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PSC 168 - Lecture 9 - Mood Disorders Characteristics
Terms in this set (28)
Unipolar Depressive Disorders
1.Major Depressive Episode
2. Persistent Depressive Disorder (similar former Dysthymia)
3. Premenstrual Dysphoric Disorder (PMDD)
1. Bipolar 1 Disorder
2. Bipolar 2 Disorder
What kind of disorder is depression?
It is a "spectrum disorder"
What are different kinds of depressive symptoms?
- Emotional Symptoms (e.g., sadness, crying)
- Cognitive Symptoms (e.g., poor memory & concentration; inability to make decisions)
- Physical Symptoms (e.g., low energy, decreased appetite, sleep, sex drive)
What is a description that is given by suffers of depression?
"A dark whole I cannot crawl out of;" "I'm a living dead person;" "I feel empty, void", "I feel nothing, I can't even cry;" "Everything is in slow motion;" "I can't think any more;" "I'm useless;" "I'm a fraud."
What is the DSM definition for depression?
For at least two weeks 5 out following nine have to be met:
1.Depressed mood most of the day
2.Diminished interest or pleasure in almost all activities previously enjoyed (anhedonia)
3.Significant weight loss or weight gain, or significant change in appetite
4Insomnia or hypersomnia
5.Psychomotor retardation or psychomotor agitation, nearly every day
6.Diminished ability to concentrate or indecisiveness
7.Fatigue or loss of energy nearly every day
8.Feelings of worthlessness of inappropriate guilt
9.Recurrent thoughts of death and/or suicidal ideation
How can you be diagnosed with Major Depressive Disorder (MDD)
MDD entails a history of one or more major depressive disorder
Symptoms must cause distress and impairment
Specifier of MDD: Single Episode vs Recurrent Episode
- 75% of those who have one episode will have at least one other episode.
- If only one episode, it likely was in response to a major life stressor.
- Without treatment, an MDD sufferer has on average 5-6 episodes in lifetime.
- An untreated major depressive episode lasts 8-10 months.
- Recovery after an episode may be complete or mild depression left.
- Dangers of repeated untreated episodes for long-term brain dysregulation.
Specifier of MDD with Psychotic Features
-Psychotic symptoms: break with reality; delusions; hallucinations
- Always associated with a severe episode, but severe episodes don't have to include psychosis).
Specifier of MDD with Mixed Features
- Presence of manic symptoms pointing at possibility of underlying bipolar dis.
- Feeling mostly depressed but combined with increased energy level, irritability, restlessness, impulsivenss; high risk for suicide!
Specifier of MDD with Anxious Distress
- Anxiety symptoms beyond what would be expected for depressive state.
Specifiers of MDD with Seasonal Patterns
-Seasonal Affective Disorder (SAD)
- Low energy, oversleeping, craving for carbohydrates
Specifiers of MDD with Peripartum Onset
Depression after pregnancy
Specifiers of MDD with Atypical Features
-Significant weight gain and increase in appetite,
- long-standing pattern of interpersonal rejection sensitivity.
Specifiers of MDD with Catatonic Features
- Motoric immobility or stupor; not responding to instructions;
- odd, bizarre postures;
- sometimes echolalia or echopraxia (repeating others speech or movements);
- sometimes motionlessness alternates with agitation
Other distinctions of MDD
-Endogenous vs. Exogenic Depression
- Endogenic vs. Exogenic Depression
- Biological vs. Environmental Depression
- Internal factors vs.
External factors causing depression
- Biochemical vs. Reactive Depression
- Genetic vs. Learned
What is the DSM Definition of Persistent Depressive Disorder (Dysthymia)
-A chronic pattern of depression that has lasted for at least 2 years.
-A person experiences depressive symptoms that are mild, moderate, or severe (Major Depression)
-Less severe symptoms but goes for longer.
-Depressed for years. Starts in childhood
Premenstrual Dysphoric Disorder (PMDD)
* Marked change in mood during a woman's premenstrual period.
(This diagnostic category was only in the appendix of DSM-IV and is now an accepted diagnosis.)
What is the DSM definition of Manic Disorder (Bipolar Disorder)
-Abnormally high energy level representing increase of normal energy level
-Abnormally and persistently elevated, expansive, or irritable mood
For manic disorder, you have 3 out of the following to be diagnosed.
- Grandiosity or inflated self-esteem
- Decreased need for sleep
- Increased talkativeness ("pressure of speech")
- Flight of ideas or racing thoughts
- Psychomotor agitation or increased in goal-directed activity (e.g. work)
- Buying sprees, sexual indiscretions, foolish investments, other pleasurable activities. (Poor judgment!)
How long do the symptoms of Manic Disorder have to last?
Symptoms last one week OR Hospitalization is needed
What are some additional symptoms that are frequently seen in Manic Disorder?
- Psychosis is common (delusions of grandeur, paranoia, hearing voices)
- Hypergraphia (writing excessively "of upmost importance")
- Hyperreligiosity (preaching in public places, writing manifestos)
- Hyperacuity and/or sharpening of all senses
- Obsessiveness and compulsions (e.g., ordering, cleaning)
- High anxiety level
- Intense affect, emotionally reactive
- Loud speech
- Self-centeredness, narcissism, manipulation
- Intrusiveness, meddling
- Quick to anger, hostility, sometimes violence, enjoys arguing
- In severe cases: disorganization of thoughts and behavior
- But also funny, spontaneous, creative
What is the DSM definition for Hypomanic Episode?
- Types of symptoms are the same as for manic episode, EXCEPT:
- Less severe symptoms
- Less impairment in social or occupational functioning
- No psychotic symptoms
- Hospitalization is NOT needed
- Symptoms need to last only at least 4 days
Bipolar Disorder 1
-At least one manic episode
-Usually mania alternates with major depression BUT for there may or may not be
depression to meet criteria for Bipolar I Disorder
Bipolar Disorder 2
At least one hypomanic episode AND one or more major depressive episodes.
-For a least 2 years, periods of hypomania symptoms and depressive symptoms.
-Depressive symptoms are milder than with Bipolar II disorder.
Specifiers of Bipolar 1 and 2 disorder
Specifiers that are same as with MDD:
With Psychotic Features (during either the manic or depressed states, or both)
* With Mixed Features
(features or depression in addition to mania,e.g., suicidal, feeling hopeless)
* With Anxious Distress
* With Seasonal Pattern
* With Peripartum Onset
Specifiers that only apply to Bipolar Disorder: Rapid Cycling
- more than 4 episodes within one year, but usually many more
- 20% of bipolars are rapic cyclers, 90% of them are women
- can be precipitated by going off mood stabilizing medication or taking antidepressants only
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