Mania and Depression – Mixed States


Among mood disorders – affective disorders – there are diseases such as depressive disorder and obsession. Their symptom complexes are well-studied, described and logical. At first glance, they are on both extremes and can not have much in common with each other. But man is not a textbook, especially when it comes to his psyche.

Depression and obsession with their manifestations do not exhaust all the conditions that could be attributed to mood disorders. There are both their nuances described and supervised by physicians, as well as mixed states that unite them.

Mixed states

These include cases where both depressive and manic symptoms are present in the same patient. This is a person who is overactive and talkative, and at the same time has depressive thoughts.

In other cases, manic and depressive symptoms change rapidly, for example, a man with mania becomes depressed for a few hours, then again manifests manic symptoms.

The accumulated clinical experience suggests that such mixed conditions occur in about 40% of patients with bipolar disorder. Today, these conditions include dysphoric mania and aggravated depression.

Dysphoric mania – taken as a more severe manic disorder or transition from mania to depression. This condition is spoken when there are several depressive symptoms during a manic episode, with suicidal thoughts and intentions being particularly serious. This type of mania is more common in women.

The high involvement of depressive temperament in dysphoric mania confirms the hypothesis that mixed states arise when the affective episode (depressed or manic) is overlaid on a temperament of opposite polarity.

An aggravated depression – defined as a major depressive episode with psychomotor restlessness, agitation and intense internal tension.

To assume depression for an athlete, at least three or more hypomanic symptoms are needed – increased coma, familiality, increased sexual desire and reduced need for sleep, easy attention retrieval, thoughtfulness, and more.

This type of depression is more common in women, usually with an earlier onset, an atypical stroke, and a greater family history of bipolar disorder.

Persistent mood disorders

Individual episodes are rare or never severe enough to justify a clinical diagnosis such as mania or depression. They continue for years and lead to significant subjective distress. These include dysthymia and cyclothymia.

Dysthymia – depressive neurosis. This is an emotional state where there is a sickening of asthenic emotions – sadness and / or fear. The affected are sad, depressed, sometimes crying. If the fearful component is predominant, they are disturbing and agitated.

Some authors describe dysthymia as a loss of the “spark of life” in teen years. In this sense, dysthymia is expressed in chronic mood depression, but not to the extent or severity of the depressive episode.

Dysthymia sufferers usually have days or weeks in which they feel good, but most of the time, sometimes even for months, they are dropped and depressed, everything is an effort and nothing pleases them.

Dysthymia usually begins in early adulthood and lasts for at least several years and sometimes indefinitely. Her appearance is related to some personal changes : low self-esteem, easy wounds, pessimistic attitudes, mood instability, hostility, social isolation, rigor, and affection.

Cyclothymia – characterized by persistent mood instability over a period of at least two years, manifested in numerous periods of mild elevation and mild depression. This instability usually develops in early adulthood and becomes a chronic move, although sometimes the mood may be normal and persistent for months.

These mood swings are usually determined by the sick as unrelated to life events. Diagnosis is very difficult, requires a long period of observation, and rarely becomes the subject of medicine. 4185