Problem 4 – Mood disorders
DEPRESSIVE DISORDERS
Major Depressive Disorder – serious and can be over a shorter period of time, anhedonia (2 weeks)
● Subtypes: postpartum onset, seasonal pattern…
● 5+ symptoms and clinical picture
Persistent Depressive Disorder/Dysthymia – chronic and continuous, less acute than MDD, symptoms
tend to ebb and flow over long period of time (more than 2 years)
2+ symptoms
Prevalence
• MDD prevalence > PDD prevalence
• 18-29 year old highest rates of depression than any other age group
• Lowest in people over 60
• Rise at the age of 85 – severe, chronic and debilitating
• depression is approximately 1.5 to 3 times higher in females than males
• Depends on the culture 3% in Japan to 16% in US
• Relapse
o 75 percent of people who experience a first episode of depression will experience
subsequent episodes
• Why do a lot of depressed people not seek help?
o Lack of finances
o Expect to get over their symptoms on their own (spontaneous recovery)
o Sypmtoms only a phase that will go away
o Learned helplessness
Suicidality - males and those with a history of suicide attempts/threats are most at risk for attempting
suicide
Comorbidity
• depression and other mental disorders, particularly substance abuse disorders
• three-fourths of participants with lifetime MDD in a large-scale research study also met the
criteria for at least one other DSM disorder
• most common are anxiety disorders, ADHD, and substance abuse
• most depression cases occur secondary to another mental health disorder, meaning that the
onset of depression is a direct result of the onset of another disorder
, BIPOLAR DISORDERS
Bipolar I – at least one manic episode (only criterion necessary), can be preceded or followed by
hypomanic or depressive episode
• Manic episode: individual reports abnormal, persistent, or expansive irritable mood for nearly all
day, every day, for at least one week
o increased activity or energy
o appear excessively happy, often engaging haphazardly in sexual or personal interactions
o mood lability – rapid shifts in mood
o inflated self-esteem / grandiosity
o Can appear delusional
o Decreased need for sleep
o Rapid pressured speech
o Disregard reciprocal nature of communication
o Racing thoughts
Bipolar II – history of hypomanic episode and a major depressive episode at 4 days
• Hypomanic episode: individual must report symptoms consistent with a major depressive episode
and at least one hypomanic episode
o must not have a history of a manic episode (if yes → Bipolar I)
o A hypomanic episode is similar to a manic episode in that the individual will experience
abnormally and persistently elevated, expansive, or irritable mood and energy levels,
however, the behaviors are not as extreme as in mania
o present for at least four days, compared to the one week in a manic episode
Prevalence
• Bipolar I & II less prevalent than depression
• Very small prevalence difference between the two
• No apparent gender differences in bipolar I
• Bipolar II → more common in women (80-90% of rapid-cycling episodes being women at least 4
episodes of mania/depression in one year)
o Depression follows mania in 66%
o 33% do not necessarily have depression
Suicidality
• bipolar 15 times more likely to attempt suicide than general public
• suicide attempts in bipolar patients 33%
• may account for one-quarter of all completed suicides