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Updated: May 18, 2025
His most important point is, perhaps, that these benign stupors showed a definite relationship to manic-depressive insanity in that some patients passed directly from stupor to typical manic excitement, while in others a “catatonic” attack replaced a depression in a circular psychosis.
In mental disease, of the type known as Maniac Depressive insanity, there is a curious oscillation of self-love and self-admiration. This disease is cyclic, in that two opposing groups of symptoms tend to appear and displace each other. In the manic, or excited state, there is greatly heightened activity with correspondingly heightened feeling of power.
Any institutional physician is familiar with the chronically elated patient, who has become a hospital character a good worker often who seems to be sufficiently repaid for his toil by the privilege of stopping the passerby to expound his ideas. Such a case is usually diagnosed as a chronic manic or a dementia praecox, according to the taste of the examiner.
The mind is not a blank, as in the stupor, or concerned only with delusions of death. Finally, there are the absorbed manic states. These are the most difficult, inasmuch as the patient is often so withdrawn and so introverted that at any given interview there may be no objective evidence of mood or ideas. Here the development of the psychosis is often an aid to diagnosis.
His loyal subjects immediately rushed to solve the problem, setting themselves to this task with an enthusiasm that an objective observer might well have described as manic. People ran back and forth, up and down, muttering, "Move the mail, shove the mail, fling it, sling it. Run. Hurry. Shoot the mail, toss it, heave it," and such like.
The unusual features which one meets in the benign stupors are ideas or mood reactions occurring apparently as interruptions to the settled quietude or in more protracted mild mood reactions, such as vague distress, depression or incomplete manic symptoms, which have been described in the chapter on affect. The interruptions are easily explained by the theory of regression.
Sex is important in determining the nature of the stupor, for he found the anergic type following mania in females only. He observed such an end to manic attacks in 6 out of 36 cases. All his cases were under 30 and he regards the prognosis as good on the whole.
At times the factors producing it are mainly environmental; at others, the problem is essentially of the patient’s own making. Of course almost any type of functional psychosis may emerge from such a state of dissatisfaction, but it is important to note that unlike manic states, for instance, stupors invariably develop from a situation of unhappiness.
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