Misplaced Pages

#928071

105-552: The symptoms of mania include elevated mood (either euphoric or irritable), flight of ideas , pressure of speech , increased energy, decreased "need" and desire for sleep, and hyperactivity . They are most plainly evident in fully developed hypomanic states, however, in full-blown mania, these symptoms become progressively exacerbated . In severe manic episodes, these symptoms may even be obscured by other signs and symptoms characteristic of psychosis , such as delusions, hallucinations, fragmentation of behavior, and catatonia . Mania

210-399: A but still an ego ideal and phallic function; he places "psychotic autism" where there is no objet petit a , no social mirror , and the absence of the ego ideal and absence of the phallic function. Jaspers defined this as a delusion arising without apparent cause. For example, suddenly, without apparent cause, having the delusional belief that one is an alien. Autokabalesis is

315-422: A 2021 research study, Nguyen et al. (2021) propose that maybe the premise that suicidal ideation is a kind of illness has been an obstacle to dealing with suicidal ideation. They use a Bayesian statistical investigation, in conjunction with the mindsponge theory, to explore the processes where mental disorders have played a very minor role and conclude that there are many cases where the suicidal ideation represents

420-447: A child does not speak at all in certain situations (such as in school) but speaks well in other conditions (like at home or at play). A rare cause of mutism is akinetic mutism which results due to a lesion around the third ventricle of the brain. Apperception is a normal phenomenon and refers to the ability to understand sensory inputs in their context, to interpret them and to incorporate them into experience. Failure of apperception

525-429: A close relationship with their father during middle adolescence. An article published in 2010 by Zappulla and Pace found that suicidal ideation in adolescent boys is exacerbated by detachment from the parents when depression is already present in the child. Lifetime prevalence estimates of suicidal ideation among nonclinical populations of adolescents generally range from 60% to 75% and in many cases its severity increases

630-432: A connection between suicidal thoughts and tendencies and taking antidepressants, increasing the risk of suicidal thoughts in some patients. Some medications, such as selective serotonin reuptake inhibitors (SSRIs), can have suicidal ideation as a side effect. Moreover, these drugs' intended effects, can themselves have the unintended consequence of increased individual risk and collective rate of suicidal behavior: Among

735-532: A course of early detection for suicidal ideation in teens stating that "risks associated with suicidality require an immediate focus on diminishing self-harming cognitions so as to ensure safety before attending to the underlying etiology of the behavior". A Psychological Distress scale known as the K10 was administered monthly to a random sample of individuals. According to the results among the 9.9% of individuals who reported "psychological distress (all categories)" 5.1% of

840-527: A degree that the feelings, thoughts and desires of a person are governed by their internal apprehension of the world and not by an external reality shared with others. Today the term is used most often to refer to a specific developmental syndrome (see autism spectrum ). Autistic thinking refers to a cognitive progress that is not in accordance with consensus reality , but rather emphasizes preoccupation with inner experiences and needs. See also § dereistic thinking . More generally, it means thinking that

945-619: A few weeks and complete recovery usually occurs within two or three months. Brain fag syndrome is an example of a culture-bound syndrome. "Brain fag" was once a common term for mental exhaustion. Today, the syndrome describes students (predominantly males, particularly in West Africa) experiencing symptoms including somatic, sleep-related and cognitive complaints, head and neck pains, difficulty in concentrating and retaining information, and eye pain. Synonym of § clouding of consciousness . Bruxism refers to teeth grinding behavior that

1050-497: A lack of will or initiative. The individual is unable to act or make decisions independently. The condition may range from subtle to overwhelming in severity. Achromatopsia is a term referring to or acquired agnosia for color. This term includes color blindness . Achromatopsia is a condition characterized by a partial or total absence of color vision. People with complete achromatopsia cannot perceive any colors; they see only black, white, and shades of gray. Incomplete achromatopsia

1155-417: A level far beyond that which they would be capable of during euthymia . A very simple indicator of a manic state would be if a heretofore clinically depressed patient suddenly becomes inordinately energetic, enthusiastic, cheerful, aggressive, or "over-happy". Other, often less obvious, elements of mania include delusions (generally of either grandeur or persecution , according to whether the predominant mood

SECTION 10

#1732783289929

1260-499: A liability. English actor Stephen Fry , who has bipolar disorder , recounts manic behaviour during his adolescence: "When I was about 17 ... going around London on two stolen credit cards, it was a sort of fantastic reinvention of myself, an attempt to. I bought ridiculous suits with stiff collars and silk ties from the 1920s, and would go to the Savoy and Ritz and drink cocktails." While he has experienced suicidal thoughts , he says

1365-436: A manic episode as one where mood is higher than the person's situation warrants and may vary from relaxed high spirits to barely controllable exuberance, is accompanied by hyperactivity, a compulsion to speak, a reduced sleep requirement, difficulty sustaining attention, and/or often increased distractibility. Frequently, confidence and self-esteem are excessively enlarged, and grand, extravagant ideas are expressed. Behavior that

1470-452: A manic episode of bipolar disorder involves the utilization of either a mood stabilizer (e.g., carbamazepine , valproate , lithium , or lamotrigine ) or an atypical antipsychotic (e.g., olanzapine , quetiapine , risperidone , aripiprazole , or cariprazine ). More recently, substances such as iloperidone have been approved for the acute treatment of manic episodes related to bipolar I disorder . The use of antipsychotic agents in

