CHAPTER 7: MOOD DISODERS AND SUICIDE

MOOD DISORDER - Involve much more severe alterations in mood for much longer periods of
time. Disturbances of mood are intense and persistent enough to be clearly maladaptive and
often lead to serious problems in relationships and work performance.
AFFECT -Soaring elation or deep depression.

MOOD DISORDERS: AN OVERVIEW

Two key moods involved in mood disorders:
DEPRESSION - Usually involves feeling of extraordinary sadness and dejection. The most
common form of mood disturbance involves this.
MANIA - Characterized by intense and unrealistic feelings of excitement and euphoria.
MIXED- MOOD CASES - The person experiences rapidly alternating moods such as sadness,
euphoria, and irritability, all within the same episode of illness.

TYPES OF MOOD DISORDERS

UNIPOLAR DEPRESSIVE DISORDERS - The person experiences only depressive episodes.

BIPOLAR DEPRESSIVE DISORDERS - The person experiences both manic and depressive
episodes.
MANIC EPISODE - The person shows a markedly elevated, euphoric, or expansive mood, often
interrupted by occasional outbursts of intense irritability or even violence - particularly when
others refuse to go along with the manic person's wishes and schemes. These extreme moods
must persist for at least a week for this diagnosis to be made.
HYPNOMANIC EPIOSDE- A person experiences abnormally elevated, expansive, or irritable
mood for at least 4 days. Symptoms are not extreme. Much less impairment in social and
occupational functioning and hospitalization is not required.

THE PREVALENCE OF MOOD DISORDERS

MAJOR DEPRESSIVE DISODER - Only major depressive episodes occur (also known as
unipolar major depression). A person with this disorder may experience a loss of energy, too
much or too little sleep, decreased appetite and weight loss, an increase or slowdown in mental
and physical activity, difficulty concentrating, irrational guilt, and recurrent thoughts of death or
suicide.
UNIPOLAR DEPRESSIVE DISORDERS
Diagnostic criteria for major depressive disorder: Require that a person must be in a major
depressive episode and never have had a manic, hypomanic, or mixed episode.

DEPRESSION AS A RECURRENT DISORDER

RELAPSE - refers to the return of symptoms within a fairly short period of time, a situation that
probably reflects the fact that the underlying episode of depression has not yet run its course.
Commonly occurs when pharmacotherapy is terminated prematurely - after symptoms have
remitted but before the underlying episode is really over.
RECURRENCE – refers to the onset of a new episode of depression, occurs in approximately
40 to 50 percent of people who experience a depressive episode.

DEPRESSION THOUGHOUT THE LIFE CYCLE

Specifiers of Major depressive episodes with melancholic features - Symptoms include 3
of the following - early morning awakening, depression worse in the morning, marked
psychomotor agitation or retardation, loss of appetite or weight, excessive guilt, qualitatively
different depressed mood.

Specifiers of Major depressive episodes with psychotic features - Delusions or

hallucinations (usually mood congruent); feelings of guilt and worthlessness common.

Specifiers of Major depressive episodes with atypical features

Mood reactivity - brightens to positive events; two of the four following symptoms: weight gain or
increase in appetite, hypersomnia, leaden paralysis (arms and legs feel as heavy as lead),
being acutely sensitive to interpersonal rejection.

Specifiers of Major depressive episodes with catatonic features

A range of psychomotor symptoms from motoric immobility to extensive psychomotor activity,
as well as mutism and rigidity.

Specifiers of Major depressive episodes with seasonal pattern

At least two or more episodes in past 2 years that have occurred at the same time (usually fall
or winter), and full remission at the same time (usually spring). No other nonseasonal episodes
in the same 2-year period.
Mood congruent
Delusions (false beliefs) and hallucinations (false sensory perceptions) seem 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.

PERSISTENT DEPRESSIVE DISORDER

Double depression - People with this condition 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.

OTHER FORMS OF DEPRESSION

LOSS AND THE GRIEVING PROCESS

1. Numbing and disbelief
2. Yearning and searching for the dead person
3. Disorganization and despair that sets in when the person accepts the loss as permanent
4. Some reorganization as the person gradually begins to rebuild his or her life.