MOOD DISORDERS:Emotional Symptoms, Cognitive Symptoms, Bipolar Disorders

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Abnormal Psychology PSY404

LESSON 26

MOOD DISORDERS

MOOD DISORDERS are the most common psychological disorders and the risk of developing

them is increasing all over the world especially among the young people.

· It is really something which scares us.

· Mood or affective disorders are syndromes of depressions or a combination of depression and

mania.

· Normal mood depression which last for a few moments or hours.

· In depression there is altered energy level, motivation, behavior, bodily functioning

· Modification in sleep and eating patterns

· When these symptoms persist they greatly impair individual's ability

At work and at home and relationships at both places.

· Unipolar depression

· Bipolar depressions

Depression is one of the most prevalent of all clinical disorders co-occurring with other medical and

psychological disorders.

· I have missed placed my important documents I am sad

· My car has been stolen I am pretty sad

· My purse has been snatched with all my money I am sad

· My student has lost her father in death she refuses to come to college

· All these are events which make an individual become sad but after some time we get over them

and move on.

· You do not encounter any such event but you are sad most of the day, irritable, tired, your appetite

and sleep patterns are irregular so you suffer from mood disorder.

· What is depression?

· A mood state.

· Why do we get depress?

· We think we are the only ones with this disorder

· What are the symptoms of depression?

· Emotional, cognitive and behavioral

· Give me one symptom of depression observed in most people

· Being isolated

· Alone

· Seclusion.

· Major depression is the leading cause of disability worldwide.

· Emotion refers subjective states of feeling, such as sadness, anger, and disgust.

· Affect refers to the pattern of observable behaviors, such as facial expression, that are associated

with these subjective feelings.

· Mood refers to a pervasive and sustained emotional response that, in its extreme form, can color

the person's perception of the world.

· Depression can refer either to a mood or to a clinical syndrome, a combination of emotional,

cognitive, and behavioral symptoms.

· The feelings associated with a depressed mood often include disappointment and despair.

· Although sadness is a universal experience, profound depression is not.

· In the syndrome of depression, which is also called clinical depression, a depressed mood is

accompanied by symptoms, such as

· fatigue,

· loss of energy,

· difficulty in sleeping, and

· changes in appetite.

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Mania, the flip side of depression, also involves a disturbance in mood that is

accompanied by additional symptoms.

· Mania is an elated mood, is the opposite emotional state from a depressed mood.

· It is characterized by an exaggerated feeling of physical and emotional well-being.

· Manic symptoms that frequently accompany an elated mood include

· inflated self-esteem,

· decreased need for sleep,

· distractibility,

· pressure to keep talking, and

· the subjective feeling of thoughts racing through the person's head faster than

they can be spoken.

· Mood disorders are defined in terms of episodes--discrete periods of time in which the person's

behavior is dominated by either a depressed or manic mood.

· Unipolar mood disorder is a mood disorder in which the person experiences only episodes of

depression.

· Bipolar mood disorder is a mood disorder in which the person experiences episodes of mania as

well as depression.

· Years ago, bipolar mood disorder was known as manicdepressive disorder.

· Although this term has been replaced in the official diagnostic manual, some clinicians still prefer

to use it because it offers a more direct description of the patient's experience.

Important Considerations in Distinguishing Clinical Depression from Normal Sadness

1. The mood change is pervasive across situations and persistent over time.

2. The mood change may occur in the absence of any precipitating events, or it may be completely out

of proportion to the person's circumstances.

3. The depressed mood is accompanied by impaired ability to function in usual social and

occupational roles.

4. The change in mood is accompanied by a cluster of additional signs and symptoms, including

cognitive, somatic, and behavioral features.

5. The nature or quality of the mood change may be different from that associated with normal

sadness.

Emotional Symptoms

· Depressed, or dysphonic (unpleasant), mood is the most common and obvious symptom of

depression.

· In contrast to the unpleasant feelings associated with clinical depression, manic patients experience

periods of inexplicable and unbounded joy known as euphoria.

Many depressed and manic patients are irritable.

Anxiety is also common among people with mood disorders, just as depression is a common

feature of some anxiety disorders.

Cognitive Symptoms

· People who are clinically depressed frequently note that their thinking is slowed down, that they

have trouble concentrating, and that they are easily distracted.

· Guilt and worthlessness are common preoccupations.

· They focus considerable attention on the most negative features of themselves, their environments,

and the future--a combination known as the "depressive triad."

In contrast to the cognitive slowness associated with depression, manic patients commonly report

that their thoughts are speeded up.

Manic patients can also be easily distracted, responding to seemingly random stimuli in a

completely uninterpretable and incoherent fashion.

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Inflated self esteem is also characteristic features of mania.