1575-427: A non-mental medical illness (e.g., hyperthyroidism ), and: (a) is causing obvious difficulties at work or in social relationships and activities, or (b) requires admission to hospital to protect the person or others, or (c) the person has psychosis . To be classified as a manic episode, while the disturbed mood and an increase in goal-directed activity or energy is present, at least three (or four, if only irritability

1680-617: A number of treatment options for people who experience suicidal ideation. The ICD-11 describes suicidal ideation as "thoughts, ideas, or ruminations about the possibility of ending one's life, ranging from thinking that one would be better off dead to formulation of elaborate plans". The DSM-5 defines it as "thoughts about self-harm , with deliberate consideration or planning of possible techniques of causing one's own death". The U.S. Centers for Disease Control and Prevention defines suicidal ideation "as thinking about, considering, or planning suicide". Another term for suicidal ideation

1785-573: A patient's response is not clear or specific enough, and a method to rate the frequency and intensity of symptoms. Treatment of suicidal ideation can be problematic due to the fact that several medications have actually been linked to increasing or causing suicidal ideation in patients. Therefore, several alternative means of treating suicidal ideation are often used. The main treatments include: therapy, hospitalization, outpatient treatment, and medication or other modalities. There are no specific diets that can treat suicidal ideation. In psychotherapy

1890-430: A person could make them more engaging and outgoing, and cause them to have a positive outlook in life. When exaggerated in hypomania, however, such a person can display excessive optimism , grandiosity , and poor decision-making, often with little regard to the consequences. A single manic episode, in the absence of secondary causes, (i.e., substance use disorders , certain medications , or general medical conditions )

1995-514: A person explores the issues that make them feel suicidal and learns skills to help manage emotions more effectively. Hospitalization allows the patient to be in a secure, supervised environment to prevent suicidal ideation from turning into suicide attempts. In most cases, individuals have the freedom to choose which treatment they see fit for themselves. However, there are several circumstances in which individuals can be hospitalized involuntarily. These circumstances are: Hospitalization may also be

2100-450: A person has a comorbid psychiatric disorder, it may be difficult to find a medication that addresses both the psychiatric disorder and suicidal ideation. Antidepressants may be effective. Often, SSRIs are used instead of TCAs as the latter typically have greater harm in overdose. Antidepressants have been shown to be a very effective means of treating suicidal ideation. One correlational study compared mortality rates due to suicide to

2205-461: A person with this condition can have their limbs placed in fixed positions as if the person were in fact made from wax. Chorea refers to erratic involuntary movements. The term comes from the Greek word " choreia " or "dance" since usually large groups of muscles are involved simulating dance-like movements. Circumstantial thinking, or circumstantial speech, refers to a person being unable to answer

SECTION 20

#1732783289929

2310-488: A question without giving excessive, unnecessary detail. This differs from tangential thinking, in that the person does eventually return to the original point, circling back on-topic. Clang associations are ideas that are related only by similar or rhyming sounds rather than actual meaning. Claparede's paradox refers to retention of non-verbal and implicit memory in people with Korsakoff's syndrome . Clouding of consciousness , also known as brain fog or mental fog ,

2415-452: A review and meta-analysis exploring this relationship found that this assumption may be too general and empirical research evidence is lacking. In hypomania, there is less need for sleep and both goal-motivated behaviour and metabolism increase. Some studies exploring brain metabolism in subjects with hypomania, however, did not find any conclusive link; while there are studies that reported abnormalities, some failed to detect differences. Though

2520-595: A risk factor. During 2008–09, an estimated 8.3 million adults aged 18 and over in the United States, or 3.7% of the adult U.S. population, reported having suicidal thoughts in the previous year, while an estimated 2.2 million reported having made suicide plans in the previous year. In 2019, 12 million U.S. adults seriously thought about suicide, 3.5 million planned a suicide attempt, 1.4 million attempted suicide, and more than 47,500 died by suicide. Suicidal thoughts are also common among teenagers. Suicidal ideation

2625-528: A role of dopamine in mania. Decreased cerebrospinal fluid levels of the serotonin metabolite 5-HIAA have been found in manic patients too, which may be explained by a failure of serotonergic regulation and dopaminergic hyperactivity. Limited evidence suggests that mania is associated with behavioral reward hypersensitivity, as well as with neural reward hypersensitivity. Electrophysiological evidence supporting this comes from studies associating left frontal EEG activity with mania. As left frontal EEG activity

2730-491: A study of individuals who did die by suicide, 91% of them likely had one or more mental illnesses. However, only 35% of those individuals were treated or being treated for a mental illness. This emphasizes the importance of early detection; if a mental illness is detected, it can be treated and controlled to help prevent suicide attempts. Another study investigated strictly suicidal ideation in adolescents. This study found that depression symptoms in adolescents as early as 9th grade

2835-460: A term for committing suicide by jumping from a very high place. Automatic obedience is an exaggerated co-operation with an examiner's request, as if the individual were an " automaton " robotically obeying a command. It is often a sign of catatonia . Automatisms are sequences of activity that occur without conscious control. They may be simple and repetitive ( tic -like) or complex, and are usually natural-looking but purposeless. Automatic behavior

