Depressive and Bipolar Disorders Chapter 7

DEPRESSIVE AND BIPOLAR DISORDERS TYPE: Depression, mania, both SEVERITY: Mild, moderate, severe DURATION: Few days, weeks, months, years

DEPRESSIVE DISORDERS A disorder that involves periods of symptoms in which an individual experiences an unusually intense sad mood. (Two week period/most every day) Dysphoria: The disorder’s essential element; an unusually elevated sad mood.

Major Depressive Disorder Acute, but time-limited, periods of depressive symptoms that are called major depressive episodes Period in which the individual experiences intense psychological and physical symptoms related to a dysphoric mood.

Depressive Symptoms Mnemonic:“Space Drags” S leep disturbance P leasure/interest (lack of) A gitation C oncentration E nergy (lack of)/fatigue D epressed mood R etardation movement A ppetite disturbance G uilt, worthless, useless S uicidal thought

Table 7.1 - Criteria for a Major Depressive Episode

Major Depressive Disorder Two major categories of major depressive disorder: Single episode Recurrent: People receive a diagnosis of recurrent major depressive disorder if they have had two or more major depressive episodes with an interval of at least two consecutive months without meeting the criteria for a major depressive episode.

Persistent Depressive Disorder (Dysthymia) A depressive disorder involving chronic depression of less intensity than major depressive disorder. Symptoms present for at least 2 years. Sleep and appetite disturbances, low energy or fatigue, low self-esteem, difficulty with concentration and decision-making, and feelings of hopelessness. Dysphoria: The emotion of sadness.

Disruptive Mood Dysregulation Disorder A depressive disorder in children who exhibit chronic and severe irritability and have frequent temper outbursts. Outbursts must be developmentally inappropriate and occur three or more times per week. Between outbursts, children with this disorder are extremely irritable or angry. Research suggests that children who show this extreme irritability and angry outbursts rather than developing bipolar disorder, they are at risk of developing depressive and/or anxiety disorders when they reach adulthood.

Premenstrual Dysphoric Disorder (PMDD) Women who experience depressed mood or changes in mood, irritability, dysphoria, and anxiety during the premenstrual phase that subside after the menstrual period begins for most of the cycles of the preceding year.

Disorders Involving Alterations in Mood

Bipolar Disorder Manic episodes and very disruptive experiences of heightened mood, possibly alternating with major depressive episodes Euphoric mood: A feeling state that is more cheerful and elated than average, possibly even ecstatic Dysphoria: The disorder’s essential element; an unusually elevated sad mood. .

Criteria for a Manic Episode Inflated self-esteem or grandiosity Decreased need for sleep Pressure to keep talking Flight of ideas Distractibility Increase in goal-directed activity Excessive involvement in activities that have a high potential for painful consequences

criteria for a hypomanic episode

Cyclothymic Disorder Symptoms that are more chronic and less severe than those of bipolar disorder. Not as intense as bipolar Met the criteria for a hypomanic episode Chronic condition Lasts at least 2 years Numerous periods of depressive symptoms Never meet the criteria for a major depressive episode

Theories and Treatment of Mood Disorders

Biological Perspectives First-degree relatives of those with major depression are two to four times the rates of nonrelatives Twin studies Altered serotonin functioning

Biological Perspectives Antidepressant medication Treatment for bipolar disorder is lithium carbonate Pharmacogenetics Light therapy