Why do mania and depression merge?

From the perspective of pathopsychology, "mania" and "depression" are both caused by emotional problems. If a person is emotionally unstable for a long time, it will cause mania or depression. This is because there is something wrong with his (her) life rhythm. Pathopsychology calls mania and depression "emotional disorder".

Mania shows that a person's mood is often in a state of excitement; On the contrary, depression shows that a person's mood is often in a low state. Mania and depression often accompany each other, or alternate attacks. Psychiatrists are collectively called "bipolar disorder" (manic-depressive psychosis).

In the novel "New Era", Tong Qi (also known as "Gao Tao") vividly introduces the performance of a bipolar patient: "He is very aggressive and thinks that others are too right and only he is extremely left; When the storm breaks out, as long as he sees some shortcomings, he will become pessimistic and inevitably hold a disappointed attitude towards reality. Probably because I often change my taste, I am often bored and unhappy at all. This kind of person can be said to be the melancholy bug of the times. He crawled and scratched everywhere, and as a result, others got up and fought because they couldn't beat the corrosion of melancholy, so melancholy had to be left to him to chew. In fact, he is still a good man. However, it's too shaking, and sometimes I can lead people to shake with him. ..... is this kind of person who has no confidence in anything, just like a child playing with a toy. Once he is happy, he doesn't love anything, and gradually he will be destroyed. He consciously walked ahead, yes, to some extent, we also admit; But sometimes he makes a mess of things! In short, such people are too easily excited and too easily depressed. "

You see, the hero in Tong Qi's novels is undoubtedly a petty-bourgeois revolutionary who wavered in the 1930s and 1940s, but if analyzed from the perspective of mental illness, he is undoubtedly a bipolar patient with manic depression.

According to statistics, in western society, manic-depressive patients account for about10%-20% of all mental patients; In the 1970s, about 6 million people in the United States suffered from bipolar disorder. In densely populated areas, the incidence of bipolar disorder was 0.5%. In addition, among intellectuals and upper-class society, there are more patients with bipolar disorder, which is obviously related to the fierce competition of mental work and nerve-racking. Similarly, generally speaking, ethnic groups with higher education level have a higher probability of suffering from manic depression, while uncivilized ethnic groups have a lower probability of suffering from manic depression; There are more women in gender; In terms of age, 20-24 years old is the most, followed by 50-54 years old. Melancholy is 6 ~ 7 times that of mania.

Although there are genetic reasons for bipolar disorder, it is mainly caused by psychological reasons. It is said that British Prime Minister Churchill suffered from bipolar disorder during World War II. In order to avoid depression, Churchill's drinking caused a stroke. Churchill, the great bourgeois politician, suffered from bipolar disorder. Isn't it because of the psychological reasons of internal and external difficulties and the clouds of war? (1) Manic depression has the following characteristics:

① Most patients have periodic attacks, that is, they go through a good and bad process from normal to morbid and then to normal to morbid. Usually, like ordinary people, there are no defects. For example, there is a 29-year-old woman in Florida, USA, who has been normal for weeks or months; During this period, she was very happy, just like normal people. However, she will cry for months, feel weak and fall into a melancholy state; During this period, she was often depressed and even wanted to commit suicide. Not only that, she will continue to fall into a manic period of several months; During this time, she was active to a frightening degree. For example, she can work energetically 18 hours a day (she works in a newspaper); At the same time, she is very active and talks endlessly, snapping up unnecessary items crazily, and trivial things like drinking and sesame seeds can also cause rage, so that all her friends want to avoid her.

After the disease is cured, it will not leave any sequelae and will not become dementia.

(3) Simple depression, if it continues to be bad after more than one year, may be complicated with other organic diseases, and it is also necessary to check that there may still be some psychological pressure that has not been eliminated.

(2) Bipolar disorder has a cause.

The cause of mania is still inconclusive, while the cause of depression is relatively clear. Now I realize that there are several aspects:

(1) is caused by the patient's unique personality. Bipolar patients are almost stubborn in character. Unlike normal people, their feelings can rise and fall, but once they break out, they will last for a long time and become stronger and stronger; Work hard and appear resolute and thorough; Have a strong sense of justice and responsibility, and can win the respect and trust of others; Very suitable for invention and creation.

