Many people ask the difference between monophasic depression and bipolar depression, next I will talk to you about the knowledge. Monophasic depression is only depressive episodes, while bipolar depression has manic episodes and depressive episodes, next, talk about manic episodes and depressive episodes. Manic episode clinical performance The typical symptoms of manic episode are high emotion, thinking, increased activity and other “three highs”, which may be accompanied by exaggerated ideas or delusions, impulsive behavior, etc.. The seizure lasts at least 1 week, and there are different degrees of social function impairment, or cause harm or adverse consequences to others. 1. Emotional high (basic symptom). The typical performance is that the patient feels good about himself, relaxed and happy, happy and joyful life; the whole day is giddy, proud and smiling. Their high emotions are infectious, and their witty speech often resonates with people around them, causing bursts of laughter. Some patients may show irritability, anger, hostility, easily jumped like thunder, and may even appear destructive and aggressive behavior, but the duration is short, easy to turn anger into joy or apologize. 2. Thinking is easy. The patient’s thinking association speed is obviously accelerated, the content of thinking is rich and varied, and he/she feels that his/her brain is smart and responsive. The volume of speech is large, fast, and the mouth is like a river, some feel that the language expression can not keep up with the speed of thinking. In some cases, the patient feels that the language expression cannot keep up with the speed of thinking. The patient is rich in association, generating concepts one after another, or quoting scriptures, or talking in a lofty manner, and making a lot of statements, and in severe cases, “sound association” and “meaning association” may appear. The patient’s mouth is often dry due to excessive talking, and in severe cases, the voice is hoarse. The content of the conversation frequently shifts with the surrounding environment, showing the phenomenon of shifting with the situation. 3.Increased activity. Patients feel energetic and capable, want to do more, do great things, want to do something, busy all day long, but more tiger head and snake tail, there is no end to death. Some of them are nosy, love to fight for justice, love to joke with others, love to approach the opposite sex; focus on dressing up, behave rashly or recklessly (such as squandering, irresponsible, or reckless), and have poor self-control. Patients do not feel tired and claim to have “incessant energy”. In severe cases, destructive and aggressive behavior may occur. Clinical behavior is slow, passive and lazy, not wanting to do anything, not willing to contact with people around, often sitting alone, lying in bed all day, not wanting to go to work, not wanting to go out, not wanting to disability activities and hobbies, often living alone behind closed doors, alienating friends and relatives, avoiding social life. In severe cases, even food and drink and their personal hygiene are disregarded, and even develop into non-verbal, non-moving, non-eating, and may reach a state of mute. Patients with anxiety may have symptoms such as fidgeting, finger grasping, rubbing hands and feet or pacing around. 4. Exaggerated perceptions and exaggerated delusions. On the background of high state of mind, there are often exaggerated ideas (often involving health, appearance, ability, status and wealth, etc.), overestimation of self, pretentiousness and overbearing. In severe cases, it can develop into exaggerated delusions, however, the content is mostly close to reality. 5. Decreased need for sleep. Significantly reduced sleep but no sleepiness is one of the characteristics of manic episodes. 6.Other symptoms. There may be increased appetite, hypersexuality, sympathetic excitement symptoms, etc. Most patients lose self-awareness in the early stage of the disease. Children and elderly patients are more atypical. Children have simpler thinking activities and more monotonous emotional and behavioral symptoms, mostly manifested as increased activities and demands. Older patients tend to show exaggeration, old age, arrogance and irritability, while emotional highs, drifting thoughts and increased activity are not obvious. Clinical manifestations of depressive episodes Depressive episodes are dominated by depressed mood, slowed thinking, reduced volitional activity and somatic symptoms. 1.Mood depression. The main manifestation is significant and persistent depressed mood, depression and pessimism; patients are worried, depressed, sad, long and short sighs all day long. Patients who are more advanced feel sullen and unhappy, lack interest in everything, and feel bored in activities they usually enjoy such as playing cards and watching soccer matches, and feel uninterested in anything, and feel “psychologically depressed” and “unmotivated”. Patients often complain that “there is no point in living” and “it’s hard to feel psychologically”. Some patients may be accompanied by anxiety and agitation symptoms. Typically, the mood depression is more severe in the morning and decreases in the evening. Under the influence of low mood, patients have low self-esteem, feel inferior to others, blame all the faults on themselves, and often produce a sense of uselessness, hopelessness, helplessness and worthlessness. They feel that they are incapable and incompetent, and feel that they have dragged down their families and society; when they look back on the past, they have achieved nothing, and feel guilty for their unimportant and dishonest behavior in the past; when they think of the future, they feel that their future is bleak, and meet that their jobs will fail, their finances will collapse, their