2940-445: A treatment option if an individual: Outpatient treatment allows individuals to remain at their place of residence and receive treatment when needed or on a scheduled basis. Being at home may improve quality of life for some patients, because they will have access to their personal belongings, and be able to come and go freely. Before allowing patients the freedom that comes with outpatient treatment, physicians evaluate several factors of

3045-521: A type of cost-benefit analysis for a life/death consideration, and these people may not be called "patients". Assessment seeks to understand an individual by integrating information from multiple sources such as clinical interviews; medical exams and physiological measures; standardized psychometric tests and questionnaires; structured diagnostic interviews; review of records; and collateral interviews. Psychologists, psychiatrists, and other mental health professionals conduct clinical interviews to ascertain

3150-959: Is antidepressant therapy. Studies show that the risk of switching while on an antidepressant is between 6-69 percent. Dopaminergic drugs such as reuptake inhibitors and dopamine agonists may also increase risk of switch. Other medications possibly include glutaminergic agents and drugs that alter the HPA axis . Lifestyle triggers include irregular sleep-wake schedules and sleep deprivation , as well as extremely emotional or stressful stimuli . Various genes that have been implicated in genetic studies of bipolar have been manipulated in preclinical animal models to produce syndromes reflecting different aspects of mania. CLOCK and DBP polymorphisms have been linked to bipolar in population studies, and behavioral changes induced by knockout are reversed by lithium treatment. Metabotropic glutamate receptor 6 has been genetically linked to bipolar, and found to be under-expressed in

3255-400: Is not usually recalled afterwards. Autoscopy is the reduplicative hallucination of "seeing one's own body from the outside" while still maintaining an egocentric visuo-spatial perspective. Autoscopy is sometimes used synonymously with out-of-body experience . Avolition is an inability to initiate and complete goal-directed behavior. It can sometimes be misinterpreted as laziness, but it

Mania - Misplaced Pages Continue

3360-688: Is suicidal thoughts . When someone who has not shown a history of suicidal ideation experiences a sudden and pronounced thought of performing an act which would necessarily lead to their own death, psychologists call this an intrusive thought . A commonly experienced example of this is the high place phenomenon , also referred to as the call of the void , the sudden urge to jump when in a high place. Euphemisms related to mortal contemplation include internal struggle , voluntary death , and eating one's gun . The risk factors for suicidal ideation can be divided into three categories: psychiatric disorders, life events, and family history. Suicidal ideation

3465-440: Is a catatonic subtype of schizophrenia . Cerea flexibilitas , meaning "waxy flexibility", refers to people allowing themselves to be placed in postures by others, and then maintaining those postures for long periods even if they are obviously uncomfortable. It is characterized by an individual's movements having the feeling of a plastic resistance, as if the person were made of wax . This occurs in catatonic schizophrenia , and

3570-488: Is a condition in which a person who has a certain disability seems unaware of the existence of their disability. § hemiasomatognosia is a subtype of anosognosia in which the person with hemiplegia neglects one half of their body. Anton syndrome , occasionally known as Anton-Babinski syndrome, is a form of cortical blindness in which the individual denies the visual impairment. The individual may attempt to walk, bumping into objects and injuring himself. Anton syndrome

3675-569: Is a disused psychiatric diagnosis. The phrase "running amok" describes the behavior of an individual who is very agitated and may be at danger of causing harm to themselves or others. The syndrome of "Amok" is found in the DSM-IV TR . Anhedonia refers to an inability to experience pleasure, and may be described as a feeling of emotional emptiness. It can be a negative symptom of schizophrenia. It also may be seen in severe depressive states and schizoid personality disorder . Anosognosia

3780-503: Is a global impairment in higher central nervous functioning. All aspects of cognitive functioning are affected. On mental status examinations it is manifest by disorientation in time, place and person, memory difficulties caused by failure to register and recall, aphasia , and agnosia . Impaired perception functioning leads to illusions and hallucinations often in the visual sensory modality. This then causes agitation and distress and secondary delusions . The term confusion state

3885-460: Is a milder form of the condition that allows some color discrimination. Achromatopsia also involves other problems with vision, including an increased sensitivity to light and glare (photophobia), involuntary back-and-forth eye movements (nystagmus), and significantly reduced sharpness of vision (low visual acuity). Affected individuals can also have farsightedness (hyperopia) or, less commonly, nearsightedness (myopia). These vision problems develop in

3990-470: Is a predictor of suicidal ideation. Most people with long-term suicidal ideation do not seek professional help. The previously mentioned studies point out the difficulty that mental health professionals have in motivating individuals to seek and continue treatment. Ways to increase the number of individuals who seek treatment may include: A study conducted by researchers in Australia set out to determine

4095-512: Is a symptom of many mental disorders and can occur in response to adverse life events without the presence of a mental disorder. There are several psychiatric disorders that appear to be comorbid with suicidal ideation or considerably increase the risk of suicidal ideation. For example, many individuals with borderline personality disorder exhibit recurrent suicidal behavior and suicidal thoughts. One study found that 73% of patients with borderline personality disorder have attempted suicide, with

4200-486: Is a syndrome with multiple causes. Although the vast majority of cases occur in the context of bipolar disorder , it is a key component of other psychiatric disorders (such as schizoaffective disorder , bipolar type) and may also occur secondary to various general medical conditions, such as multiple sclerosis ; certain medications may perpetuate a manic state, for example prednisone ; or substances prone to abuse, especially stimulants, such as amphetamine and cocaine . In

