The British Journal of Psychiatry 130: 72-78 (1977)
© 1977 The Royal College of Psychiatrists
Slow and rapid psychobiological alterations in a manic-depressive patient: clinical phenomenology
FJ Stoddard, RM Post and WE Bunney Jr
A distinctive pattern of clinical change during eight affective episodes is
reported in a rapidly cycling manic-depressive patient. After a rapid
switch to near maximal intensity of affective symptoms, slow changes in
symptomatology were documented by significant slopes and correlation
coefficients over the course of each episode. Decreases in depression,
anxiety, drowsiness, helplessness/hopelessness, anger, and sadness preceded
the switches into mania; decreases in mania, euphoria, seeking others, and
talking preceded the switches into depression. Psychologically important
events appeared to regularly precede rapid mood switches. It is suggested
that the consistent, slow clinical changes which occur during affective
episodes may reflect part of an underlying rhthmic biological process and
that environment events may be capable of triggering a final common pathway
for the mood switch during a vulnerable period.