Symptoms and circuits in mania

Symptoms and circuits in mania

The same general paradigm of monoamine regulation of the efficiency of information processing in specific brain circuits can be applied to mania as well as depression, although this is frequently thought to be in the opposite direction and in some overlapping but also some different brain regions compared to depression. The numerous symptoms required for the diagnosis of a manic episode are shown in . Like major depression, each symptom of mania is also hypotheticallyFigure 6-47 associated with inefficient information processing in various brain circuits, with different symptoms topographically localized to specific brain regions ( ).Figure 6-48

Figure 6-47. . According to the , aSymptoms of mania Diagnostic and Statistical Manual of Mental Disorders manic episode consists of either elevated/expansive mood or irritable mood. In addition, at least three of the following must be present (four if mood is irritable): inflated self-esteem/grandiosity, increased goal-directed activity or agitation, risk taking, decreased need for sleep, distractibility, pressured speech, and racing thoughts.

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Figure 6-48. . Alterations in neurotransmission within each of theMatching mania symptoms to circuits eleven brain regions shown here can be hypothetically linked to the various symptoms of a manic episode. Functionality in each brain region may be associated with a different constellation of symptoms. PFC, prefrontal cortex; BF, basal forebrain; S, striatum; NA, nucleus accumbens; T, thalamus; Hy, hypothalamus; A, amygdala; H, hippocampus; NT, brainstem neurotransmitter centers; SC, spinal cord; C, cerebellum.

Generally, the inefficient functioning in these circuits in mania may be essentially the opposite of the malfunctioning hypothesized for depression, but may be more accurately portrayed as “out of tune” rather than simply excessive or deficient, especially since some patients can simultaneously have both manic and depressed symptoms. Generally, treatments for mania either reduce or stabilize monoaminergic regulation of circuits associated with symptoms of mania.

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