People suffering from manic depression are 60 times more likely to commit suicide than the general population. They are also at a higher risk of becoming alcoholics and drug-abusers.
Also known as bipolar disorder, manic depression is a brain disorder that causes unusual shifts in a person’s mood, energy, and ability to function. It differs from the change of moods in a normal person as the symptoms of manic depression are extremely severe. As a result, performance at work, school or even family relationships are affected. People suffering from manic depression go through intense moods. They feel happy and energized on certain days and sad and depressed on other days. Each mood swing can last a week or more. As a result of these mood changes, they suffer from insomnia, can’t concentrate or are unable to work.
Manic depression often begins in a person’s late teen or early adult years though adults and children can develop it, too. The illness usually lasts a lifetime. The causes are genetic factors, abnormal brain structure and brain function, coupled with environmental factors. Children with a parent who has manic depression are six times more likely to have this mental disease. Yet genes are not the only factor. Studies of identifiable twins have shown that the twin of a person with manic depression does not always develop this order. By using brain-imaging tools such as positron imaging tomography (PET) and functional magnetic resonance imagning (fMRI), scientists have identified differences between brains of people with manic depression and brains of healthy people. Nevertheless, most scientists agree there is no single cause.
Manic depression mood changes are referred to as “mood episodes.” Sufferers may have manic episodes, depressive episodes, or “mixed” episodes. A mixed episode combines both manic and depressive symptoms. Each mood episodes can last from one to two week every day.
During the manic episode, patients may (a) feel euphoric or “high”, (b) be talkative, (c) be agitated or irritable, (d) have difficulty keeping calm, relaxing or sleeping, (e) feel they are high-achievers capable to accomplishing many things, (f) do risky things, like spending a lot of money or having reckless sex. On the other hand, when the depressive episode sets in, they (a) feel “down” or depressed, (b) feel worried and empty, (c) become forgetful and can’t concentrate, (d) lose interest in recreational pursuits (e) abandon their previous ambitions and goals, (f) feel physically sluggish, and (g) contemplate suicide.
Currently, manic depression has no cure except for treatment to control the symptoms. Treatment works best when it is continuous instead of continual. Remember, it is a life-long disease.
Medications attempt to relieve existing symptoms as well as to prevent symptoms from recurring. The most popular drugs belong to a group called neuroletpics, which, unfortunately, have side effects such as drowsiness, dizziness and increased appetite leading to weight gain. Older medications in this class can cause muscle stiffness, shakiness, and uncoordinated muscle twitches. Mood stabilizers are often prescribed during the manic episode while anti-depressants are often dispensed during the depression episode. However, these medications can be result in birth defects in pregnant women. Patients should not stop taking a medication without a doctor’s advice. Stopping medication suddenly can be dangerous as it can worsen the symptoms of manic depression.
Different kinds of psychotherapy, or “talk” therapy can play an important role in helping people with manic depression. Therapy can help them change their behaviour and manage their lives. It can also help patients get along better with family and friends. Psychotherapies that have been found to be effective are family-focused therapy, psycho-education, cognitive therapy, interpersonal therapy, and social rhythm therapy.
Family-focused therapy involves educating family members about the disorder and how to help the victim cope with the mental disease. Psycho-education teaches the patients and their family members about the warning signs and full-blown symptoms. In cognitive behavioral therapy, the psychiatrist works to help the patient identify, challenge, and decrease negative thinking and otherwise dysfunctional belief systems. The goal of interpersonal therapy aims to identify and manage problems which the sufferers may have in their relationships with others. Social rhythm therapy encourages stability of sleep-wake cycles, with the goal of preventing or alleviating the sleep disturbances often associated with this disorder.
( c) Electroconvulsive therapy
Often crudely referred to as electric shock, electroconvulsive therapy (ECT) is a treatment in which a convulsion is produced by passing an electric current through the brain. However, a common side effect is temporary amnesia. ECT is primarily used for manic depression that is resistant to medications. Given under anesthesia, ECT may be unilateral (electrodes on one side of the head) or bilateral (electrodes on both sides).
(d) Natural supplements
Herbal herbal and natural supplements, such as St. John’s wort or omega-3 fatty acids may assist to alleviate the symptoms. Consult a doctor before taking any supplement. Scientists are not totally sure how these products affect people with manic depression.
Helping a family member with manic depression
Advise your family member to see a doctor to get the right diagnosis and treatment. He or she may be referred to a psychiatrist by the doctor. You may need to make an appointment and go with him or her to consult the psychiatrist. (In most Government hospitals, walk-ins are not accepted and a referral letter is necessary.) Here are some helpful things you can do to help your relative:
— Be patient with his or her condition
— Encourage your relative to talk, and listen to him or her carefully
— Be understanding to his or her mood swings
— Include your family member’s friend or relatives in recreational activities
— Remind him or her that getting better is possible with the right treatment.
Helping myself if I have manic depression?
Seek medical treatment and stick with it. It takes time, and it is not easy. But treatment is the best way to start feeling better. Here are some tips:
— Talk to your doctor about your treatment
— Stay on your medication
— Keep a routine for eating and sleeping
— Make sure you get enough sleep and exercise
— Learn to recognize your mood swings
– Ask a friend or relative to help you stick with your treatment
— Be patient about your symptoms as improvement takes time.
How does manic depression affect friends and family?
When a friend or relative has manic depression, it affects you too. Taking care of someone with this mental ailment can be stressful. You have to cope with the mood swings and sometimes other problems, such as substance or alcohol abuse. Sometimes, the stress can strain your relationships with other people. Caregivers can miss work or lose free time. If you are taking care of someone with manic depression, take care of yourself too. Try to keep your own stress level down so that you can do a better job.
Where to seek help?
If you’re not sure where to get help, call your family doctor. You can also contact the Malaysian Mental Health Association or Malaysia Malaysian Psychiatric Association (please refer below).
The Family Support Group (FSG) of Malaysian Mental Health Association (MMHA) is a self-help group. It is run by a sub-committee comprising care-givers of a mentally ill family member, with a psychiatrist as adviser. The Group helps family members of the mentally ill by: (a) providing education through public talks and forums on the nature, treatment and management of different types of mental disorders, (b) providing opportunities for members to share their problems and experiences with others in similar situations and to learn from one another. For details, please contact:
Malaysian Mental Health Association (MMHA)
No. 8 Jalan 4/33, Off Jalan Othman,
46000 Petaling Jaya, Selangor
Tel: (+603) – 7782 5499
Fax: (+603) – 7783 5432
If you suspect you are suffering from manic depression or that a family member is trapped in this mental disorder, you can contact: Malaysian Psychiatric Association, P.O. Box 12712, 50786 Kuala Lumpur. The Association does not recommend any psychiatrist but has a list of private psychiatrist clinics for you to choose from. Check out www.psychiatry-malaysia.org.