Affective bipolar disorder (F31) is earlier designated.The term manic-depressive psychosis (Krepelin E., 1921). In the 60s of the twentieth century, the term “bipolar” was introduced. According to the American classification DSM-VI, for the diagnosis of this diagnosis requires a history of mania episode for at least a week. The modern concept of bipolar disorders includes in this concept not only bipolar disorders of various types, but also cyclotymia, hyperthymia.
This mental disorder is largely determined by the constitutional characteristics of a person and is a chronic mental illness. At the same time, periods of remission can be quite long and last for years (the debut of the disease often occurs in adolescence and usually begins with the depressive phase).
A recurrent depressive disorder (recurrent depression) is characterized by a cyclical course. According to some scientists, approximately 10–20% of patients who have had a pronounced depressive episode develop further bipolar disorder. According to other researchers, the second depressive episode occurs in 75–80% of cases within 4–6 months after the first. The transition from a recurrent depressive disorder to a bipolar type of flow (periodic change of the depressive and manic phases) is noted in 5–20% of cases. In half of the cases this occurs after the first depressive episode, in the rest – after 2-4. Between the first episodes of bipolar disorder usually lasts about 5 years, later they can recur annually.
For bipolar depression, there is a relationship with personality characteristics (tendency to cyclothymia), onset in adolescence and youth, (debut of the disease often begins with the depressive phase), the onset of depression after childbirth and frequent relapses of the disease. For bipolar disorders, episodes of psychosis, increased drowsiness, and severe adynamic depression are characteristic. Unfortunately, the onset of therapy for this mental disorder is often delayed due to the late diagnosis of the disease.
Recurrent depressive disorder
Recurrent (from Lat. Recuro – run back, return), or recurring (recurring) depressive disorder (according to MKB-10-F33) is characterized by repeated depressive episodes, with a lack of individual episodes of elevated mood and hyperactivity in the history. The expressed forms of recurrent depressive disorder correspond to the previously used term: depressive type of manic-depressive psychosis (melancholia).
Recurrent depressive disorder can debut at any age, but usually begins after twenty years. Without treatment, it can last months and years, against the background of therapy – to go away within 2-3 months, however, in case of cessation of maintenance therapy for at least 6-9 months (which is observed quite often), depression can recur again.
Some researchers attribute to recurrent depressive disorder, the so-called. seasonal affective disorder in which episodes of depression occur depending on the time of year. At the same time, there is a point of view according to which seasonal depression depends not so much on the season, but on the number of sunny days.
Cyclothymia – unsharply expressed mood swings. For decades, this disease was “absorbed” by neurasthenia and hysteria (Osipov, VP, 1931). A comprehensive development of the theory of cyclotime belongs to Y.V. Cannabih (1914).
Cyclothymia is characterized by short cycles over several days, with inhibited depression being replaced by increased activity, elevated mood and irritability, and a reduced need for sleep. Bipolar tendencies with cyclothymia can manifest as ease of mood changes after taking antidepressants.