4305-596: Is actually a negative symptom of schizophrenia . Belle indifference or la belle indifférence is characterized by a lack of concern and feeling of indifference about a disability or symptom. It can be seen in conversion disorder . Bouffée délirante is a French term used in the past for acute and transient psychotic disorders (F23 in ICD-10 ). In DSM-IV , it is described as " brief psychotic disorder " (298.8). The symptoms usually have an acute onset and reach their peak within two weeks. The symptoms start resolving in

Mania - Misplaced Pages Continue

4410-431: Is associated with depression and other mood disorders ; however, many other mental disorders , life events and family events can increase the risk of suicidal ideation. Mental health researchers indicate that healthcare systems should provide treatment for individuals with suicidal ideation, regardless of diagnosis, because of the risk for suicidal acts and repeated problems associated with suicidal thoughts. There are

4515-556: Is associated with an increased rate of suicide and attempted suicide. The pro-suicidal effects of benzodiazepines are suspected to be due to a psychiatric disturbance caused by side effects, such as disinhibition , or withdrawal symptoms. Life events are strong predictors of increased risk for suicidal ideation. Furthermore, life events can also lead to or be comorbid with the previously listed psychiatric disorders and predict suicidal ideation through those means. Life events that adults and children face can be dissimilar and for this reason,

4620-493: Is caused by damaging the occipital lobes bilaterally or from disrupting the pathway from the primary visual cortex into the visual association cortex. Anwesenheit refers to the false perception of an unfamiliar presence. It is commonly associated with periods of grief, schizophrenia and other emotional disturbances. This is an alternate term for delusional perception. It is one of the Schneiderian first rank symptoms and

4725-443: Is defined as a true perception, to which an individual attributes a false meaning. Aphemia is the alternate term for mutism . Mutism is absence of speech with apparently normal level of consciousness. Mutism can be dissociative (hysterical) in which an individual (commonly a child or adolescent) stops speaking at once without involvement of any neurological or physical contributing factor; or it can be elective (selective) in which

4830-496: Is defined in the American Psychiatric Association 's diagnostic manual (DSM) as a "distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 1 week and present most of the day, nearly every day (or any duration, if hospitalization is necessary)," where the mood is not caused by drugs/medication or

4935-417: Is driven by internally oriented wishes and desires regardless of external factors. Lacanian Leon Brenner, citing Laurent, places autism at a level between "Ausstoßung" and "Bejahung", at the "first level of signification", under the banner of "autistic foreclosure", with Imaginary-demand and Real-need but no Symbolic-desire. Lacanian Pablo Lerner places "neurotic autism" where there is no objet petit

5040-531: Is euphoric or irritable), hypersensitivity, hypervigilance , hypersexuality, hyper-religiosity, hyperactivity and impulsivity, a compulsion to over explain (typically accompanied by pressure of speech), grandiose schemes and ideas, and a decreased need for sleep (for example, feeling rested after only 3 or 4 hours of sleep). In the case of the latter, the eyes of such patients may both look and seem abnormally "wide open", rarely blinking, and may contribute to some clinicians' erroneous belief that these patients are under

5145-546: Is generally thought to be a reflection of behavioral activation system activity, this is thought to support a role for reward hypersensitivity in mania. Tentative evidence also comes from one study that reported an association between manic traits and feedback negativity during receipt of monetary reward or loss. Neuroimaging evidence during acute mania is sparse, but one study reported elevated orbitofrontal cortex activity to monetary reward, and another study reported elevated striatal activity to reward omission. The latter finding

5250-502: Is important to manage symptoms of mania and depression, studies show relying on medications alone is not the most effective method of treatment. Medication is most effective when used in combination with other bipolar disorder treatments, including psychotherapy , self-help coping strategies, and healthy lifestyle choices. Lithium is the classic mood stabilizer to prevent further manic and depressive episodes. A systematic review found that long term lithium treatment substantially reduces

5355-557: Is marked by the individual leaping from topic to topic which have only the most tenuous, if any, connection with each other. This is in contrast with flight of ideas , whereby the individual's successive ideas may be linked and "understandable" to the listener. See also § akataphasia and § entgleisen term introduced by (Cameron). From aut = "self" and - ism = "state or orientation". Originally, Eugen Bleuler used this term to describe schizophrenia. In general, it refers to any (pathological) tendency to be self-absorbed to such

SECTION 50

#1732783289929

5460-527: Is none. Akataphasia (Kraepelin 1896) refers to a syntactic disturbance of speech resulting from dissolution of logical ordering of thoughts. It manifests as rambling speech. Compare Derailment . Akathisia refers to a subjective feeling of restlessness in the lower limbs that is related to abnormal activity in the extrapyramidal system in the brain, often due to antipsychotic medication. It tends to manifest as an inability to sit still. Alexithymia refers to an inability to identify and describe emotions in

5565-423: Is not always the case that the clearly manic/hypomanic bipolar patient needs or wants medical help; such persons often either retain sufficient self-control to function normally or are unaware that they have "gone manic" severely enough to be committed or to commit themselves . Manic persons often can be mistaken for being under the influence of drugs . In a mixed affective state , the individual, though meeting

