A few patients of Depressive disease also suffer from episodes of manic disorder. In manic disorder, the patient suffers from symptoms which are opposite to those of Depressive disease. When the same person suffers from both the episodes, that is, manic as well as depressive episodes, the illness is diagnosed as manic depressive disorder (bipolar affective disorder).

Symptoms

Elated Mood: Patients become overconfident, feel they can do everything, think that nothing is impossible, laugh excessively and make others laugh. They feel they have contacts with V. I. P.s and can get any work done through them.

Excessive Talk: Patients talk more than they usually do. They can talk on any topic and they talk continuously. Patients make friendship with even strangers. They talk with unknown persons as if they have known them for years. They talk about confidential 68 matters to everyone.

Excessive Activities: Patients are, all the time, on the move, meet relatives whom they have not met for months together, visit relatives and friends very frequently and for very trivial reasons, make lots of plans for activities (at work, socially, etc.) do things for which they feel good but which have bad effects (spending too much money, foolish business investments, inappropriate sexual activities).

Excessive Spending: Patients purchase things which are not required, purchase things in quantity which is many times more than what is actually needed, travel in taxis although they may not have money or are not able to afford it.

Excessive Energy: Patients do not get tired inspite of overactivities.

Irritability: Whenever the patients are opposed or obstructed, they get irritated and angry.

Sleep is Reduced: For these patients, 2 to 4 hours sleep appears sufficient during this phase. Patients get up around 4.00 a.m. and wake up other family members and force them to work.

Treatment

Drug Therapy: There are specific drugs like haloperidol, lithium, carbamazepine which are effective in the management of manic episode. Chlorpromazine may be given initially for sedative purpose.

ECTs: ECT may be necessary if the patient is unco-operative and unmanagable. ECT is also indicated if drug therapy does not produce the desired results.

Psychotherapy: Drug therapy is of prime importance. Once the patient has become normal, then psychotherapy and counselling are initiated. The purpose of psychotherapy is to prevent relapses and recurrences.