Manic Access

Pathophysiology

Manic-depressive psychosis, also called Bipolar psychosis, periodic psychosis, circular psychosis, is a cyclical mood disturbance, which is characterized by the occurrence of episodes of mental excitement, which are called manic attacks. These alternate with bouts of depression, which are called crises of melancholy. Most often the patient returns to his or her usual general condition between episodes, that is to say between attacks.

There are different clinical forms of manic-depressive psychoses:

• La bipolar psychosis characterized by alternating manic and melancholic crises, during which the symptoms are identical to those occurring in endogenous depression.
• La unipolar psychosis which is characterized by the succession of episodes of the same type, but generally of the depressive type as occurs in endogenous depression.
• La cyclothymia is an alternation of episodes of lesser intensity, and of the type hypomanic et depressive, rather mild. These episodes have the characteristic of lasting only a few days, and of alternating with insomnia, and a hypersomnia, that is, too much sleep.
• L'hypomania chronic is characterized by the occurrence of periods of excitement and exaltation, which predominate over episodes of depression. The other characteristic of chronic hypomania is the presence of shortened sleep.
• La manic crisis, is a euphoric exaltation. At first, behavior is more or less normal, and speech is coherent. Gradually, there arises a tumultuous unbridledness, and a total incoherence. The evolution can be towards an extravagance, a debauchery marked by equivocations about objects of sexual desire, associated with social discredit, and ruin.

La acute manic crisis, is characterized by extreme excitement during which the patient is likely to tear his clothes, scream, and howl with laughter. He presents others with a very detailed speech (logorrhea) inexhaustible, containing a large number of obscenities, and puns generally in bad taste. There are also minor forms of manic crisis called manic episodes, characterized by the occurrence of a insomnia, and irritability.