The stand is less than 1 meter tall and is partly wrapped in bandages. Aside from its swollen stomach and large skull-like head, the body is fairly lanky and skeletal. It can produce thorns from its body and has what appears to be an umbilical cord coming out of its stomach.
Neurochemical Manipulation: Manic Depression is able to increase the biological functions of organisms by piercing them with its thorns. The application of this technique is very broad as it includes uses such as increasing the human heart beat causing it to explode, forcing irregular stomach digestion, or doping a person to increase his physical attributes for a couple of minutes, after which the body breaks down.
It also has the power to make salt into a powerful opiate and inject it as a solution into people for a drug-like effect. The drawback is that the drug formed from the salt only exists for a total of two weeks before reverting back into salt.
Massimo's stand appears to have abilities opposite of his brother, Tonio's. While Pearl Jam focuses on targeting diseases and issues within the body and heals them, Manic Depression's main purpose is to directly affect neurochemical processes and health with uncertain and negative results.