5670-475: Is often sufficient to diagnose bipolar I disorder . Hypomania may be indicative of bipolar II disorder . Manic episodes are often complicated by delusions and/or hallucinations ; and if the psychotic features persist for a duration significantly longer than the episode of typical mania (two weeks or more), a diagnosis of schizoaffective disorder is more appropriate. Certain obsessive–compulsive spectrum disorders as well as impulse-control disorders share

5775-428: Is out-of-character and risky, foolish or inappropriate may result from a loss of normal social restraint. Some people also have physical symptoms, such as sweating , pacing, and weight loss . In full-blown mania, often the manic person will feel as though their goal(s) are of paramount importance, that there are no consequences, or that negative consequences would be minimal, and that they need not exercise restraint in

5880-413: Is present) of the following must have been consistently present: Though the activities one participates in while in a manic state are not always negative, those with the potential to have negative outcomes are far more likely. If the person is concurrently depressed, they are said to be having a mixed episode . The World Health Organization 's International Classification of Diseases (ICD) defines

5985-613: Is seen in delirious states. Astasia-abasia is a form of psychogenic gait disturbance in which gait becomes impaired in the absence of any neurological or physical pathology. The person usually walks in a bizarre manner. They stagger and appear as if going to fall, but always manage to catch hold of something in time. Sometimes these people cannot even stand, but on the other hand they are well able to move their legs while lying down or sitting. Often associated with conversion disorder or somatization disorder. Asyndesis means loosening of association. A milder form of derailment of thought, it

6090-462: Is sometimes used to mean clouding of consciousness, but is avoided whenever possible because it is ambiguous. Suicidal ideation Suicidal ideation , or suicidal thoughts , is the thought process of having ideas, or ruminations about the possibility of completing suicide . It is not a diagnosis but is a symptom of some mental disorders , use of certain psychoactive drugs , and can also occur in response to adverse life circumstances without

6195-609: Is used to promptly alleviate symptoms of agitation, aggression , and psychosis . Antidepressant monotherapy is not recommended for the treatment of depression in patients with bipolar disorders I or II, and no benefit has been demonstrated by combining antidepressants with mood stabilizers in these patients. Some atypical antidepressants , however, such as mirtazapine and trazodone , have been occasionally used after other options have failed. In Electroboy: A Memoir of Mania by Andy Behrman, he describes his experience of mania as "the most perfect prescription glasses with which to see

6300-485: Is useful from a descriptive and differential diagnostic point of view. Mania varies in intensity, from mild mania ( hypomania ) to delirious mania, marked by such symptoms as disorientation, acute psychosis , incoherence, and catatonia . Standardized tools such as Altman Self-Rating Mania Scale and Young Mania Rating Scale can be used to measure severity of manic episodes. Because mania and hypomania have also long been associated with creativity and artistic talent, it

6405-418: Is usually seen in children. In Capgras syndrome , the individual feels that a person familiar to them, usually a family member, has been replaced by an imposter . This is a type of delusion that can be experienced as part of schizophrenia . Capgras syndrome and several other related disorders are referred to as " delusional misidentification syndrome ". Catalepsy is the term for catatonic rigidity of

SECTION 60

#1732783289929

6510-618: The ICD-10 , there are several disorders with the manic syndrome: organic manic disorder ( F06.30 ), mania without psychotic symptoms ( F30.1 ), mania with psychotic symptoms ( F30.2 ), other manic episodes ( F30.8 ), unspecified manic episode ( F30.9 ), manic type of schizoaffective disorder ( F25.0 ), bipolar disorder , current episode manic without psychotic symptoms ( F31.1 ), bipolar affective disorder, current episode manic with psychotic symptoms ( F31.2 ). Before beginning treatment for mania, careful differential diagnosis must be performed to rule out secondary causes. The acute treatment of

6615-1368: The amygdala and other subcortical structures such as the ventral striatum tend to be increased, although results are inconsistent and likely dependent upon task characteristics such as valence. Reduced functional connectivity between the ventral prefrontal cortex and amygdala along with variable findings supports a hypothesis of general dysregulation of subcortical structures by the prefrontal cortex. A bias towards positively valenced stimuli , and increased responsiveness in reward circuitry may predispose towards mania. Mania tends to be associated with right hemisphere lesions, while depression tends to be associated with left hemisphere lesions. Post-mortem examinations of bipolar disorder demonstrate increased expression of Protein Kinase C (PKC). While limited, some studies demonstrate manipulation of PKC in animals produces behavioral changes mirroring mania, and treatment with PKC inhibitor tamoxifen (also an anti-estrogen drug) demonstrates antimanic effects. Traditional antimanic drugs also demonstrate PKC inhibiting properties, among other effects such as GSK3 inhibition. Manic episodes may be triggered by dopamine receptor agonists , and this combined with tentative reports of increased VMAT2 activity, measured via PET scans of radioligand binding , suggests

6720-646: The subthalamic nucleus in Parkinson's disease has been associated with mania, especially with electrodes placed in the ventromedial STN . A proposed mechanism involves increased excitatory input from the STN to dopaminergic nuclei. There are certain psychoactive substances that can induce a state of manic psychosis, including: amphetamine , cathinone , cocaine , MDMA , methamphetamine , methylphenidate , oxycodone , phencyclidine , designer drugs , etc. Mania can also be caused by physical trauma or illness . When