However, if people with this personality develop a strong sense of justice and responsibility in the direction of seeking their own rights, they will become quarrelsome and fanatical. This tendency often plays an important role in the onset of bipolar disorder. People with this disposition should have a good rest when they are very excited, but they will "whip" themselves to continue their work, so they are tired, manic or depressed and become uninterested in anything.

② It is related to the condition at the time of onset. For women, most of the reasons that easily lead to depression are specific family problems such as moving, having children, spouse's death and children's marriage. For men, it is mostly because of work problems such as job transfer and job promotion. As for depression caused by various physical diseases, work-related accidents, and the death of loved ones, both men and women have it.

The research on the situational causes of mania is relatively weak, but it is certain that there are: economic distress, relocation, job transfer, death of a close relative, physical illness, accidental trauma and so on. It has been suggested that the change of seasons, the change of endocrine system, even the disruption of daily life, the oppression and coercion of external forces, etc. , can also cause this disease.

Many bipolar disorders occur in the same family system. According to the research report, about 24% children of bipolar patients also suffer from bipolar disorder. However, in contrast, in normal adults, the detection rate of manic depression is only 0.4%. It can be seen that bipolar disorder is hereditary, but it cannot be concluded that bipolar disorder is completely determined by heredity. Studies on twins have confirmed that although the incidence of identical twins (monozygotic twins) is as high as 50%- 100%, the incidence of fraternal twins (monozygotic twins) is as low as 30% or even less. This situation strongly refutes the view that manic depression is completely determined by heredity.

Bipolar disorder is an emotional disease, which is caused by the dysfunction of the emotional center of the brain. According to the latest biological research, the "amine" metabolism related to the function of the hypothalamus and limbic system of the brain, if abnormal, will cause manic depression. There is a biologist abroad named Hilde Kraut. After years of experimental research, he believes that mania is caused by the increase of catecholamine in body fluids, while depression is caused by the decrease of catecholamine.

There are other different explanations for the physiological mechanism and biological factors of manic depression, which are not listed here. In a word, bipolar disorder is neither mysterious nor terrible. As long as we find the cause, we can "prescribe the right medicine" and get good results.

Because mania and depression often coexist, they can be divided into: ① rigid mania; (2) rigid melancholy state; ③ Amorphous manic state; ④ There are four types of amorphous depression.

With the rapid development of modern psychiatry, clinical experience has proved that bipolar disorder can be cured in a short time with the cooperation of psychotherapy. More than 20 years ago, the era when bipolar disorder could only be treated by "electroshock therapy" is gone forever. At present, electroshock therapy is only used occasionally for patients with excited mania, when they refuse to eat and are particularly resistant to drugs, and when patients with depression are in a serious coma.

At present, there are many specific drugs that can treat patients with mania and depression. Clinical experience fully proves that both mania and depression can be completely cured in a short time as long as these drugs are combined with psychotherapy. Therefore, there is no need to have any terrible thoughts about bipolar disorder. A physician I know used "continuous sleep therapy" to give a patient with depression a large dose of sleeping pills, which made him sleep all day and all of them were cured.

Psychotherapy is a very effective adjuvant therapy for manic depression. This therapy refers to a kind of psychotherapy to treat mental illness without drug treatment. It talks with mental patients through inspiration, advice, suggestions and consultation to enhance mutual understanding and trust. Therefore, in psychotherapy, we should first pay attention to gaining the trust of patients; At the same time, it is a shameful idea to help patients get rid of bipolar disorder. "Biography of Vivien Leigh" said: "Vivian has always regarded Dr. Donach as a benefactor, and only he kindly said to her,' You are ill, I can help you', so Vivian trusts him very much. Jack, the actor's dying partner, comforted her and said, "Why are you ashamed?" You set an example for many people with this disease. As long as you think that you have achieved success again and again in the struggle against the disease, I believe that all people will get inspiration and strength from you. "

The full respect and trust of Dr. Donak and Jack for Vivien Leigh and their sincere concern for her have a great influence on Vivien Leigh's bipolar disorder.