Daily our mood may fluctuate between physiological feelings of happiness and some sadness, generally, by external events . These rule changes have an adaptive role as they allow an individual to adjust their responses to environmental conditions. In clinical is good to distinguish between these mood swings "physiological" commonly odd or even exceptional, from those that characterize mood disorders are a very common disease among the population involving as much as 20% thereof. specifically is meant by the term "mood disorders" a number of pathological conditions caused by specific alterations in neurotransmitter between two extremes: mania and depression.
While changes are linked to specific organic-biological, the other is not possible to ignore the importance of environmental events as significant etiologic cofactor. That is, at times, the onset of symptoms of dysthymia, whether manic or depressive episodes are preceded by stressful nature of mental, physical or social.
has been shown that in the period preceding the onset of psychopathological picture, patients complain of stress load than normal and is often perceived as intolerable. It was therefore suggested that excessive stress loads may render less latent, in susceptible individuals, or sub-clinical forms of mood disorders. It is therefore clear that more marked is the genetic predisposition and biological individual, the lower the intensity of stimuli that can induce severe depressive or manic episodes . These conditions make it difficult to distinguish what is abnormal from normopatia, so it is important that both the specialist to conduct a proper diagnosis. It is generally regarded as significant of a deep and persistent malaise a condition that negatively affects the life of the subject. A epidemiological prevalence depression was found in female subjects with a higher incidence than men. However, it is difficult to systematize the overall incidence of these disorders because some have a breakthrough performance.
Among the major risk factor for bipolar depression include: •
female;
• aged between 35 and 45 years;
• family history of depression and alcoholism
• adverse childhood experiences in family environment ;
• Recent negative events;
• birth in the previous six months;
While for bipolar depression sembrerebbe che il fattore di rischio principale sia rappresentato da una storia familiare di disturbo bipolare e dalle stato socio-economico.
Per semplificare si possono considerare quattro tipologie di disturbi che hanno un andamento fasico e ciclico:
• Depressione maggiore: umore depresso, perdita di interesse e riduzione delle attività quotidiane, perdita di peso, insonnia o ipersonnia, perdita di energia, scarsa capacità di concentrazione, idee suicide. Per essere considerata patologica, questa condizione deve portare un cambiamento totale rispetto all'umore che la persona ha normalmente.
• Episodio maniacale: caratterizzato by elevated mood and irritability, high self-esteem, little need for sleep, logorrhea, hyperactivity, easy distraibiltà, clearly dangerous actions that bring pleasure.
• Bipolar disorder: often manifests itself initially as hypomania and can masquerade as abuse of alcohol or drugs or poor school performance or work. If untreated, the disorder tends to worsen and lead to episodes of mania or depression.
• Dysthymia: feeling depressed for years, mainly characterized by changes in appetite, sleep disturbances, low self-esteem, poor concentration and reduced decision-making skills.
Come riportato pocanzi oggi si è più propensi a far rientrare la sintomatologia in un ottica biopsico-sociale dove fattori genetici, biologici, di vita, relazionali e sociali interagiscono. E’ chiaro che non possiamo distinguere un “noi biologico” da un “noi psicologico” e quindi, anche nei disturbi dell’umore i due fattori sono intimamente e strettamente correlati e hanno una proporzione diversa da individuo a individuo. Per giunta una volta che tale sintomatologia è iniziata,
indipendentemente dall’evento scatenante, si sviluppano rapidamente una serie di problemi psichici e fisici che si alimentano reciprocamente favorendo la crescita del disturbo.
To conclude that observed in the clinic is that mood disorders can begin at different ages, even though depression is more common in women between 35 and 45 years and in men over 45 years, have a course that can be episodic and lack of recognition of the disease may worsen the prognosis. Diagnosis is based on interviews with the patient, through careful observation, and long after completing the appropriate test.
therapy that appears to have greater success relies on an integrated treatment pharmacological / psychotherapeutic and there are cases where hospitalization may be necessary especially at the most acute. It 'important that when the family or the person himself is aware of a number of changes will be immediately alerted the family doctor to make an early diagnosis. The most severe forms are treated in public or private sector specialists.
Dr. Lorenzo Flori
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