Manic depression, also known as bipolar disorder, is classified as a type of affective disorder or mood disorder that goes beyond the day's ordinary ups and downs, becoming a serious medical condition and important health concern in this country. Manic depression is characterized by periodic episodes of extreme elation, elevated mood, or irritability (also called mania) countered by periodic, classic depressive symptoms.

Who is affected by manic depression? Manic depression affects more than 2.3 million American adults - or about 1.2 percent of Americans age 18 and older in a given year. When symptoms are present before the age of 12, they are often confused with attention-deficit/hyperactivity disorder (ADHD) - a syndrome that is usually characterized by serious and persistent difficulties resulting in inattentiveness or distractibility, impulsivity, and hyperactivity.

Affecting men and women equally (although women are more likely to experience more depressive and less manic symptoms), manic depression often begins in adolescence or early adulthood. In fact, the average age at onset for a first manic episode is during the early 20s.

Manic depression is likely to run in families and, in some cases, is believed to be hereditary. Researchers are still undergoing intense research to identify a gene that may be responsible for this disorder.

What are the symptoms of manic depression? The following are the most common symptoms of manic depression. However, each individual may experience symptoms differently.

Depressive symptoms may include:

persistent sad, anxious, or empty mood loss of interest in activities once previously enjoyed excessive crying increased restlessness and irritability decreased ability to concentrate and make decisions decreased energy thoughts of death or suicide, or suicide attempts

increased feelings of guilt, helplessness, and/or hopelessness weight and/or appetite changes due to over- or under-eating changes in sleep patterns social withdrawal physical symptoms unrealized by standard treatment (i.e., chronic pain, headaches) Manic symptoms may include:

overly inflated self-esteem decreased need for rest and sleep increased distractibility and irritability increased physical agitation excessive involvement in pleasurable activities that may result in painful consequence; this may include provocative, aggressive, or destructive behavior increased talkativeness excessive "high" or euphoric feelings increased sex drive increased energy level uncharacteristically poor judgment increased denial For a diagnosis of manic depression to be made, an individual must exhibit both depressive and manic symptoms to a varying degree, depending upon the severity of the disorder. The symptoms of manic depression may resemble other psychiatric conditions. Always consult your physician for a diagnosis.

How is manic depression diagnosed? Because depression has shown to often co-exist with other medical conditions, such as heart disease, cancer, or diabetes, and other psychiatric disorders, such as substance abuse, or anxiety disorders, seeking early diagnosis and treatment is crucial to recovery. A diagnosis is often made after a careful psychiatric examination and medical history performed by a psychiatrist or other mental health professional.

Treatment for manic depression: Specific treatment for manic depression will be determined by your physician based on:

your age, overall health, and medical history extent of the disease your tolerance for specific medications, procedures, or therapies expectations for the course of the disease your opinion or preference Treatment may include either, or a combination, of the following:

medication (i.e., mood-stabilizing anticonvulsants such as lithium, valproate, or carbamazepine, and/or antidepressants such as Prozac, Zoloft, or Paxil) psychotherapy (most often cognitive-behavioral and/or interpersonal therapy that is focused on changing the individual's distorted views of themselves and the environment around them, working through difficult relationships, and identifying stressors in the environment and how to avoid them)

electroconvulsive therapy (ECT) Recognizing the varied and extreme mood swings associated with manic depression is crucial in obtaining effective treatment, and avoiding the potentially painful consequences of the reckless, manic behavior.

In most cases, long-term, preventive treatment is necessary to stabilize the mood swings associated with manic depression.

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