Alternating episodes of mania and depression, a "roller coaster" mood is actually related to this disease!

Mr. Lu (pseudonym), 33 years old, felt depressed 5 years ago and had no interest in doing anything, but the symptoms improved on their own. 4 years ago, he felt depressed again, had suicidal thoughts, and wrote a suicide note, and was diagnosed with depressive disorder.

Three years ago, he suddenly became excited, talkative, irritable, exaggerated, spoke fast, easily changed the subject, was busy all day, liked to dress up, and loved to socialize with the opposite sex. In the past two years, his condition has recurred, with alternating manic and depressive symptoms. After adjusting the medication in the outpatient clinic, the condition has been basically relieved. During this period, he was able to work and take care of his parents.

In the past month, he became excited, talkative, slept less, lost temper and threw things. At the persuasion of his parents, he was admitted to the Adult Psychiatry Department (male) of Hunan Provincial Second People's Hospital (Provincial Brain Hospital) for inpatient treatment and was diagnosed with bipolar disorder.

Li Xinchun, director of the adult psychiatry department (male) , introduced that bipolar disorder, also known as bipolar affective disorder, refers to a type of mood disorder with simultaneous manic (or hypomanic) episodes and depressive episodes. It generally presents an episodic course, with mania and depression often cyclically or alternately occurring, or they may exist in a mixed manner. Each episode of symptoms often lasts for a period of time and has adverse effects on the patient's daily life and social functions.

The pathogenesis of this disease is still unclear, but a large number of studies have shown that genetic factors, neurochemical factors, and psychosocial factors have a significant impact on the occurrence of this disease. Most cases have an acute or subacute onset, and are more likely to occur in late spring and early summer.

Treatment of bipolar disorder follows these principles:

1. Principle of comprehensive treatment: Treatment includes psychotropic medication, physical therapy, psychotherapy (including family therapy) and crisis intervention.

2. Principle of individualized treatment: When formulating a treatment plan, it is necessary to consider many factors such as the patient's gender, age, main symptoms, physical condition, whether to use combined medications, first onset or recurrence, previous treatment history, etc., and select appropriate drugs.

3. Principles of long-term treatment: Treatment is divided into three stages, namely acute treatment, consolidation treatment and maintenance treatment.

4. Mood stabilizers are the basic treatment principle.

5. Principles of combined medication.

6. The principle of regular testing of blood drug concentrations.

Research has found that patients who have recovered from drug treatment have a high relapse rate within one year after stopping medication, and the relapse rate of bipolar disorder is significantly higher than that of unipolar depressive disorder. The vast majority of bipolar disorder patients may have multiple relapses. Director Li Xinchun reminds patients to take medication strictly according to doctor's orders, not to stop or reduce medication without permission, and to have regular checkups.

Hunan Medical Chat Special Author: Liu Zhiying, Department of Adult Psychiatry (Male), Hunan Second People's Hospital (Provincial Brain Hospital)

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(Edited by YH)