6825-670: The ability to think clearly. Racing thoughts and misperceptions lead to frustration and decreased ability to communicate with others. Mania may also, as earlier mentioned, be divided into three "stages". Stage I corresponds with hypomania and may feature typical hypomanic characteristics, such as gregariousness and euphoria . In stages II and III mania, however, the patient may be extraordinarily irritable, psychotic or even delirious . These latter two stages are referred to as acute and delirious (or Bell's), respectively. Various triggers have been associated with switching from euthymic or depressed states into mania. One common trigger of mania

6930-460: The average patient having 3.4 attempts. The following list includes the disorders that have been shown to be the strongest predictors of suicidal ideation. These are not the only disorders that can increase the risk of suicidal ideation. The disorders in which risk is increased the greatest include: Antidepressant medications are commonly used to decrease the symptoms in patients with moderate to severe clinical depression , and some studies indicate

7035-412: The cases, the office visit took place within a week of the suicide, and most of the victims had a diagnosed depressive disorder. There are many centers where one can receive aid in the fight against suicidal ideation and suicide. Hemelrijk et al. (2012) found evidence that assisting people with suicidal ideation via the internet versus more direct forms such as phone conversations has a greater effect. In

7140-547: The cause of suicidal ideation . Upon the start of using antidepressants, many clinicians will note that sometimes the sudden onset of suicidal ideation may accompany treatment. This has caused the Food and Drug Administration (FDA) to issue a warning stating that sometimes the use of antidepressants may actually increase suicidal ideation. Medical studies have found antidepressants help treat cases of suicidal ideation and work especially well with psychological therapy. Lithium reduces

7245-744: The causes are physical, it is called secondary mania . In some individuals, manic symptoms are also correlated with the season of spring. The mechanism underlying mania is unknown, but the neurocognitive profile of mania is highly consistent with dysfunction in the right prefrontal cortex , a common finding in neuroimaging studies. Various lines of evidence from post-mortem studies and the putative mechanisms of anti-manic agents point to abnormalities in GSK-3 , dopamine , Protein kinase C , and Inositol monophosphatase . Meta analysis of neuroimaging studies demonstrate increased thalamic activity, and bilaterally reduced inferior frontal gyrus activation. Activity in

7350-416: The cortex. Pituitary adenylate cyclase-activating peptide has been associated with bipolar in gene linkage studies, and knockout in mice produces mania like-behavior. Targets of various treatments such as GSK-3 , and ERK1 have also demonstrated mania like behavior in preclinical models. Mania may be associated with strokes, especially cerebral lesions in the right hemisphere. Deep brain stimulation of

7455-400: The current DSM-5 , hypomanic episodes are separated from the more severe full manic episodes, which, in turn, are characterized as either mild, moderate, or severe, with certain diagnostic criteria (e.g., catatonia , psychosis ). Mania is divided into three stages: hypomania, or stage I; acute mania, or stage II; and delirious mania ( delirium ), or stage III. This "staging" of a manic episode

7560-494: The desire for suicide or its effects persists even as major obstacles to suicidal action are removed, with the effect that the incidences of suicide and suicide attempts increase. In 2003, the U.S. Food and Drug Administration (FDA) issued the agency's strictest warning for manufacturers of all antidepressants (including tricyclic antidepressants [TCAs] and monoamine oxidase inhibitors ) due to their association with suicidal thoughts and behaviors. Further studies disagree with

7665-406: The elevated mood and energy level typical of hypomania could be seen as a benefit, true mania itself generally has many undesirable consequences, including suicidal tendencies , and hypomania can, if the prominent mood is irritable as opposed to euphoric , be a rather unpleasant experience. In addition, the exaggerated case of hypomania can lead to problems. For instance, trait-based positivity for

7770-399: The father in late adolescence is "significantly related to suicidal ideation". Liu goes on to explain the relationship found between closeness with the opposite sex parent and the child's risk of suicidal thoughts. It was found that boys are better protected from suicidal ideation if they are close to their mothers through early and late adolescence; whereas girls are better protected by having

7875-428: The first few months of life. Achromatopsia is different from the more common forms of color vision deficiency (also called color blindness), in which people can perceive color but have difficulty distinguishing between certain colors, such as red and green. Mild illusions or misperceptions associated with changes in mood; e.g. mistaking a shadow for the presence of a person, perceiving movement in peripheral when there

7980-426: The flow of thoughts. Racing thoughts also interfere with the ability to fall asleep. Manic states are always relative to the normal state of intensity of the affected individual; thus, already irritable patients may find themselves losing their tempers even more quickly, and an academically gifted person may, during the hypomanic stage, adopt seemingly "genius" characteristics and an ability to perform and articulate at

8085-485: The former, speech, though adequate in verbiage, conveys very little information and may consist of stock phrases or vague references. In poverty of thought, by contrast, there is a far-reaching impoverishment of the entire thinking of the individual, who, as a result, says very little. It is typically a negative symptom of schizophrenia , although it may also be seen in advanced dementia. Amenomania (compound of Latin amoenus , "cheerful"; and Greek μανία, "madness")

8190-404: The general criteria for a hypomanic (discussed below) or manic episode, experiences three or more concurrent depressive symptoms. This has caused some speculation, among clinicians, that mania and depression, rather than constituting "true" polar opposites, are, rather, two independent axes in a unipolar—bipolar spectrum. A mixed affective state, especially with prominent manic symptoms, places

