
The exact symptoms of manic depression are difficult to define due to the fact that the disorder itself is so incredibly complex. Unlike most other depressive disorders, manic depression or bipolar disorder as it is sometimes called typically involves several different types of episodes.
These include Major Depressive Episodes which form part of the criteria used to define Clinical Depression, Manic Episodes, Hypomanic Episodes, Mixed Episodes and Unspecified Episodes. In addition, the disorder is also further divided into Bipolar 1 Disorder and Bipolar 2 Disorder.
A Hypomanic Episode is defined as follows:
• A distinct mood which is different to the individual's usual non-depressed mood but is in no way psychotic. The hypomanic episode should not severely impair important areas of functioning or require the individual to be hospitalized. The mood experienced is elevated, expansive or irritable and extends continuously over at least four days.
• The change in mood should be easily observable by others and should not be due to the use of any substance, or the result of some form of general medical condition. If the mood disturbance is elevated or expansive, three of the following additional symptoms should simultaneously be present, if the mood is irritable four of the following additional symptoms should simultaneously be present in the individual:
• A decreased need for sleep.
• Pressure to keep talking or significant increase in verbal communication.
• Trouble concentrating on the simplest of tasks and distractibility.
• Psychomotor agitation or an increase in goal driven activity.
• Flight of ideas and thoughts.
• A significant increase in self esteem or ideas of grandiosity.
• Excessive involvement in detrimental albeit pleasurable activities.
Manic Episodes are similar to Hypomanic Episodes in the sense that additional symptoms are identical. There are however a number of important differences between the two, these being namely that:
• In a Manic Episode, symptoms last for at least one week or any duration if hospitalisation is necessary. Hypomanic Episodes by contrast only last for a minimum of four days.
• Symptoms of a Manic Episode must in no way meet the criteria for a Mixed Episode.
• In the case of Manic Episodes, psychotic characteristics must be present or the disturbance in mood should be severe enough to cause a marked impairment in important areas of functioning. In addition, hospitalization may be necessary so as to prevent the individual causing harm to themselves or others.
• Manic Episodes need not be easily observable by others, although it is likely that they will be.
A Mixed Episode by contrast involves the following:
• Aside from duration, all the criteria for a Manic and a Major Depressive Episode are met and are present every day for the duration of at least one week.
• Psychotic characteristics are present or the disturbance in mood is severe enough to cause a marked impairment in important areas of functioning. In addition, hospitalization may be necessary so as to prevent the individual causing harm to themselves or others.
• The symptoms are not the result of the use of some form of substance or due to a general medical condition.
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