“AFTER ALL, THERE IS NOTHING AS INTERESTING AS

PEOPLE, AND ONE CAN NEVER STUDY THEM

ENOUGH” VINCENT VAN GOGH

Depression and Bipolar Disorder

Acosta, Marry Rose D.

BS.PT-3

EAC-Cavite

Etiological Factors

• Hereditary Factors• Biochemical Hypothesis• Stressful Life Events• Cognitive Styles as Vulnerabilities

DEPRESSION DISORDER

• is a mental disorder characterized by a pervasive and persistent low mood that is accompanied by low self-esteem and by a loss of interest or pleasure in normally enjoyable activities.

History In Ancient Greece, disease was thought due to an imbalance

in the four basic bodily fluids, or humors. Personality types were similarly thought to be determined

by the dominant humor in a particular person. Derived from the Ancient Greek melas, "black", and kholé,

"bile", Melancholia -described as a distinct disease with particular

mental and physical symptoms by Hippocrates in his Aphorisms, where he characterized all "fears and despondencies, if they last a long time" as being symptomatic of the ailment.

Aretaeus of Cappadocia

-is one of the most celebrated of the ancient Greek physiciansThere is some uncertainty regarding both his age and country, he practiced in the 1st century CE, during the reign of Nero or Vespasian.-later noted that were "dull or stern; dejected or unreasonably torpid, without any manifest cause".-The humoral theory fell out of favor but was revived in Rome by Galen. Melancholia was a far broader concept than today's depression; prominence was given to a clustering of the symptoms of sadness, dejection, and despondency, and often fear, anger, delusions and obsessions were included-His work, The Canon of Medicine, became the standard of medical thinking in Europe alongside those of Hippocrates and Galen.

• Kurt SchneiderKurt Schneider

--German psychiatrist  coined the German psychiatrist  coined the terms endogenous depression and reactive terms endogenous depression and reactive depression in 1920, he latter referring to depression in 1920, he latter referring to reactivity in mood and not reaction to reactivity in mood and not reaction to outside events, and therefore frequently outside events, and therefore frequently misinterpreted. The division was challenged misinterpreted. The division was challenged in 1926 by Edward Mapother who found no in 1926 by Edward Mapother who found no clear distinction between the types.clear distinction between the types.

Sigmund Freud -had likened the state of melancholia to

mourning in his 1917 paper Mourning and Melancholia. He theorized that objective loss, such as the loss of a valued relationship through death or a romantic break-up, results in subjective loss as well; the depressed individual has identified with the object of affection through an unconscious, narcissistic process called the libidinal cathexis of the ego.

Bipolar Disorder

•  -is a mental illness. Individuals with bipolar disorder experience episodes of an elevated or agitated mood known as mania, alternating with episodes of depression.

• - Bipolar disorder is the name used to describe a set of 'mood swing' conditions, the most severe form of which used to be called 'manic depression'.

• The high moods are called mania or hypomania and the low mood is called depression.

• However, it is important to note that everyone has mood swings from time to time. It is only when these moods become extreme and interfere with personal and professional life that bipolar disorder may be present and a psychiatric assessment may be warranted.

Types of Bipolar Syndrome• Bipolar disorder I is the more severe disorder in

terms of symptoms- with individuals being more likely to experience mania, have longer 'highs', be more likely to have psychotic experiences and be more likely to be hospitalised.

• Bipolar disorder II is diagnosed when a person experiences the symptoms of a high but with no psychotic experiences. These hypomanic episodes tending to last a few hours or a few days, but longitudinal studies suggest impairment is often as severe as in bipolar I disorder.

History of Bipolar Syndrome The ancient Greeks and Romans were responsible for the terms

“mania” and “melancholia,” which are now the modern day manic and depressive. They even discovered that using lithium salts in baths calmed manic patients and lifted the spirits of depressed people. Today, lithium is a common treatment for bipolar patients.

The Greek philosopher Aristotle not only acknowledged melancholy as a condition, but thanked it as the inspiration for the great artists of his time. 

It was common during this time that people across the globe were executed for having bipolar disorder and other mental conditions because as the study of medicine advanced, strict religious dogma stated these people were possessed by demons and should therefore be put to death

• Robert Burton

• -In the 17th Century, Robert Burton wrote the book, The Anatomy of Melancholy, which addressed the issue of treating melancholy (non-specific depression) using music and dance as a form of treatment. While mixed with medical knowledge, the book primarily serves as a literary collection of commentary of depression, and vantage point of the full effects of depression on society. It did, however, expand deeply into the symptoms and treatments of what is now known as clinical depression. 

Signs and symptoms

• There are four types of mood episodes in bipolar disorder:

• mania,

• hypomania,

• depression, and

• mixed episodes.

• Each type of bipolar disorder mood episode has a unique set of symptoms.

Signs and symptoms of mania

• In the manic phase of bipolar disorder,

• feelings of heightened energy, creativity, and

• euphoria are common

• People experiencing a manic episode often talk a mile a minute, sleep very little, and are hyperactive.