8295-439: The individual's lack of judgment and insight regarding periods of exacerbation of characteristic states. Manic patients are frequently grandiose, obsessive, impulsive, irritable, belligerent, and frequently deny anything is wrong with them. Because mania frequently encourages high energy and decreased perception of need or ability to sleep, within a few days of a manic cycle, sleep-deprived psychosis may appear, further complicating

8400-686: The influence of a stimulant drug, when the patient, in fact, is either not on any mind-altering substances or is actually on a depressant drug. Individuals may also engage in out-of-character behavior during the episode, such as questionable business transactions, wasteful expenditures of money (e.g., spending sprees), risky sexual activity, abuse of recreational substances, excessive gambling, reckless behavior (such as extreme speeding or other daredevil activity), abnormal social interaction (e.g., over-familiarity and conversing with strangers), or highly vocal arguments. These behaviours may increase stress in personal relationships, lead to problems at work, and increase

8505-478: The limbs which often results in abnormal posturing for long intervals. Cataplexy refers to a sudden loss of muscle tone and is commonly precipitated by a strong emotional response. Catatonia involves a significant psychomotor disturbance, which can occur as catalepsy , stupor , excessive purposeless motor activity, extreme negativism (seemingly motiveless resistance to movement), mutism , echolalia (imitating speech), or echopraxia (imitating movements). There

8610-688: The list of events that increase risk can vary in adults and children. The life events that have been shown to increase risk most significantly are: According to a study conducted by Ruth X. Liu of San Diego State University , a significant connection was found between the parent–child relationships of adolescents in early, middle and late adolescence and their likelihood of suicidal ideation. The study consisted of measuring relationships between mothers and daughters, fathers and sons, mothers and sons, and fathers and daughters. The relationships between fathers and sons during early and middle adolescence show an inverse relationship to suicidal ideation. Closeness with

8715-472: The manic side of his condition has had positive contributions on his life. The nosology of the various stages of a manic episode has changed over the decades. The word derives from the Ancient Greek μανία ( manía ), "madness, frenzy" and the verb μαίνομαι ( maínomai ), "to be mad, to rage, to be furious." Flight of Ideas This glossary covers terms found in the psychiatric literature;

8820-412: The nature of a patient or client's difficulties, including any signs or symptoms of illness the person might exhibit. Clinical interviews are "unstructured" in the sense that each clinician develops a particular approach to asking questions, without necessarily following a predefined format. Structured (or semi-structured) interviews prescribe the questions, their order of presentation, "probes" (queries) if

8925-440: The patient at a greater risk for suicide . Depression on its own is a risk factor but, when coupled with an increase in energy and goal-directed activity, the patient is far more likely to act with violence on suicidal impulses. Hypomania , which means "less than mania", is a lowered state of mania that does little to impair function or decrease quality of life. Although creativity and hypomania have been historically linked,

9030-414: The patient. These factors include the patient's level of social support, impulse control and quality of judgment. After the patient passes the evaluation, they are often asked to consent to a "no-harm contract". This is a contract formulated by the physician and the family of the patient. Within the contract, the patient agrees not to harm themself, to continue their visits with the physician, and to contact

9135-561: The physician in times of need. There is some debate as to whether "no-harm" contracts are effective. These patients are then checked on routinely to assure they are maintaining their contract and avoiding dangerous activities (drinking alcohol, driving fast and not wearing a seat belt, etc.). Prescribing medication to treat suicidal ideation can be difficult. One reason for this is that many medications lift patients' energy levels before lifting their moods. This puts them at greater risk of following through with attempting suicide. Additionally, if

9240-448: The presence of a mental disorder. On suicide risk scales, the range of suicidal ideation varies from fleeting thoughts to detailed planning. Passive suicidal ideation is thinking about not wanting to live or imagining being dead. Active suicidal ideation involves preparation to kill oneself or forming a plan to do so. Most people who have suicidal thoughts do not go on to make suicide attempts, but suicidal thoughts are considered

9345-430: The pursuit of what they are after. Hypomania is different, as it may cause little or no impairment in function. The hypomanic person's connection with the external world, and its standards of interaction, remain intact, although intensity of moods is heightened. But those with prolonged unresolved hypomania do run the risk of developing full mania, and may cross that "line" without even realizing they have done so. One of

9450-493: The risk of altercations with law enforcement. There is a high risk of impulsively taking part in activities potentially harmful to the self and others. Although "severely elevated mood" sounds somewhat desirable and enjoyable, the experience of mania is ultimately often quite unpleasant and sometimes disturbing, if not frightening, for the person involved and for those close to them, and it may lead to impulsive behaviour that may later be regretted. It can also often be complicated by

9555-467: The risk of bipolar manic relapse, by 42%. Anticonvulsants such as valproate , oxcarbazepine , and carbamazepine are also used for prophylaxis . More recent drug solutions include lamotrigine and topiramate , both anticonvulsants as well. In some cases, long-acting benzodiazepines , particularly clonazepam , are used after other options are exhausted. In more urgent circumstances, such as in emergency rooms, lorazepam , combined with haloperidol ,

9660-553: The risk of suicide in people with mood disorders. Tentative evidence finds clozapine in people with schizophrenia reduces the risk of suicide. Electroconvulsive therapy Suicidal ideation rates among lesbian , gay , bisexual , transgender ( LGBT ) youth are significantly higher than among the general population. Suicidal ideation, which has a higher prevalence among LGBT teenagers compared to their cisgender and heterosexual peers, has been attributed to minority stress , bullying, and parental disapproval. South Korea has

