Infectious humor ceases to amuse. Recognition of the various mood states is essential so that the person who has manic-depressive illness can obtain effective treatment and avoid the harmful consequences of the disease, which include destruction of personal relationships, loss of employment, and suicide. 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. 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. Manic-depressive illness is often not recognized by the patient, relatives, friends, or even physicians. Hypomania may feel good to the person who experiences it. Thus, even when family and friends learn to recognize the mood swings, the individual often will deny that anything is wrong.