severe altercations in the mood for much longer periods. Mood disturbances are
intense and persistent enough to lead to serious problems in relationships and work
performance.
Depression
A prolonged feeling of helplessness, hopelessness, and sadness
Mania
a mood disorder marked by a hyperactive, wildly optimistic state (euphoria and
excitement)
unipolar depressive disorders
a person experiences only depressive episodes
bipolar and relative disorders
a person experiences both depression and manic episodes.
Depressive episodes
a person is markedly depressed or loses interest in formerly pleasurable activities
(or both) for at least 2 weeks, as well as other symptoms such as change in sleep or
appetite, or feelings of worthlessness.
manic episode
A sudden, rapidly escalating emotional state characterized by extreme euphoria,
excitement, physical energy, and rapid thoughts and speech. They are often
interrupted by occasional outbursts of intense irritability or even violence. Must last
,at least a week, and have at least three symptoms in the same period.
Hypomanic episode
A period (4 days) during which a person experiences manic symptoms but without
significant interference in daily functioning. There is much less impairment in
social and occupational functioning in hypo-mania.
Major Depressive Disorder (MDD)
(Uni-polar major depression) Must be in major depression and never have had a
manic, hypomanic or mixed episode.
Fatigue, insomnia, Feelings of worthlessness etc.
Significant distress or impairment in social, occupational or other important areas
of functioning.
relapse
return of symptoms within a fairly short period.
a situation that probably reflects the fact the underlying episode of depression has
not yet run its course.
Recurrence
Refers to the onset of a new episode of depression.
Specifiers
different patterns of symptoms that sometimes characterize major depressive
episodes which may help predict the course and preferred treatments for the
condition
Major depressive episode with melancholic features
in addition to meeting the criteria for a major depressive episode, a patient either
has lost interest or pleasure in almost all activities or does not react to usually
pleasurable stimuli or desired events.
Severe major depressive episode with psychotic features
,Delusions or hallucinations( usually mood-congruent); feelings of guilt and
worthlessness common
mood-congruent
Any delusion or hallucinations present.
In some sense appropriate to serious depression because the content is negative in
tone, such as themes of personal inadequacy, guilt, deserved punishment, death, or
disease.
Major depressive episode with atypical features
Mood reactivity- brightens to positive events; two of the following symptoms:
weight gain or increase of appetite, hypersomnia, leaden paralysis( arms and legs
feel heavy as lead), being acutely sensitive to interpersonal rejection.
Major Depressive Episode with catatonic features
A range of psychomotor symptoms from motoric immobility( catalepsy- a
stuporous state) to extensive psychomotor activity, as well as mutism and rigidity
Recurrent major depressive episode with a seasonal pattern
Also known as seasonal affective disorder.
At least two episodes of depression in the past 2 years occurred at the same time of
the year(Fall and winter), and full remission must have also occurred at the same
time of the year(spring).
Persistent depressive disorder
characterized by a persistently depressed mood most of the day, for more days than
not, for at least 2 years.
Periods of normal mood may occur briefly but only for a few days to a few weeks.
double depression
Are moderately depressed on a chronic basis but undergo increased problems from
time to time, during which they also meet criteria for a major depressive episode.
normal response of grief
, Grief usually has 4 phases
1. numbing and disbelief
2. yearning and searching for the dead person
3. disorganization and despair that set in when the person accepts the loss as
permanent
4. some reorganization as the person gradually begins to rebuild his or her life.
postpartum "blues"
changeable mood, crying easily, sadness, and irritability often liberally intermixed
with happy feelings. May lead to Major depressive disorder
Serotonin transporter gene
A gene involved in the transmission and re-uptake of serotonin, one of the key
neurotransmitters involved in depression. Alles are involved; short(s) long(l)
(s/s)= might predispose people to depression
Monoamine theory of depression
That depression was at least sometimes due to an absolute or relative depletion of
one or both of these neurotransmitters at important receptor sites.
Epinephrine and serotonin
Unable to prove to be responsible for depression
Anhedonia
inability to experience pleasure
hypothalamic-pituitary-adrenal axis (HPA)
is partly controlled by norepinephrine and serotonin. the hormone cortisol, which is
excreted by the outermost portion of the adrenal glands and is regulated through the
complex feedback loop.
Hypthalamic pituitary thyroid axis
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