Manic depression: symptoms, causes and treatments

Manic depression: this concept, which has just been used today, refers to one of the most common mood disorders and experienced after depression.

It is one of the oldest names currently known as bipolar disorder. Although for some this name can have even romantic connotations, the truth is that it is a disorder which generates a lot of suffering and can cause serious alterations in the daily life of those who suffer from it, its treatment being essential.

In this article we will see what is manic depression, What are the causes attributed to it and some of the main treatments applied.

    What is manic depression?

    Manic depression, manic depression or bipolar disorder. These different denominations have emerged in different historical contexts in which different orientations and currents of thought have also prevailed, although in practice they refer to the same disorder.

    More precisely, in all cases, reference is made to a mental disorder classified among mood disorders and characterized by the presence of one or more episodes of mania and / or hypomania. alternating or in the absence of depressive episodes.

    Thus, in this disorder, the mood may change from an episode of maximum elation and increased activity and energy to a state of deep sadness, hopelessness and passivity. This fluctuation can be followed or separated by an asymptomatic period., And the shift from one pole to another can happen in a short time.

      Types of bipolar disorder or manic depression

      There are two basic types of bipolar disorder: type 1 has at least one manic or mixed episode, which may be preceded or followed by a major depressive episode. However, the latter is not essential for diagnosis. With regard to type 2 bipolar disorder, the presence of one or more major depressive episodes accompanied by at least one hypomanic episode is required for its diagnosis, without in any case a manic or mixed episode.

      Expansive mood appears in manic episodesEuphoric or even irritable in which a high level of restlessness and activity occurs for most of the day for at least a week. In this state generally appears feeling of grandiosity (being able to reach delirium), logorée, flight of ideas or feeling that the thread of thought is lost, tachypsychia, distractibility, disinhibition, aggressiveness, hallucinations and tendency to risk already not assess the consequences acts themselves. Hypomanic symptoms are similar, but not as severe, symptoms such as hallucinations and delusions may not occur and occur for at least four days.

      In depressive episodes, there is low mood and / or loss of interest and the ability to experience pleasure along with other symptoms such as hopelessness, lack of energy and passivity, eating and sleeping disorders, fatigue or thoughts of death or suicide for at least two weeks.

      Symptoms effects

      The symptoms mentioned above, whether or not alternating manic and depressive episodes, generate a large number of repercussions on the subject which can alter and limit a wide variety of elements and vital areas.

      Academically and professionally, the existence of episodes can affect the ability to develop and follow plans, decrease performance or generate conflicting or unproductive behavior, as well as decrease the subject’s ability to concentrate. You may also have difficulty evaluating aspects such as the value and use of money. because of the extreme impulsiveness that can arise.

      The social sphere can also be affected. In the manic phase, the subject may show uninhibited sexuality and / or be irritable or even aggressive, present delusions of grandeur and antisocial behavior, at the same time as in the depressive phases you might lose interest in relating.

      In any case, one of the aspects with which the greatest care must be taken is that of the possibility of suicide. In fact, manic depression is one of the mental disorders in which the risk of suicide is higher.

        Possible causes

        If the origin of manic depression is not entirely clear, the explanations offered are generally based on factors of biological origin very similar to those of depression. The existence of imbalances in the synthesis and absorption of neurotransmitters is proposed.

        Specifically, it has been observed that norepinephrine levels decrease during depressive episodes and increase in maniacs. The same goes for dopamine. As for serotonin, it is found in lower proportions than usual in both types of episodes.

        Structures such as the amygdala are altered and hypoperfusion is also seen in different areas of the brain during different types of episodes (less blood comes in than it should due to frontotemporal mania and left prefrontal depression. ). It has also been proposed that bipolar or manic symptoms may be linked to problems with nerve signal transport.

        The environment also participates in its genesis, destabilizing events emphasizing the biological rhythm. In addition, it is also proposed as in depression the existence and influence of cognitive distortions that generate dysfunctional patterns. The cognitive triad of thoughts about oneself, the world, and one’s future would oscillate between depressive negative thoughts and other expansive and glorified thoughts.


        The treatment of manic depression or bipolar disorder requires a multidisciplinary approach. The main goal of treatment is to maintain a stable mood. for that pharmacologically, mood stabilizers are usedThe main one is lithium salts. This substance has a little known but generally very effective mechanism of action, based on its modulation of synaptic transmission. Once the subject has stabilized, it is necessary to establish a maintenance dose which prevents further attacks.

        However pharmacological treatment can cause bothersome side effects. It is therefore necessary to apply strategies such as psychoeducation in order to promote adherence. You can also teach self-report and symptom strategies that can warn of the onset of a seizure and prevent it from happening.

        Working with the environment is also essential, so that those close to the affected person know why certain attitudes and behaviors are resolved, relationship issues are resolved and they can help to help the affected person and know how to identify possible symptoms. . The manic-depressive subject may benefit from other psychological treatments used in depression, like Beck’s cognitive therapy.

        There is also interpersonal and social rhythm therapy as a treatment based on the regulation of biorhythms and personal relationships which may be useful for subjects with this disorder.

        In some particularly severe cases, and particularly in cases where there are severe manic symptoms, psychotic symptoms or an imminent risk of suicide, electroconvulsive therapy has been applied successfully (Which is currently applied in a controlled manner, with sedation and monitoring).

          Bibliographical references:

          • American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. Fifth edition. DSM-V. Masson, Barcelona.
          • Belloch, Sandín and Ramos (2008). Manual of psychopathology. McGraw-Hill. Madrid.
          • Sants, JL; Garcia, LI; Calderon, MA; Sanz, LJ; of rivers, P .; Left, S .; Román, P .; Hernangómez, L .; Navas, E .; Lladre, A and Álvarez-Cienfuegos, L. (2012). Clinical Psychology. CEDE PIR preparation manual, 02. CEDE. Madrid.
          • Welch, Calif. (2016). Electroconvulsive therapy. A: Stern TA, Fava M, Wilens TE, Rosenbaum JF, eds. Comprehensive clinical psychiatry at Massachusetts General Hospital. 2nd ed. Philadelphia, PA: Elsevier

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