Understanding Affective Disorder


Dr. Goke Akinrogunde

One psychiatric condition that often goes unnoticed for a while in the affected individual by close relatives / friends is affective disorder; this is because for a number of individuals with affective disorder, they can still function socially to a large extent, still able to attend to routines, until when it gets to a point of no return, when functioning at work or school etc becomes socially difficult and impermissible.

Affective Disorder is an entity that connotes two extreme components potentially existing in phases in the same individual. These components are “mania” at one end of the pole and “depression” at the other end; meaning that a fellow with affective disorder might be having an attack of mania, which could be aggressive and outgoing for the moment and at a later period, can also come down with depression – now becoming withdrawn to self, exhibiting low mood, sleeping excessively etc.

As the name indicates, affective disorder implies that the psychopathology is with the mood and the inner feelings of the individual. For want of space, the discussion today is restricted to mania.

Features of mania, hypomania
A manic exhibits features consistent with unjustifiable high mood (elation) or and increased energy. An understanding of the mental illness referred to as mania and its milder form – hypomania will suffice with the enumerated symptoms below. Interestingly mania, has equal preponderance in males and females

Delusion of grandiose
‘Delusion of grandiose’ is said to occur where an individual thinks highly of himself beyond the actual reality and this could also connotes the claim to be in possession of special powers like witchcraft power, unreal political power etc

It is necessary to point that other symptoms must exist together to cumulatively add up to a diagnosis of mania or in the milder form – hypomania. The list includes the following symptoms among others.

The individual feels unduly very happy beyond what can be explained by the present reality of things. You ask him for an example, what’s his mood like and he answered that he is very, very happy with an expression on his face that convened this happiness in an infectious way. This becomes instructive when the reality on ground does not fit in with such feeling of undue happiness; say for an example, when some kind of disaster has just occurred to the individual.

Here the individual functions socially well but find himself indulging in physical activities that are rather much more than the ordinary comprehension for a normal individual. The fellow might be involved with carrying out all alone some domestic tasks that ordinarily normally take about four or more people to do.

This is sensory experience in the absence of a stimulus; there are various forms of hallucination. These involves seeing things (visual), hearing things (auditory), feeling strange movement on the body (tactile) or smelling things (olfactory) etc in the absence of real stimulus. You then have a situation when the fellow claimed to be seeing things that others present are not seeing. Hearing voice(s) talking to him, which others present cannot hear etc.

Easily Irritable and highly Intolerant
This is a manifestation of undue intolerance of others’ views, and this is coming out of the fact the fellow thinks he is specially placed above and beyond others. Any attempt to draw him to the point of conjecture soon lead to an indecorous outburst, which is not appropriate for the time and moment.

Increased appetite
A mania patient may find himself/herself developing a feeling and urge to fill the stomach indiscriminately beyond what is considered appropriate; with this development, it is more likely for the individual to add more weight in the course of the illness, provided food is actually sufficiently available to eat in the first instance.

Pressure of speech
This involves the vocalisation of many ideas in a rush, trying to say many things at the same time though the subjects of the ideas are usually related. I should also add that mania patients not unusually exhibit feature of talkativeness.

Increased sexual desire and sexual dis-inhibition
Here the individual develops increased sexual drive that is out proportion to his/her usual desire and this may include making sexual overtures to those individuals he/she is not expected, per culture and tradition, to make such advances to. This could also extend to forceful sexual seizure as in attempted rape or actual raping.

This involves excessive religious activities in the strict meaning of the word – excessive, that have gone clearly above the normal practice and expectations from the individual.

Undue generosity and spending spree
This is a common manifestation in maniac patients, where the fellow engage in dashing out his/her things during the illness in a Father Christmas-like fashion, this could also involve the parting away with a large part of his money usually to both soliciting and unsolicited individuals.

Reduced sleep time with increased energy
Here the fellow developed an increased energy level within; he sleeps so little say for just two hours in the night but wakes up refreshed and carries on with the day’s activities with a renewed vigor without any facial dullness or other signs of poor sleep.