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Re: cause of manic depression

Posted by Durga on September 1, 1998, at 1:30:14

In reply to Re: cause of manic depression, posted by Toby on August 7, 1998, at 11:49:35

> No. A trauma in childhood can result in depression in a child or can later come back as delayed post traumatic stress disorder or contribute to almost lifelong chronic depression (mild or severe). But manic depression is different. Mania is a spell of feeling super great, maybe extremely irritable, there's an increase in activity (starting a bunch of new projects, cleaning, taking on extra work), grandiose thinking like you have special powers or you're someone famous, need only a few hours of sllep but still have tons of energy, thoughts go faster than you can talk no matter how fast you talk, too distractible, using poor judgement and doing things that may be harmful like running up thousands of dollars on the credit card in a few days or suddenly getting promiscuous. This kind of behavior and thinking is caused by a chemical problem that can be inherited or caused by some glitch in the brain's wiring. Drugs can trigger it but usually only in people who were susceptible to it in the first place, the drugs just make it come on earlier. Some medical illnesses and certain medications like high dose steroids can trigger a manic episode but usually treating the illness and removing the offending medication will fix the problem without recurrence.

Bipolar Disorder (Manic Depressive Illness) is overwhelmingly believed to be a biological disorder rather than a disorder of reaction to trauma. Current thinking is relating Bipolar Disorder to Epilepsy or other seizure disorder. This hypothesis purports that in Bipolar Disordered individuals, as stressors build, the thresh hold to an episode of mania or depression is lowered until electrical activity in the brain can no longer regulate receptor sites for various neurotransmitters, such as serotonin, norepinepherine, Dopamine, GABA, muscarinic, nicotinic, opiate, histamine and cholinergic sites. Like a siezure in epilepsy, there is a thresh hold of stimuli the brain can handle. Increase stimuli beyond that thresh hold and there is an uncontrolled electrical discharge which inhibits the brain from properly regulating areas that affect memory, sensory-motor perception and control, respiration and countless others as is evidenced visually when observing and individual during the tonic and clonic phases of a generalized or partial-complex seizure. Interestingly, sensory perceptions reported by individuals during a seizure originating in the temporal lobe of the brain are similar, though of far less duration, to those reported by people during an episode of severe mania or depression. In addition, it now seems that lithium is not the most affective treatment for Bipolar Disorder. The last 10-15 years have revealed that medications for seizure disorders are as effective if not more effective in controlling episodes. Medications in the antisiezure class that are widley prescribed include Depakote (currently most favored choice of treatment), Klonopin, Tegratol, Lamictal, and Nurontin.
One idea that does come to mind when a person seems to go through rapid mood shifts that only last a few hours or days at the very most, and is often misdiagnosed as Bipolar Disorder is Borderline Personality Disorder( I think it's a bad name for a disorder because it confuses many people with it's name and what an individual with this disorder actually presents with for treatment. These individuals very often have had difficult childhoods, whether as severe as abuse or in the relationships with parents. Theory today states Borderline personalities are not illnesses as in Bipolar or Major Depressive Disorder. Rather these individuals have developed a systematic and rigid way to deal with every day stress and relationships. Some individuals go through sharp changes in mood quickly in response to a stressor in their environment. Unlike Bipolar, these mood changes are of very short duration and usually not of the same severity. Also, once the perceived threat or stressor has been resolved, the Borderline Personality returns to a baseline mood. In Bipolar and Major Depressive Disorder, even removing a stressor that may have contributed to the triggering of an episode, the individual most likely continue in their episode until medication relieves the symptoms or with enough time, the person may have a spontaneous recovery. With continued medication treatment, episodes can be greatly diminished.
In summary: Bipolar is biologic; has severe, long lasting symptoms that do not respond to the environment.
Borderline Personality is most probably not biologic, rather is the collection of patterns of behaviors that may hhave formed as a result of abuse or relationship instability with parents as a child. The mood changes are of shorter duration, are not as severe clinically and they often respond to resolution of a conflict in the environment. There currently is no standard medication of choice to treat a Borderline Personality.
Hope I was able to help and not confuse w/ all of the details.




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