families will have misfortunes, and their health will definitely deteriorate. On the basis of pessimism and disappointment, there is a feeling of isolation, accompanied by self-blame and self-guilt, and even delusions of guilt (the patient has the unfounded conviction that he/she has made a serious mistake, an unforgivable sin, and should be severely punished, so he/she believes that he/she is so guilty that he/she has to die or refuses food to commit suicide; the patient asks for labor reform to atone for his/her sin); there is also a suspicion of illness on the basis of somatic discomfort. The patient may also have delusions of relationship (the patient believes that things in the environment that are not related to him are related to him), delusions of victimization (the patient is convinced that he is being followed, monitored, slandered, isolated, etc. The patient may refuse food, press charges, run away, or act in self-defense, self-injury, or hurt others under the control of delusions), and so on. Some patients may also experience hallucinations. 2. Delayed thinking. Patients have slow thinking and association, slow reaction, closed thinking, and feel that “the brain is like a rusty machine” or “the brain can’t open like a layer of paste”. The clinical manifestation is the reduction of active speech, the speed of speech is obviously slowed down, the voice is low, the patient feels that the brain can not be used, it is difficult to think about problems, and the ability to learn and work is reduced. 3. Decreased volitional activity. Clinical behavior is slow, life is passive, lazy, do not want to do things, do not want to contact with the surrounding people, often sit alone, bedridden, do not want to go to work, do not want to go out, do not want to disability usually like activities and hobbies, often closed door to live alone, alienate friends and relatives, avoid social. In severe cases, even food and drink and their personal hygiene are not taken into account, and even develop into non-verbal, non-moving, non-food, and can reach the state of rigor mortis. Patients with anxiety may have symptoms such as fidgeting, finger grasping, hand rubbing or pacing around. Patients with severe depressive episodes are often accompanied by negative suicidal ideation and behavior. Negative pessimistic thoughts and self-blame can lead to desperate thoughts that “ending one’s life is a relief” and “one is redundant in the world”, and can promote planning for suicide and develop into suicidal behavior. The concept of suicide usually arises gradually, the lighter the person only feels that life is meaningless and not worth staying, and gradually the idea of sudden death arises, with the aggravation of depression, the concept of suicide becomes stronger and stronger, and tries to end oneself by all means. 4.Somatic symptoms. Mainly sleep disorders (mainly manifested as early awakening, usually 2 to 3 hours earlier than usual, unable to fall asleep after waking up, which is characteristic for the diagnosis of depressive episodes, and can also be manifested as difficulty in falling asleep and not sleeping deeply; a few manifest as excessive sleep), loss of appetite, weight loss, loss of libido, constipation, pain in any part of the body, impotence, amenorrhea, weakness, etc. Somatic discomfort can involve all organs. Autonomic dysfunction is also more common. 5. Other. Depersonalization, dissociation of reality and its obsessive-compulsive symptoms may occur. In addition to depression, most patients with geriatric depression have prominent anxiety and irritability, which can sometimes be manifested as irritability and hostility. Psychomotor retardation and somatic complaints are more pronounced than in younger patients. The symptoms of cognitive impairment, similar to dementia, may be more pronounced due to significant delays in thinking and memory loss, such as decreased ability to calculate, remember, understand and judge. Somatic complaints are more common in the digestive tract, such as loss of appetite, bloating, constipation, etc. They often dwell on a single physical complaint and tend to develop suspicion, which can lead to hypochondriacal, vain and sinful delusions. Bipolar disorder Clinical features: Repeated (at least twice) marked changes in mood and activity level, sometimes manifesting as elevated mood, high energy and increased activity, sometimes as depressed mood, low energy and decreased activity. The inter-episode period usually resolves completely. Manic and depressive symptoms may occur together in a single episode, such as a depressed state of mind with excessive activity and verbal urgency for days to weeks, and a manic state of mind with agitation, decreased energy and instinctive activity. Depressive and manic symptoms can also change rapidly, varying from day to day and even from time to time. The above are only the common clinical manifestations of the disease, and whether it is the disease or not needs to be analyzed by the specialist according to the specific situation of each patient. What I want to say to the patients and their families about the disease is: (1) I understand the patients’ pain very well, the patients’ emotional experience is really there, not something that the patients think about, not something that will disappear if the patients don’t want to; (2) Medication is very important to improve the patients’ depression/mania, improve sleep, appetite, weight, libido and other symptoms, form a new virtuous cycle, and improve the patients’ quality of life; (3) The patients’ family members’ (3) The support and understanding of the patient’s family is important to improve the patient’s confidence in treatment, and at the same time, as the patient’s family needs to be alert to the patient’s negative behaviors such as suicide.