MOOD DISORDERS

BIPOLAR DISORDER | JULIA GECA

DEPRESSIVE AND BIPOLAR DISORDERS
Bipolar disorder, formerly known as manic depression, is a mental illness characterized by extreme mood
swings that include emotional highs (mania or hypomania) and lows (depression). You may feel sad or
hopeless when you are depressed, and you may lose interest or pleasure in most activities.

UNIPOLAR DEPRESSION: THE DEPRESSIVE DISORDERS

Depressive disorders, on the other hand, have no redeeming characteristics. They bring severe and long-
lasting psychological pain that may intensify as time goes by. Those who suffer from such disorders may
lose their will to carry out the simplest of life’s activities; some even lose their will to live.

How common is unipolar disorder?

People of any age may suffer from unipolar depression. In most countries, however, people in their forties
are more likely than those in any other age group to experience this problem. Women are at least twice
as likely as men to have episodes of severe unipolar depression.

What are the symptoms of Depression?

Emotional Symptoms
Most people who are depressed feel sad and dejected. They describe themselves as feeling “miserable,”
“empty,” and “humiliated.” They tend to lose their sense of humor, report getting little pleasure from
anything, and in some cases display anhedonia, an inability to experience any pleasure at all.

Motivational Symptoms
Depressed people typically lose the desire to pursue their usual activities. Almost all report a lack of drive,
initiative, and spontaneity. They may have to force themselves to go to work, talk with friends, eat meals,
or have sex.

Behavioral Symptoms
Depressed people are usually less active and less productive. They spend more time alone and may stay
in bed for long periods.

Cognitive Symptoms
Depressed people hold extremely negative views of themselves. They consider themselves inadequate,
undesirable, inferior, perhaps evil

Physical Symptoms
People who are depressed frequently have such physical ailments as headaches, indigestion, constipation,
dizzy spells, and general pain

Diagnosing Unipolar Depression

According to DSM-5, a major depressive episode is a period of two or more weeks marked by at least five
symptoms of depression, including sad mood and/or loss of pleasure. In extreme cases, the episode may
include psychotic symptoms, ones marked by a loss of contact with reality, such as delusions—bizarre
ideas without foundation—or hallucinations— perceptions of things that are not actually present.

WHAT CAUSES UNIPOLAR DEPRESSION?

researchers have found that depressed people have a larger number of stressful life events during the
month just before the onset of their disorder than do other people during the same period of time

The Biological View

Medical researchers have been aware for years that certain diseases and drugs produce mood changes.
Could unipolar depression itself have biological causes? Evidence from genetic, biochemical, anatomical,
and immune system studies suggests that often it does

Genetic Factors
family pedigree, twin, adoption, and molecular biology gene studies—suggest that some people inherit a
predisposition to unipolar depression. Family pedigree studies select people with unipolar depression as
probands (the proband is the person who is the focus of a genetic study), examine their relatives, and see
whether depression also afflicts other members of the family

Biochemical Factors
Low activity of two neurotransmitter chemicals, norepinephrine and serotonin, has been strongly linked
to unipolar depression

Brain Anatomy and Brain Circuits

biological researchers now believe that the root cause of psychological disorders involves more than just
a single neurotransmitter or single brain area
They have determined that emotional reactions of various kinds are tied to brain circuits networks of brain
structures that work together, triggering each other into action and producing a particular kind of
emotional reaction

The Immune System

the immune system is the body’s network of activities and body cells that fight off bacteria, viruses, and
other foreign invaders. When people are under intense stress for a while, their immune systems may
become dysregulated, leading to lower functioning of important white blood cells called lymphocytes and
to increased production of C-reactive protein (CRP), a protein that spreads throughout the body and
causes inflammation and various illnesses

Psychological Views
The psychological models that have been most widely applied to unipolar depression are the
psychodynamic, behavioral, and cognitive models. The psychodynamic explanation has not been strongly
supported by research, and the behavioral view has received only modest support. In contrast, cognitive
explanations have received considerable research support and have gained a large following.
 • The Psychodynamic View
Sigmund Freud and his student Karl Abraham developed the first psychodynamic explanation of
depression. They began by noting the similarity between clinical depression and grief in people who lose
loved ones: constant weeping, loss of appetite, difficulty sleeping, loss of pleasure in life, and general
withdrawal
• The Behavioral View
Behaviorists believe that unipolar depression results from significant changes in the number of rewards
and punishments people receive in their lives

• Cognitive Views
Cognitive theorists believe that people with unipolar depression persistently view events in negative ways
and that such perceptions lead to their disorder

TREATMENT FOR UNIPOLAR DEPRESSION

A variety of treatment approaches are currently in widespread use for unipolar depression. We first look
at the psychological approaches, focusing on the psychodynamic, behavioral, and cognitive therapies. We
then explore the socio- cultural approaches, including a highly regarded intervention called interpersonal
psychotherapy. Next, we look at effective biological approaches, including electroconvulsive therapy,
antidepressant drugs, and new brain stimulation interventions. In the process, we can see that unipolar
patterns of depression are indeed among the most successfully treated of all psychological disorders.

