Typical case.
Patient Li, male, 34 years old, married, corporate clerk.
The patient was originally introverted, about six months ago, no obvious cause all day cheerful, unusually happy emotions (nothing actually happened); talk a lot, talk especially fast, sometimes do not wait for others to finish his boast, others with his speech has been unable to keep up with his speed; good bragging, sometimes said that the leadership especially valued him, he will soon be able to become a manager, said how capable they are, etc., talk humor; Energetic, going out all day, busy with the east and west; quick change of temper, easily provoked, very enthusiastic to doctors and nurses in the hospital.
Diagnosis: Mania
Mania and depression belong to the same affective mental disorder, but the clinical manifestations of the two are exactly opposite. Depression takes extreme low mood w as the main symptom, while mania mainly manifests extreme high mood. Excessively low mood is a pathological phenomenon, however, excessively high mood is also abnormal.
Clinical manifestations of mania.
Typical symptoms: high emotion, racing thoughts, and increased activities. In medical terms, it is called “three high” symptoms.
1, emotional high: this is the main symptom of mania, the patient feels that the mood is particularly good, pleasant and joyful, immersed in holiday-like joy all day long. Patients are cheerful and laughing all day long, especially easy to “people crazy”. They are nosy, and they are always around to see what’s going on. Some patients are irritable and easily get into conflicts with people around them.
2, agile thinking: the patient’s thinking association is very fast, and talk with people not only answer, and from time to time will be interspersed with some funny and humorous, infecting the surrounding people, making people feel very relaxed and happy, some patients talk like a river, and talk, and frowning, expression is unusually rich, vivid. Some patients think of too many things at once, so they cannot express themselves in words coherently, and the medical phenomenon called “phonetic connection” and “fluttering of ideas” appears.
3. Increased movement: Patients have no free time, they are busy all day long, they especially like to participate in public welfare activities and are willing to help others. Some of them are busy dressing up or shopping all day. Some patients are busy in and out of the day, the result is “not busy at all out of the name”.
4, other psychiatric symptoms: some patients can produce exaggerated delusions, think they are extremely smart or descendants of a famous family, think they are the boss of a multinational group, can do inventions and so on. In many familiar people’s eyes, this is really bragging. The vast majority of patients sleep less, but they still have a lot of energy. Some patients are hypersexualized, often approaching and flirting with the opposite sex, and even engaging in “outlandish” behavior. In addition, a few patients may experience hallucinations and impulsive behaviors.
Causes of bipolar disorder
Mania mostly occurs in adolescence around 20 years old, and the onset of the disease may be related to genetic factors, neurobiological factors and psychosocial factors
1, genetic factors: Through the study of the prevalence rate of the first-degree relatives of patients, the co-morbidity rate of twins and the co-morbidity rate of monozygotic twins, it is presumed that manic-depressive psychosis may be inherited to the next generation through the X chromosome, or may be inherited through other channels.
2, physical factors: psychologists Kretschmer and Sheldon et al. believe that the incidence of short fat type with cyclic personality is significantly higher. The main characteristics of cyclic personality are sociability, cheerfulness, wide range of interests, good movement, easy to be excited and optimistic, but also easy to become worried and worried. Patients with mesodermal skeletal and muscular development and connective tissue are more likely to have the disease than those with ectodermal slender and delicate physique.
3, the function and metabolic abnormalities of central neuromediators: abnormal function of central noradrenergic system, abnormal function of central 5-hydroxytryptaminergic system, hypothesis of seed amine metabolism disorder, neuroendocrine dysfunction, abnormal electrolyte metabolism, etc.
4, mental factors: the onset of manic-depressive psychosis may be related to mental stimulation factors, but can only be regarded as precipitating factors.
How to treat mania.
The onset of mania is “coming and going”, that is, it usually starts rapidly, and after proper treatment, the symptoms are quickly controlled within a few weeks or even a few days. Mania not only has a short course, but also has a good prognosis, and patients can basically return to the original normal state after the remission of the disease.
With mild manic symptoms should first be actively adjusted, if the bad mood continues for two weeks is still not obvious relief, should promptly find a psychiatrist. For those who already have a history of anxiety disorder or mania, they should now take the initiative to find a psychiatrist to adjust the medication and insist on taking it. At present, such patients are mainly treated with medication to control his excitement and agitation, and then take medication to prevent relapse. The treatment effect is better, basically can restore the normal state, and the spirit is not easy to decline.
Drug treatment.
1.Anti-psychotic drug treatment.
Applicable to patients with mania, especially those with obvious psychomotor excitement symptoms. Commonly used drugs are chlorpromazine, haloperidol, clozapine, which can be given orally in general, and those with obvious excitement symptoms can be given by intramuscular injection.
2, lithium salt treatment: the commonly used lithium salt preparation is lithium carbonate.
3.Anti-epileptic drugs: such as carbamazepine, valproate, etc.
Mania is an affective psychosis, especially excitement, high emotion and increased speech and action. When light mania is more complete and unified mental activity, the impression is warm, generous, polite, enhanced ability, and even reused because of this. When the mania is more severe, there will be behavioral disorder, unable to complete daily work, and even easy to be impulsive and destroy things. Once the mania is detected, the patient should be sent to the hospital for medical treatment. The key to the treatment of this disease is early diagnosis and systematic treatment. As a relative of the patient, you should send the patient to a specialized hospital for treatment, do not listen to the wandering doctor and delay the treatment, and of course, do not believe in gods and ghosts.