Bipolar disorder, also known as bipolar disorder, is an affective disorder that combines manic, hypomanic, and depressive episodes. Because simple clinical mania is extremely rare, manic episodes should be considered "bipolar disorder".
Bipolar disorder "usually develops between the ages of 15 and 24 years and does not seek medical attention because people are emotional, energetic, and feel good about themselves during hypomanic episodes; When it comes to depressive episodes, it is easy to ignore the previous manic symptoms, so these patients are often missed or misdiagnosed as unipolar depression.
The main symptom of bipolar disorder is a large swing in mood, which changes from high or irritable mood to pessimism and despair, and then recycles, often accompanied by a period of normal mood in between. Behavior also changes dramatically along with changes in emotion, which are called manic episodes when emotions are high, and depressive episodes when mood is low.
Medical case: Wu, female, 18 years old.
Chief complaint: depressed and uncomfortable, depressed mood for more than half a year. Medical history: irritability, heart throbbing, sleepless nights due to mental stimulation half a year ago, and then gradually turned into mental depression, timidity, self-isolation, or even pessimism and misanthropy.
Initial diagnosis: mental depression, dullness and discomfort, lack of interest, insomnia and early awakening, timidity and frightening. The tongue is pale red, pale, and the veins are thin.
Western medicine diagnosis: bipolar affective disorder, depressive episode Chinese medicine diagnosis: depression syndrome differentiation and examination machine: liver deficiency and weakness, qi stagnation for a long time and depression.
Treatment: Nourish the liver and regulate qi, open depression and dissipate knots, accompanied by nourishing the heart and calming the nerves.
Prescription Medicine: Astragalus membranaceus, Salvia, Bupleurum chinensis, Raw oysters, Citrus aurantium, Jujube kernels, Cypress kernels, Raw keel, Cocos gods, Angelica, Ligustrum ligustrum, Yuanzhi, fried white peony.
Second diagnosis: After the drug, the depressive symptoms improved, the sleep improved, but I still felt palpitations, backache, frequent urination, and poor food intake. The tongue is pale red, the moss is thin and white, and the pulse is heavy.
Prescription medicine: add hyssop, fried eucommia, and dogwood.
Third diagnosis: the symptoms of depression have improved significantly, I have been able to go out to communicate with others, I have regained confidence in life, I can engage in appropriate work, and my sleep has improved. The tongue is pale red, pale, and the veins are thin.
After 6 months, the patient was re-examined, and his condition was stable and the drug was discontinued.
Bipolar disorder is an affective disorder that alternates episodes of mania and depression. In this case, he was irritable at the beginning of the illness and then turned into depression, which can be regarded as a depressive episode, which belongs to the category of "depression" in Chinese medicine. Depression is mostly caused by emotional discomfort and stagnation of qi, so it is mainly based on soothing the liver and relieving depression. However, the reason for the stagnation of the qi is the difference between the virtual and the real. Under normal circumstances, the liver can reach the depression and anger through the liver's discharge, and it will not become depressed.
The liver's ability to excrete lies in the deficiency and reality of liver qi, which varies in strength and weakness due to people's physique, temperament, gender, age and other factors, so the same amount of mental stimulation can cause depression in some people, while others will not get sick. Therefore, the lack of liver qi and the weakness of the qi machine have become one of the pathogenesis of depression. This is the clinical practice of "depression caused by deficiency", and the liver qi should be tonified to strengthen its ability to excrete and reach the level. At this time, do not blindly use qi medicine to soothe the liver and regulate qi and then cut down liver qi, so as to avoid the disadvantages of "deficiency".