• They may also feel like they’re all-powerful, invincible, or destined for greatness.

Hypomania symptoms• Hypomania is a less severe form of mania.

• People in a hypomanic state feel euphoric, energetic, and productive, but they are able to carry on with their day-to-day lives and they never lose touch with reality To others, it may seem as if people with hypomania are merely in an unusually good mood. However, hypomania can result in bad decisions that harm relationships, careers, and reputations. In addition, hypomania often escalates to full-blown mania or is followed by a major depressive episode.

Common symptoms of bipolar depression include:

• Feeling hopeless, sad, or empty.

• Irritability

• Inability to experience pleasure

• Fatigue or loss of energy

• Physical and mental sluggishness

• Appetite or weight changes

• Sleep problems

• Concentration and memory problems

• Feelings of worthlessness or guilt

• Thoughts of death or suicide

Signs and symptoms of a mixed episode

• A mixed episode of bipolar disorder features symptoms of both mania or hypomania and depression.

• Common signs of a mixed episode include depression combined with agitation, irritability, anxiety, insomnia, distractibility, and racing thoughts.

• This combination of high energy and low mood makes for a particularly high risk of suicide.

TREATMENT OPTIONS

• Hospitalization for mania, severe depression

• Lifestyle change

• Substance abuse treatment

• Therapy that can help you overcome your depression

• Psychotherapy

• Electric shock treatment

• Interpersonal therapy

• Psychodynamic therapy

• Cognitive behavioral therapy

• Natural ways to overcome your depression

• Exercise

• Nutrition

• Get enough sleep

• Three types of therapy are especially helpful in the treatment of bipolar disorder

• Cognitive-behavioral therapy

• Interpersonal and social rhythm therapy

• Family-focused therapy

• Complementary treatments for bipolar disorder

• Light and dark therapy

• Mindfulness meditation

• Acupuncture

NEVER GIVE UP

It will help patient to be inspired by us, rather than the

other way around.

Thank You…

References American Psychiatric Association Steering Committee on Practice Guidelines (2004). American Psychiatric Association Steering Committee on Practice Guidelines (2004).

Practice guidelines for the treatment of patients with bipolar disorder, In Practice guidelines for the treatment of patients with bipolar disorder, In American American Psychiatric Association Practice Guidelines for the Treatment of Psychiatric Disorders: Psychiatric Association Practice Guidelines for the Treatment of Psychiatric Disorders: Compendium 2004 Compendium 2004 (pp(pp. . 526-612). Arlington: American Psychiatric Association. 526-612). Arlington: American Psychiatric Association.

Buaer, M. & McBride, L. (1996). Buaer, M. & McBride, L. (1996). Structured Group Psychotherapy for Bipolar Disorder: The Structured Group Psychotherapy for Bipolar Disorder: The Life Goals Program. Life Goals Program. New York: Springer Publishing Company.New York: Springer Publishing Company.

Huxley, N., Parikh, S. & Baldessarini, R. (2000). Effectiveness of psychosocial treatments in Huxley, N., Parikh, S. & Baldessarini, R. (2000). Effectiveness of psychosocial treatments in Bipolar Disorder: State of the evidence. Bipolar Disorder: State of the evidence. Harvard Review of Psychiatry, Harvard Review of Psychiatry, 8, 126-140. 8, 126-140.

Nathan, P. & Gorman, J. (2002). Nathan, P. & Gorman, J. (2002). A Guide to Treatments That Work. A Guide to Treatments That Work. New York: Oxford New York: Oxford University Press. University Press.

Newman, C., Leahy, R., Beck, A., Reilly-Harrington, N. & Gyulai, L. (2002). Newman, C., Leahy, R., Beck, A., Reilly-Harrington, N. & Gyulai, L. (2002). Bipolar Bipolar Disorder: A Cognitive Therapy Approach. Disorder: A Cognitive Therapy Approach. Washington, D.C.: American Psychological Washington, D.C.: American Psychological Association.Association.

Rivas-Vazquez, R., Johnson, S., Rey, G., Blais, M. & Rivas-Vazquez, A. (2002). Current Rivas-Vazquez, R., Johnson, S., Rey, G., Blais, M. & Rivas-Vazquez, A. (2002). Current treatments for Bipolar Disorder : A review and update for psychologists. treatments for Bipolar Disorder : A review and update for psychologists. Professional Professional Psychology: Research and Practice, Psychology: Research and Practice, 33, 212-223. 33, 212-223.

Vieta, E. & Colom, F. (2004). Psychological interventions in Bipolar Disorder: From Vieta, E. & Colom, F. (2004). Psychological interventions in Bipolar Disorder: From wishful thinking to an evidence-based approach. wishful thinking to an evidence-based approach. Acta Psychiatrica Scandinavica,Acta Psychiatrica Scandinavica,110, 34-38. 110, 34-38. Kaplan and sadock's synopsis of psychiatry ebookKaplan and sadock's synopsis of psychiatry ebook