These are essentially affective disorders or disorders involving the mood of the subject with manifestation of excitement and elation of the mood. The patient is optimistic, confident with general feeling of well being and marked euphoria.
In HYPOMANIA there are pressure of talk and psychomotor overactivity, ceaseless activity, with flight of ideas, increased drive, circumstantiality and distractability. The subject is enthusiastic, witty, humorous, overconfident, alert, expansive and friendly. He is interfering in nature and acts disproportionately.
In ACUTE or DELIRIUS MANIA the above features are notable in greater degree and severity in their manifestations. There may be delusion of great physical and intellectual strength. Excessive excitement and restlessness may lead to frequent exhaustion.
DEPRESSIVE PSYCHOSIS (MELANCHOLIA)
In this condition, the sufferer has intense feeling of depression and grief without any reason.
Depressive stage of the mind develop due to many factors which may often be explainable and often not. The cause of depression may be (a) endogenous, when some genetic, biochemical, metabolic, senility, or puerperal reaction or hormonal disturbance is responsible ; (b) reactive, when some psychosocial interaction or problem or failure, frustration and similar factors are responsible and (c) a person may suffer from depression as a result of long term use of psychotropic drugs.
Signs and symptoms – General appearance and behaviour – The face is either rigid and immobile or there is expression of sorrow, anxiety or despair feeling. The subject is slow in movement and has heavy tired gait.
Mood – There is feeling of sadness, dejection and lack of energy. Condition is usually worse in the morning.
Talk – Output is less or may occasionally be continuous. There may be complete muteness or constant chattering.
Thinking capacity – Diminished, inability to concentrate or formulate ideas or taking decision.
Thought contents – He only counts his difficulties, there is delusion of persecution and hypochondriacal or nihilistic delusion. There is derealisation and depersonalisation.
Disorder of perception – There are illusion and hallucinations.
Attitude towards personal affairs and others – There is loss of interest in work, home, family, hobbies, recreation and personal well being. The subject may be agitated.
Sleep – disturbed sleep, insomnia, early rise.
Muscular activity – There is retardation or slowness of motor activities.
Other physical signs symptoms – There is loss of appetite with loss of body weight. There are headache, bodily pain, dyspepsia, feeling of tightness in the chest, constipation, increased urinary frequency, palpitation, blurred vision, dryness of mouth, paraesthesia, loss of libido in men and menstrual disturbance (mostly insufficiency) in females. In extreme cases, the patient may lie stuporous in most of the time.
(Simple melancholia is the mildest form and acute melancholia is the severe form. In chronic melancholia, there is marked improvement of the physical signs and symptoms but not of the mental signs and symptoms).
Danger – Depressed psychotics (melancholics) are, or, may be potential suicides and they may also commit homicide.