of that patient/client outside of the hospitalized environment from the point of crisis requires constant due diligence by both the patient/client and the professionals dedicated to that purpose.

      And then enters the real demon, borrowing from mythology, some would say, is the world of economics. What costs more? hospitalization or preventative care? Values and worth come into play with both morals of the self, which both the patient/client, the professionals, and those of society in general being diversified today have each, and the ethics of professionals and those societies, the subsequent industry of mental health care, and governmental agencies associated. And, as commentary has shared it is regional to the extent of continents as well as the neighborhood.

      With jesting try creating that maze into a computer game with modern game theory thought . . .

    • married2medicine profile image
      Author

      Funom Theophilus Makama 3 years ago from Europe

      Thanks a lot for your comment tsmog

    • married2medicine profile image
      Author

      Funom Theophilus Makama 3 years ago from Europe

      @ Lambservant.. I had to unfortunately delete a comment of yours here with another. Yes, I admit to having the D.Virtual.Doctor's account which was used to comment here... I have deleted the comment alongside your other comment.

      In relation to what your thoughts (which is parallel to another comment here) I want to appreciate the care. I am a fresh medical doctor who graduated last year in June. I had lots of notes on clinical situations, during my clinical training, which I thought it fit to convert them into articles (In this case, hubs)... I see nothing wrong in chipping one or two ideas from whatever sources you claimed I copied to make them hubs here.....

      So, if peradventure my hubs are much similar to other medical or clinically related articles, it is mere coincidence and definitely inevitable. Clinical cases, are medical facts with very little deviation (which grossly occur in language terms and structure in all similar articles)... So, if I had plagiarized another site, hubpages in the first place will not allow me publish them. And if you think I am copying a textbook, then well... I think I should have that much time and energy to do so, considering my work and the expected load I will need to first of all type them, then putting other contents such as photos (which all will need downloading first, then uploading), so thanks for the compliment!.... Besides, you can never tell me any article written in this present age, is 100% (Write about forgiveness for instance and if your school of thought is a very popular one, there would be no way, I will fish out 150 articles on forgiveness without getting one very similar to yours, especially if you used the same internet to do your research).. A professional sector as Medicine will hardly have much deviations in different directories when the same topic is discussed.

      As for my posting speed. I converted my medical notes to articles before I even launched this account. From June (2013) till January (2014) has produced more than 600, five hundred-words Microsoft words articles on my computer and all I do right now is just paste them and add some pictures (which as well is not wrong nor against the policies of hubpages)..

      As much as I want to acknowledge your concern, I still want to advice you on the level of your arrogance... I am not copying any site, nor have I copied any textbooks. If my lecture notes during my medical training days seem very very very similar to any site or textbook, IT IS PURELY COINCIDENTAL! And show me any article here which is defined by this claim, I will look into it and if convinced, I will delete it!

      I will not stop "pasting" my hubs as you claim and if there is any cause for alarm, I will rectify it immediately. Thank you very much and I hope you read more of my "pasted" hubs.

      Thank you!

    • lambservant profile image

      Lori Colbo 3 years ago from Pacific Northwest

      I didn’t make the plagiarise accusation, Mary McShane did. I said I had suspected but gave you the benefit of the doubt.

    • married2medicine profile image
      Author

      Funom Theophilus Makama 3 years ago from Europe

      Thanks anyway! Caution noted... I took my time today to do a review of the articles I had planned uploading before I started publishing them. I will take caution as from now on!

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