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.
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:
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.
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.
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:
In this, the patient suffers from serious mental disturbance so that his physical and mental processes lose their vitality and energy.
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.
In this the patient experiences a recurrence of waves of mania so that conditions of excitement and peace alternate quite rapidly.
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.
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:
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.
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.
Some psychologists have attributed this disease to organic disturbances within the body, in particular disturbances of metabolism, digestive system, blood pressure and endocrine glands.
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.
It that the patient benefits from physical rest, comfort, nutritive food, warm baths, being employed, casual walk etc.
Some patients also benefit by sleep therapy.
As in the case of other mental diseases, the psychoanalytic method proves efficacious in this disease.
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.