MANIC DEPRESSION

Manic depression is a relatively common psychiatric illness affecting people world wide.

It is a mood-swinging disorder with recurrent episodes of elation and depression. There is wide variation in illness patterns and treatment needs. In elation (or hypomania) there is excessive energy and activity, little need for sleep, and racing thoughts. These can be accompanied by grandiose notions with loss of judgement. On the other hand, depression often brings lack of energy and loss of interest in our surroundings and usual activities, slowness of thought, and difficulty in making decisions and communicating with others. There can be feelings of guilt, worthlessness, and despair. In either case, when the mood swing is marked, perceptions may be distorted.

Causes

Many factors contribute to the illness. Although heredity may play a part, 40% of people with manic depression have no family history of the illness. Research also indicates a biochemical disturbance. Stressful life events can play a major part in precipitating a swing into either phase.

Treatment

About 20% of people who have a first episode never have another. For the rest, good quality of life is usually possible with treatment and increased understanding of the illness.

Many people are helped by "mood stabilisers" such as lithium carbonate (Priadel, Camcolit) and carbamazepine (Tegretol). Treatment with antidepressants and/or major tranquillisers may also be necessary.

Hospital admission may be required, often in response to acute crisis. Many could be averted if better support systems were available. A variety of "talking treatments", including one-to-one therapy and self-help groups, are also useful.