Psychiatry - the branch of medicine which deals with out of order mental conditions separates off abnormal mood states - Affective illnesses - from the normal run of mood upsets.
I think the most important thing to state is that there is an illness of mood, that can be so enduring that it must have medication or physical treatment. Without it, the condition, although always recovering itself , can take up to two years to do that by itself.
More commonly it is a matter of months.
Whilst the state of illness is continuing, there is a risk of a move into a period of heavier burden of it, which the sufferer cannot bear.
It needs medication or other medical treatment
You cannot 'overcome' Medical mood illnesses yourself, by something you do, or things that happen to you in the ordinary way.
Medical depression has its own autonomy; It goes along its own way.
It can be made more unbearable and difficult to get through, by misguided, often well meaning, explanations and advice about things that are recommend that the sufferer should do before relief/cure is found, or what the sufferer should not have done, to get the condition in the first place or to make it persist.
Very often sufferers have tried all these things and more and are in some level of despair that what helps 'normal' depression has not helped them.
The failure only adds and worsens the burden.
The chief indication of depression is 'medical' is a significant duration of a persistent overall change, every part of general mental health.
Duration over three weeks
Changes in mental behaviour from before. Drive, purpose, interest, energy, empathy are unable to be activated; low spirits are everywhere.
The symptom changes now do not react as mood normally does; they persist - they have gone into their own pattern.
Medical depression is not to be defined by what appears to be the mildness or seriousness of the disability, but by the autonomous nature - going along on its own way - and the nature of the disabilities that show up the mood change. A mild medical depression which continues for weeks and months is a very definite medical condition with consequences that can be serious. It should not go un-addressed.
The changes that occur are typical.
Interest which was present is lost and does not now attract or entertain. This is so to some degree with all 'appetites' - food, sex, activities, work.
Ordinary activities carry a burden of effort.
Sleep is disturbed and this, less so in young people, is the best marker for the depression being 'medical'. It is unrefreshing in the morning, interrupted, and curtailed.
The sleep disturbance is not to be seen as the cause of depression, but the consequence, and a diagnostic for it.
Treatment for the sleeplessness is to deal with the depression not to turn to sleeping pills, in quantities,which may give the despairing the opportunity for overdose.
There is often a pattern to 'medical' depression which makes for a point of distinction from ordinary sadnesses and despairs.
In 'medical'depression the condition is usually worse in the morning and can lift appreciably in the evening. To an extent that observers in the morning get a different impression from people visiting in the evening when the mood lifts to some extent.
How to distinguish this medical mood condition from normal depression - unhappiness, sadness at loss of supportive companionship
In general terms those conditions can feel comforted in different settings, so that a relief for some time can be obtained, if not sustained.
There are times in the day, in some places, and in something going on, which gives an escape from the mood.
Sleep will also vary - not always broken, shortend, and unrefreshing.
An abnormal mood is stuck, and stays in Its pattern until - puzzlingly, but absolutely so - the condition goes away as puzzlingy as it started. Whatever is being given at the time gets the credit from this spontaneous resolution. Medical mood illnesses can last from weeks,months, occasionally something like two years, but sometimes even just days [ some premenstrual depression is a remnant of endogenous depression ] the duration of illness to come cannot be known, although a past history may, but only may, be helpful.
Sadness, despair, grief, loss, debt, persistently poor or lost companionship, insufficient distancing; these are accountable. They have an understandable, proportionate response to a source of the reaction in the life lived. They come after a particular happening and relate to it. They call for 'professional' substitutive companionship, self examination in supportive relationships of the kind that cognitive behaviour therapy provides., or new replacement better life events-...protective cover ... ' I can't - I am seeing the doctor , the counsellor , the team , whatever ' ... -
Medical and psychiatric intervention - is temporary - using medical authority to win protection from further upset - from locally arising pressures - and to gain distancing in time and space, until better times arrive, and better supporting companionship is in place.