9765-548: The risk of suicide. Parents who are unaccepting of their child's expressed LGBT sexuality, especially in a predominantly Christian culture as exists in South Korea, creates a hotbed for suicidal ideation (see under LGBT youth below). Early detection and treatment are the best ways to prevent suicidal ideation and suicide attempts. If signs, symptoms, or risk factors are detected early then the individual might seek treatment and help before attempting to take their own life. In

9870-573: The same participants reported suicidal ideation. Participants who scored "very high" on the Psychological Distress scale "were 77 times more likely to report suicidal ideation than those in the low category". In a one-year study conducted in Finland, 41% of the patients who later died by suicide saw a healthcare professional, most seeing a psychiatrist. Of those, only 22% discussed suicidal intent on their last office visit. In most of

9975-563: The self. In Alice in Wonderland experience, individuals perceive objects (including animals and other humans, or parts of humans, animals, or objects) as appearing substantially smaller than in reality. Generally, the object appears far away or extremely close at the same time. An alternate term for this is somaesthetic aura . Also see § Lilliputian hallucinations Literally, this term means "not having words". The term may refer to either "poverty of speech" or "poverty of thought". In

10080-591: The set of persons taking the medication, a subset feel bad enough to want to attempt suicide (or to desire the perceived results of suicide) but are inhibited by depression-induced symptoms, such as lack of energy and motivation, from following through with an attempt. Among this subset, a "sub-subset" may find that the medication alleviates their physiological symptoms (such as lack of energy) and secondary psychological symptoms (e.g., lack of motivation) before or at lower doses than it alleviates their primary psychological symptom of depressed mood. Among this group of persons,

10185-416: The signature symptoms of mania (and to a lesser extent, hypomania ) is what many have described as racing thoughts . These are usually instances in which the manic person is excessively distracted by objectively unimportant stimuli. This experience creates an absent-mindedness where the manic individual's thoughts totally preoccupy them, making them unable to keep track of time, or be aware of anything besides

10290-467: The six months following the first six observatory months. During the six months of treatment, experimenters found suicidal ideation reduced from 47% of patients down to 14% of patients. Thus, it appears from current research that antidepressants have a helpful effect on the reduction of suicidal ideation. Although research is largely in favor of the use of antidepressants for the treatment of suicidal ideation, in some cases antidepressants are claimed to be

10395-650: The suffix "-mania," namely, kleptomania , pyromania , and trichotillomania . Despite the unfortunate association implied by the name, however, no connection exists between mania or bipolar disorder and these disorders. Furthermore, evidence indicates a vitamin B 12 deficiency can also cause symptoms characteristic of mania and psychosis. Hyperthyroidism can produce similar symptoms to those of mania, such as agitation, elevated mood, increased energy, hyperactivity, sleep disturbances and sometimes, especially in severe cases, psychosis. Postpartum psychosis can also cause manic episodes ( unipolar mania ). A manic episode

10500-449: The treatment of acute mania was reviewed by Tohen and Vieta in 2009. When the manic behaviours have gone, long-term treatment then focuses on prophylactic treatment to try to stabilize the patient's mood, typically through a combination of pharmacotherapy and psychotherapy . The likelihood of having a relapse is very high for those who have experienced two or more episodes of mania or depression. While medication for bipolar disorder

10605-406: The use of SSRI antidepressants in certain counties. The counties which had higher SSRI use had a significantly lower number of deaths caused by suicide. Additionally, an experimental study followed depressed patients for one year. During the first six months of that year, the patients were examined for suicidal behavior including suicidal ideation. The patients were then prescribed antidepressants for

10710-521: The warning, especially when prescribed for adults, claiming more recent studies are inconclusive in the connection between the drugs and suicidal ideation. Individuals with anxiety disorders who self-medicate with drugs or alcohol may also have an increased likelihood of suicidal ideation. Most people are under the influence of sedative-hypnotic drugs (such as alcohol or benzodiazepines) when they die by suicide, with alcoholism present in between 15% and 61% of cases. Use of prescribed benzodiazepines

10815-508: The word origins are primarily Greek , but there are also Latin , French , German , and English terms. Many of these terms refer to expressions dating from the early days of psychiatry in Europe. Abreaction is a process of vividly reliving repressed memories and emotions related to a past event. Sigmund Freud used hypnosis to rid his patients of pathological memories through abreaction. Aboulia or Abulia , in neurology, refers to

10920-484: The world... life appears in front of you like an oversized movie screen." Behrman indicates early in his memoir that he sees himself not as a person with an uncontrollable disabling illness, but as a director of the movie that is his vivid and emotionally alive life. There is some evidence that people in the creative industries have bipolar disorder more often than those in other occupations. Winston Churchill had periods of manic symptoms that may have been both an asset and

11025-450: Was interpreted in the context of either elevated baseline activity (resulting in a null finding of reward hypersensitivity), or reduced ability to discriminate between reward and punishment, still supporting reward hyperactivity in mania. Punishment hyposensitivity , as reflected in a number of neuroimaging studies as reduced lateral orbitofrontal response to punishment, has been proposed as a mechanism of reward hypersensitivity in mania. In

#928071