Educationals

Distributing and spending sprees

In a range of mania, it is not uncommon for the patients to distribute house hold articles, food, clothes and money. Frequently they also go on spending sprees. A patient during his manic phase purchased a couple of gold chains, bracelets, wrist watches and gifted some of these items to his friends. A lady was famous in her neighbourhood, as during her manic phases she would buy lots of vegetables and grocery items and distribute it to the poor people. The poor people in the neighbourhood would eagerly wait for her manic episodes.

Delusions and hallucinations

Apart from delusion of grandiosity, occasionally patients may harbour persecutory delusions which are secondary in nature. They may feel that because they are very rich some enemies may try to rob them of their wealth.

Hallucinations are uncommon during manic episodes but once in a while, the patient may claim that he can communicate with God and can hear God's voice.

DEPRESSIVE EPISODE

Sadness, Apathy and Lethargy

Pervasive sadness of mood is the hallmark of depressive episode. Patient just doesn't feel good even in the best of environment. It is qualitatively different from the feelings of unhappiness which one has after some unpleasant incident. It is associated with apathy and lethargy. They prefer to stay alone and there might be frequent crying spells either without any reason or over very trivial matters. Some patients may have more agitation and restlessness rather than classical sadness of mood

Loss of self esteem and confidence.

A bank officer refused promotion during one of his depressive episode as he thought that he would not be able to cope up with higher responsibilities. Along with loss of confidence, they also have difficulty in taking decision and as a result may continue to postpone the work.

Diminished interest and concentration

Patients don't feel like doing anything and they have to literally force themselves even to complete the daily routine. They do not enjoy activities they once enjoyed, any more, and so avoid participating in such activities. Quite often they complain of difficulty in concentration, forgetfulness and as a result make frequent mistakes in their work.

Hopelessness, Worthlessness, Helplessness and Suicidal ideation

Along with sadness of mood and other associated symptoms patients may start feeling that life is not worth living. He may see the situation as hopeless and may feel helpless to deal with it. Suicidal ideations are very common during depressive episodes and if not dealt with, in time, patient may attempt suicide.

Poverty of ideas and preoccupation with somatic symptoms

Like manic patients, even depressed patients have a typical manner of interacting. They speak in a very low and monotonous voice and prefer to answer in one or two words as far as possible. They may complain that their mind is blank.

Psychomotor retardation and easy fatiguability

All the activities of a depressed patient go at a very slow pace. He may take more time than usual in taking bath, eating food or in completing a given task. He also gets tired and fatigued easily.