Manic-depressive illness typically emerges in adolescence or early adulthood and continues to flare up across the life course, disrupting or destroying work, school, family, and social life. Severe depression or mania may be accompanied by periods of psychosis. Psychotic symptoms associated with manic-depressive disorder typically reflect the extreme mood state at the time. Symptoms of mania and depression are present at the same time. The symptom picture frequently includes agitation, trouble sleeping, significant change in appetite, psychosis, and suicidal thinking.
Depressed mood accompanies manic activation.
Symptoms of mania, depression, or mixed state appear in episodes, or distinct periods of time, which typically recur and become more frequent across the life span. These episodes, especially early in the course of illness, are separated by periods of wellness during which a person suffers few to no symptoms. A variety of medications are used to treat manic-depressive disorder. But even with optimal medication treatment, many people with manic-depressive disorder do not achieve full remission of symptoms. Psychotherapy, in combination with medication, often can provide additional benefit.