Psychoses:
Psychoses are generally divided into two classes functional
and organic. In organic psychoses, organic and physiological factors play a
primary part.
On the other hand in functional psychoses, physiological
factors play a lesser part than psychological causes. Clinical psychology
restricts its study to functional psychoses since their causes and cure are
more purely psychological.
Functional
psychoses are mainly of the following there kinds.
1.
Schizophrenia
2.
Paranoia
3.
Manic depressive psychosis.
Manic Depressive psychosis:
In this disease, as seems to be
indicated by its very name, the patient exhibits mania and depression or one
after the other. These type of patients are more of women than men as also more
of urban that of rural. Originally excessive mania and excessive depressions
were regarded as separate maladies.
It was between 1850 and 1854, that
Falret and Baillarger indicated the fact that the conditions of mania and
depressions were to be seen alternately in the same individual. In 1899,
Kreplien pronounced the two conditions to be identical and from then to the
present they have been accepted as much.
Conditions of Mania and depression:
Both mania and depression are seen
together. But in both of these there are three distinct and different
conditions with the result that the disease takes many forms. Mania shows the
following forms:
Hypomania:
In this the patient appears to be
very happy, he accepts every incident and object that he comes across with joy.
He shows a distinct tendency to self-projection.
Acute Mania:
In
this there is a greater excitement that in the preceding condition with the
result that the patient looses his sense of thought and action. He exhibits
signs of excessive joy and emotion.
Hypermania:
In this condition, the mania is even more pronounced than in
the second stage so that the patient can be observed dancing, singing and
laughing with the exuberance of a madman. Parallel to Mania, the depressive
psychosis also takes three forms:
Simple retardation:
In this, the patient suffers from
serious mental disturbance so that his physical and mental processes lose their
vitality and energy.
Acute melancholia:
In this, the patient differs from
greater depression and the blues than in the previous condition. The patient
develops a sense of inadequacy and he or she is even sometimes lead to suicide.
Stuporous melancholia :
In this condition, the tendency
towards suicide is further strengthened because the patient is now disappointed
with life. His feelings for crime soon grow on him, he is seen crying:
ventilating and irritated with himself or herself.
Kinds of manic depressive psychosis:
Besides the above-mentioned
conditions of Mania and depression this mental disease also exhibits the
following kinds.
Recurrent
mania:
In this the patient experiences a recurrence of waves of
mania so that conditions of excitement and peace alternate quite rapidly.
Recurrent melancholia:
In this, the patient constantly
experiences a state of melancholic depression.
Alternating mania / depression:
In
this the patient experiences excitement or mania then returns to his normal
condition but then moves on to a state of depression. In this manner he or she
oscillates between mania and depression.
Mania / depression of double form:
In this the patient exhibits both mania / depression of
double form.
Circular manic depression:
In this the patient changes from
mania to depression on a circular pattern.
Symptoms of manic-depressive
psychoses:
Weakness of perception:
The patient' s power of perception
is observed to be weak; hence the patient cannot concentrate or any subject.
Indefinite and vague consciousness:
In a very severe state of the
disease, the patient' s consciousness of his surroundings is very vague and
indefinite so much so that at time he has no consciousness of time and place.
Delusion:
The patient exhibits a persecutory
delusion in depression and a grandeur delusion in a condition of mania with the
result that his decisions are wrong and defective.
Hallucination and mirage:
Both in the state of depression and
mania, the patient are subject to appropriate hallucinations and mirages.
Extremely emotional reactions:
The patient further shows signs of very intensively
emotional reactions. In a state of manic delight he shows anger, egotism and
erotic emotion, which in a state of depression, he exhibits fear. In the first
condition the patient is extremely restless and active while in the other he is
inactive and lethargic.
Causes of manic-depressive
psychosis:
Various psychologists have offered different explanations of
the causes of this psychosis. The main ones are as follows:
Heredity:
Pressen
and Steecker have concluded that this disease is primarily hereditary and there
is no doubt that many have the disease on account of their heredity, but this
view does not hold true in each and every case.
Environment:
Besides heredity, the environment particularly that of the
home and family plays an important part in causing the disease. Rosanoff has
laid considerable stress on the importance of environment.
Physical disorganization:
Some psychologists have attributed this disease to organic
disturbances within the body, in particular disturbances of metabolism,
digestive system, blood pressure and endocrine glands.
Personality type:
Those, who admit the concept of personality type, have
believed that the patient suffering from this disease is a particular
personality type. According to Jung this disease occurs mostly in individuals
who are extroverts. Kretschener opines that it occurs mainly in the case of
cyclothymics personality type.
Sense of inferiority:
To Adler, the main cause of this disease is repression of
the individual' s urge for self-assertion. Such repression causes sense of
interiority in him. To him, mania is caused by self-assertion and depression by
anxiety.
Imbalance between self-assertion and
self-sacrifice:
McDougall has traced disease to an imbalance between the
instincts of self-assertion and self-sacrifice. In enthusiasm the instinct of
self-assertion is in the ascendant and in depression, it is the instinct of
self-sacrifice, which dominates, while an imbalance between the two leads to
the manifestation of this particular psychosis.
Regression and discipline:
In
elucidating this disease, Jung has laid much stress on the fact of regression
towards the anal and oral stages as well as on discipline of the superego. This
causes feelings of guilt in the individual with the result that he appears
depressed.
The opposite effect of guilt causes mania. But all do not
agree on this Freudian thought from the above elucidation of the various causes
of this psychosis, it is apparent that heredity, environment feelings of
anxiety, organic disturbances etc, all play important parts in causing it. But
psychological influences are by far the more important.
Cure of manic-depressive psychosis:
The following methods help in the
cure of manic-depressive psychosis.
Physical treatment:
It that the patient benefits from
physical rest, comfort, nutritive food, warm baths, being employed, casual walk
etc.
Sleep therapy:
Some patients also benefit by sleep therapy.
Psychoanalytic method:
As in the case of other mental
diseases, the psychoanalytic method proves efficacious in this disease.
Shock therapy:
Some people also benefit by shock therapy. The successful
treatment of mental disease depends to a large extent upon the personal
ability, qualities of personality and experience of the psychiatrist. It will
take quite some time before the symptoms, causes, and cures of each disease are
actually established beyond doubt and this will need further experimentation
and research.
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