1. PSY 436 Instructor: Emily E. Bullock, Ph.D.
Mood Disorders
PSY 436
Instructor: Emily E. Bullock, Ph.D.

2. Mood Disorders
Mood Disorders: disturbances in mood that are unusually severe or prolonged and impair their ability to function in meeting their normal responsibilities

3. DSM-IV-TR Mood Disorders
Major Depressive Disorder
Dysthymic Disorder
Depressive Disorder NOS
Bipolar I Disorder
Bipolar II Disorder
Cyclothymic Disorder
Bipolar Disorder NOS
Mood Disorder due to general medical condition
Substance-induced mood disorder
Mood Disorder NOS

4. Episode First must understand the criteria for:
Major depressive episode
Manic episode
Mixed episode
hypomanic episode

5. Major Depressive Episode
Depressed mood most of the day
Markedly diminished interest or pleasure in all, or almost all activities, most of the day
Significant weight loss when not dieting or weight gain
Insomnia or hypersominia
Psychomotor agitation or retardation
Fatigue or loss of energy
Feelings of worthlessness or excessive or inappropriate guilt
Diminished ability to think or concentrate or indecisiveness
Recurrent thoughts of death, suicidal ideation/attempt

6. Manic Episode Inflated self-esteem or grandiosity
Decreased need for sleep
More talkative than usual or pressure to keep talking
Flight of ideas, racing thoughts
Distractibility
Increased in goal-directed activity
Excessive involvement in pleasurable activities that have a high potential for painful consequences

7. Mixed Episode
Criteria are met both for a manic episode and a major depressive episode (except for duration) nearly every day during at least a 1 week period

8. Hypomanic Episode
Same symptoms as a manic episode but less time of symptoms, less severity, and less impairment in functioning is required to diagnose

9. Major Depressive Disorder
Presence of at least one major depressive episode
Not better accounted for by other axis I diagnoses
There has never been a manic episode, mixed episode, or hypomanic episode

10. Major Depressive Disorder
Specifiers
Mild, moderate, severe without psychotic features/severe with psychotic features
Chronic
With catatonic features
With melancholic features
With atypical features
With postpartum onset
With or without interepisode recovery
With seasonal pattern

11. Prevalence of Major Depressive Episodes by Gender

12. Dysthymic Disorder
Depressed mood for most of the day, for more days than not, for at least 2 years
Presence of at least two of the following
Poor appetite or overeating
Insomnia or hypersomnia
Low energy or fatigue
Low self esteem
Poor concentration or difficulty making decisions
Feelings of hopelessness
Person is not without two of above symptoms for more than 2 months during a 2 year period

13. Dysthymic Disorder (criteria cont.)
No major depressive episode during the first two years of the disturbance
Not better accounted for by other mood disorder
No history of manic or mixed episode
Symptoms did not occur during the course of a psychotic disorder
Not due to a substance or general medical condition
Cause clinically significant distress or impairments

14. Bipolar I Disorder--Types
Single Manic Episode
Presence of only one manic episode and no past major depressive episode
Most Recent Episode Hypomanic
Currently or most recently in a hypomanic episode
There has previously been one manic episode
Most Recent Episode Manic
Currently (or most recently) in a manic episode
There has previously been at least one major depressive episode, manic episode, or mixed episode

15. Bipolar I Disorder--Types
Most Recent Episode Mixed
Currently or most recently in a mixed episode
There has previously been at least one major depressive episde, manic episode, or mixed episode
Most Recent Episode Depressed
Currently or most recently in a depressed episode
There has previously been at least one manic episode or mixed episode
Most Recent Episode Unspecified

16. Bipolar II Disorder
Presence or history of one or more major depressive episodes
Presence or history of at least one hippomanic episode
There has never been a manic episode or mixed episode

17. Cyclothymic Disorder
For at least 2 years, the presence of numerous periods with hypomanic symptoms and numerous periods with depressive symptoms that do not meet criteria for a Major Depressive Episode
During the 2 yr period, the person has not been without the symptoms in criteria A for more than 2 months at a time
No Major Depressive Episode, Manic Episode, or Mixed Episode has been present during the first two years of the disturbance

18. Treatment of Mood Disorders
Psychodynamic Approaches
Interpersonal psychotherapy (IPT)
Behavioral Approaches
What is learned can be unlearned
Learned helplessness
Cognitive Approaches
Negative thinking/cognitive distortions

19. Treatment of Mood Disorders
Biological Approaches
Antidepressant Drugs
Drug Treatments for Bipolar Disorder
Electroconvulsive Therapy (ECT)

20. Suicide Who Commits Suicide? Why Do People Commit Suicide?
Perspectives on Suicide
Predicting Suicide

21. Suicide Rates According to Age

22. Suicide Suicide Prevention Ask how attempt is to be made
Draw the person out
Be sympathetic
Suggest means to work out problems
Accompany person to a professional
Don’t say “You’re talking crazy”