Many people experience self-destructive ideas and impulses when they are depressed.

Interest in suicide usually develops gradually and may begin with the vague sense that life is not

worth living.

Somatic Symptoms

· The somatic symptoms of mood disorders are related to basic physiological or bodily functions.

· They include fatigue, aches and pains, and serious changes in appetite and sleep patterns.

· Trouble getting to sleep is common.

· In the midst of a manic episode, a person is likely to experience a drastic reduction in the need for

sleep.

Although some depressed patients report that they eat more than usual, most reduce the amount

that they eat; some may eat next to nothing.

People who are severely depressed commonly lose their interest in various types of activities that

are otherwise sources of pleasure and fulfillment.

Some patients complain of frequent headaches and muscular aches and pains.

Behavioral Symptoms

· The symptoms of mood disorders also include changes in the things that people do and the rate at

which they do them.

· The term psychomotor retardation refers to several features of behavior that may accompany the

onset of serious depression.

· The most obvious behavioral symptom of depression is slowed movement.

Patients may walk and talk as if they are in slow motion.

Others become completely immobile and may stop speaking altogether.

Some depressed patients pause for much extended periods, perhaps several minutes, before

answering a question.

In marked contrast to periods when they are depressed, manic patients are typically gregarious and

energetic.

Other Problems Commonly Associated with Depression

· Within the field of psychopathology, the simultaneous manifestation of a mood disorder and other

syndromes is referred to as comorbidity, suggesting that the person exhibits symptoms of more

than one underlying disorder.

· Alcoholism and depression are clearly related phenomena.

· Eating disorders and anxiety disorders are also more common among first-degree relatives of

depressed patients than among people in the general population.

Brief Historical Perspective

· The first widely accepted classification system was proposed by the German physician Emil

Kraepelin.

· Kraepelin divided the major forms of mental disorder into two categories: dementia praecox, which

we now know as schizophrenia, and manicdepressive psychosis.

· He based the distinction on age of onset, clinical symptoms, and the course of the disorder (its

progress over time).

The manicdepressive category included all depressive syndromes, regardless of whether the

patients exhibited manic and depressive episodes or simply depression.

In comparison to dementia praecox, manicdepression typically showed an episodic, recurrent

course with a relatively good prognosis.

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Despite the widespread acceptance and influence of Kraepelin's diagnostic system, many alternative

approaches have been proposed.

Two primary issues have been central in the debate regarding definitions of mood disorders.

First, should these disorders be defined in a broad or a narrow fashion?

A narrow approach to the definition of depression would focus on the most severely disturbed

people--those whose depressed mood is entirely pervasive and associated with a wide range of

additional symptoms.

A broader approach to definition would include mild depression, which lies somewhere on the

continuum between normal sadness and major depression.

The second issue concerns heterogeneity.

All depressed patients do not have exactly the same set of symptoms, the same pattern of onset, or

the same course over time.

Are there qualitatively distinct forms of mood disorder, or are there different expressions of the

same underlying problem?

Is the distinction among the different types simply one of severity?

Contemporary Diagnostic Systems

· The DSM-IV-TR approach to classify mood disorders recognizes several subtypes of depression,

placing special emphasis on the distinction between unipolar and bipolar disorders.

· The overall scheme includes two types of unipolar mood disorder and three types of bipolar mood

disorder.

Unipolar Disorders

· The unipolar disorders include two specific types: major depressive disorder and dysthymia.

· In order to meet the criteria for major depressive disorder, a person must experience at least one

major depressive episode in the absence of any history of manic episodes.

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Dysthymia differs from major depression in terms of both severity and duration.

Dysthymia represents a chronic mild depressive condition that has been present for many years.

In order to fulfill DSM-IV-TR criteria for this disorder, the person must, over a period of at least 2

years, exhibit a depressed mood for most of the day on more days than not.

Two or more of the following symptoms must also be present for a diagnosis of dysthymia:

1. Poor appetite or overeating

2. Insomnia or hypersomnia

3. Low energy or fatigue

4. Low self-esteem

5. Poor concentration or difficulty making decisions

6. Feelings of hopelessness

The distinction between major depressive disorder and dysthymia is somewhat artificial because

both sets of symptoms are frequently seen in the same person.

In such cases, rather than thinking of them as separate disorders, it is more appropriate to consider

them as two aspects of the same disorder, which waxes and wanes over time.

Bipolar Disorders

· All three types of bipolar disorders involve manic or hypomanic episodes.

· The mood disturbance must be severe enough to interfere with occupational or social functioning.

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A person who has experienced at least one manic episode would be assigned a diagnosis of bipolar

I disorder.

To be fully discussed in lecture no 27.

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