Bipolar depression is different from unipolar depression, and its characteristics include emotional instability, irritability, psychomotor agitation, mental competition/crowding, increased sleep, obesity/weight gain, inattention, more suicidal thoughts, anxiety and substance abuse (tobacco, alcohol, drugs, etc. ).
Attention can't be concentrated for a long time, and it is easily influenced by the external environment. Memory enhancement, disorder and variability; When the attack is extremely serious, the patient is extremely excited and uneasy, and may have short and fragmented auditory hallucinations, and his behavior is disordered and aimless, accompanied by impulsive behavior; There may also be disturbance of consciousness, hallucination, hallucination and incoherent thinking, which is called delirium mania. Most patients will lose their insight in the early stage of the disease.
Mixed seizure
It means that manic symptoms and depressive symptoms appear at the same time in one episode, which is relatively rare in clinic. It usually happens when mania and depression quickly reverse. For example, patients with manic episodes suddenly turn to depression, and then return to mania a few hours later, giving people a "mixed" impression. However, this mixed state generally lasts for a short time, and most of them quickly turn into mania or depression. Both manic symptoms and depressive symptoms are atypical in mixed attacks, which are easily misdiagnosed as schizophrenia, mood disorder or schizophrenia.
Because bipolar disorder recurs in a circulatory way for almost life, its frequency is much higher than that of depression, so the principle of long-term treatment should be adhered to. The purpose of acute treatment is to control symptoms and shorten the course of disease; The purpose of consolidation treatment is to prevent the recurrence of symptoms and promote the recovery of social function; The purpose of maintenance treatment is to prevent recurrence, maintain good social function and improve the quality of life.
In principle, patients with bipolar depression do not advocate the use of antidepressants, because it is easy to induce manic episodes, rapid cycle episodes or lead to chronic depression symptoms. For patients with severe depressive episodes or even obvious negative behaviors, patients with depressive episodes accounting for the vast majority in the whole course, and patients with severe anxiety and obsessive-compulsive symptoms, short-term combined use of antidepressants can be considered on the basis of full use of emotional stabilizers. Once the above symptoms are relieved, antidepressants should be reduced or stopped as soon as possible.
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