The Affective illnesses are called endogenous depression ( endogenous = not provoked by events from without - but arising from changes somewhere within ) , manic depression, puerperal depression; unipolar or bipolar where the affect is on the one side or the other; bipolar where there are moves into overactive elated shifts and at other times into the down moods; often mixed states and frequent shifts. between both.
The abnormal mood states have no adequate explanation from what is going on in the life of the person.
That does not mean that the sufferer is free from life events. Life goes on outside the sufferer, but the mood change is not a reflection of that.
There is a break in a previous habit of living; and a later break, a return out of illness, into normal mood variation - when the autonomous duration of the illness has run its course.
In between whiles the abnormal mood runs along independently of events
Depressive Affect illnesses are pervasive and global, reducing every interest and any energy; sexual attraction, food appraisal, hobby preoccupations, personal interests, the things of the day; not focussed on some particular thing although one aspect may be singled out.
Where the mood is heightened there is excess. Surprising energy; little need for sleep; promiscuity, spendfests, irritable dominance; grand schemes, soon moved off.
These mood changes are unaccountable in terms of what is going on in the life of the person at the time of onset; nor do any fluctuations, nor the ending of the illness phase, match up to any changes going on.
When the psychiatry establishment in the nineteen thirties tried to make out a different illness - a reactive depression - the same level and quality of illness but after a significant life challenge - by there being different precipitating things going on at the onset which would have set the affective illness on its course - they found that the two categories they had in practice separated, could not be separated in the relative proportion of adverse life events at that time of onset of the illness.
The affective illnesses go their own way.
They do not accord with success or failure. They do not react to what is expected ordinarily to bring relief to upset moods like changes of scene or good fortune.
There is no reasonable or justifiable explanation; neither, for the pattern - lessening towards the evening, worse in the early hours and morning, nor for the proportion, nor for the duration of the mood variation.
[ The pattern is common but not always there; when it is it can mislead people observing and diagnosing - if seen in the latter part of the day, there may seem to be litle wrong. ]
Its autonomy overrides personality.
Because of this, insight is lost - insight and judgement is coated with the same clouding.
No reason for it; therefore no reason for it to stop.
No explanation for it; then how and why should it ever end.
Using ordinary explanations in the lives of the people afflicted there is no satisfactory explanation for the course nor the degree. Using ordinary expedients that in the life of this person have previously lifted them out of a reaction to ordinary adverse events here brings no response.
Nothing can be pointed to which allows the pattern and degree to matched to an explanatory understanding.
Whereas an ordinary mood can be explained by an observer who knows the person and the circumstances, this abnormal state, its pattern and its duration, cannot be accounted for in that way.
Its onset and its fluctuation are inexplicable within the limits of normal explanatory usage. Its recovery - it's disappearance likewise has no explanation.
Sometimes the endogenous depresions are sub-divided - retarded, agitated, melancholic.
It is likely that these variations follow the 'degree of affect change and the pattern of personality; retarded in the introverted personality; agitated in the more outgoing, or the those carrying high levelof anxiety all the time.
Lesser degrees of endogenous mood change fade into normal range for observers - the milder forms can be seen as nervous anxiety and doubt. Sufferers know something is wrong but cannot announce it clearly. It is the persistence, the duration, the lack of response to natural easements, the pattern and consistency, that places the category of illness.
The milder forms can be the more 'dangerous' as they are often not taken seriously by observers; or even by the person themselves, who blame themselves for their ill state.
Agitation in outward personalities can be seen as histrionic clamouring, attention seeking - which gets rejection in our culture, and adds to the burden of the illness - when proper attention is in fact what they need.
The conclusion that this is illness meets resistance all the way; and receives disappointment all along, as 'no cause' ' no explanation ' bemuses all in contact.
When sufferers get to medical contact their bewilderment often means they do not well put their case.
It may take some time to get the appropriate treatment.
How then do the Affect illnesses come about at all?
What about next time: advanced declarationsmanaging bipolar