Psychological Approaches
The psychological treatments used most often to combat unipolar depression come from the
psychodynamic, behavioral, and cognitive schools of thought.
Psychodynamic therapy, the oldest of all modern psychotherapies, continues to be used widely for
depression even though research has not offered strong evidence of its effectiveness
Behavioral therapy, effective primarily for mild or moderate depression, is practiced less often today than
it was in past decades
Cognitive therapy and cognitive-behavioral therapies have performed so well in research that they have
a large and growing following among clinicians

➢ Sociocultural Approaches
sociocultural theorists trace the causes of unipolar depression to the broader social structure in
which people live and the roles they are required to play

Multicultural Treatments
therapists typically have special
cultural training and a heightened awareness of their clients’ cultural values and the culture-
related stressors, prejudices, and stereotypes that their clients face. They make an effort to help
clients develop a comfortable (for them) bicultural balance and to recognize the impact of their
own culture and the dominant culture on their views of themselves and on their behaviors
 Family-Social Treatments
Therapists who use family and social approaches to treat depression help clients change how they
deal with the close relationships in live

➢ Biological Approaches
biological treatments can bring significant relief to people with unipolar depression. Usually,
biological treatment means antidepressant drugs or popular herbal supplements

Electroconvulsive Therapy
In an ECT procedure, two electrodes are attached to the patient’s head, and 65 to 140 volts of
electricity are passed through the brain for half a second or less. This results in a brain seizure that
lasts from 25 seconds to a few minutes. After 6 to 12 such treatments, spaced over 2 to 4 weeks,
most patients feel less depressed

BIPOLAR DISORDERS | PABALAN, KRISTA

BIPOLAR DISORDERS - it was also called as manic depression; it causes extreme mood swings that
include emotional highs and lows; a stressful circumstances or situation often triggers the symptoms;
are equally common in women and men, however, women may have more depressive episodes and
more rapid cycling; it usually occurs between 14-40 years of age

SYMPTOMS OF MANIA

• Dramatic and inappropriate rises in mood

• A person in the throes of mania has active, powerful emotions in search of an outlet
• Shows a very active behavior.
• MOTIVATIONAL REALM: they enthusiastically seek out friends, new interests, and were
notaware that their social style is overwhelming, domineering, and excessive
• COGNITIVE REALM: they have a poor judgement and planning; during SEVERE EPISODES
OFMANIA some has trouble remaining coherent or in touch with reality
• PHYSICAL REALM: they feel remarkably energetic, they typically get little sleep yet feel and
actwide awake

DIAGNOSING BIPOLAR DISORDER

FULL MANIC EPISODE - display an abnormal high or irritable mood, increased activity or energy,
typicallyshows 3 symptoms of mania, shows psychotic feature like delusions or hallucinations

HYPOMANIC EPISODE - less severe than full manic episode; period of abnormally elevated, extreme
changes in mood, behavior, activity and energy level

2 KINDS OF BIPOLAR DISORDERS:

1. BIPOLAR I DISORDER - have full manic and major depressive episodes; it's an alternation of
weeks of mania, then a period of wellness, in turn by an episode of depression; displays
bothmanic and depressive symptoms like racing thoughts and extreme sadness
2. BIPOLAR II DISORDER - hypomanic episodes alternate with major depressive episodes over
thecourse of time; people with this pattern accomplish huge amounts of work during their
 mild manic episodes

* if a person has 4 or more episodes within a year period it is considered as RAPID CYCLING

* periods of feeling low followed by periods of extreme happiness and excitement is a

CYCLOTHYMICDISORDER

CAUSES OF BIPOLAR DISORDERS

• NEUROTRANSMITTERS - Norepinephrine (increases heart rate and blood pumping from
the heart) activity of people with mania is said to be higher than that of depressed, and
they were given RESERPINE the blood pressure drug known to reduce norepinephrine
activity in the brain, and the manic symptoms of some subsided; low serotonin activity
and low norepinephrine leadsto depression, low serotonin activity and high
norepinephrine leads to mania.
• ION ACTIVITY - irregularities in the transport of ions may cause neurons to do neuron
transmission or firing too easily resulting to mania, or to stubbornly resist firing resulting
todepression
• BRAIN STRUCTURE - Basal Ganglia and Cerebellum are smaller; Dorsal Raphe Nucleus (it is
where serotonin was produced), Striatum (a neuronal circuit necessary for voluntary
movementcontrol), Amygdala (process fearful and threatening stimuli), Hippocampus (major
role in learning and memory), and Prefrontal Cortex (cognitive control function) have some
abnormalities
• GENETIC FACTORS – if one of the parents is diagnosed with this there are 10% chance that
thechild would have it also

SADNESS - is often one of the symptoms found in depression, but most often it is a perfectly normal
negative emotion triggered by a loss or other painful circumstance

TREATMENTS

• LITHIUM - if patients were given low dose there would be little to no effect to the disorder;
highdose on the other hand could lead to poisoning; only correct doses will lead to noticeable
change of the disorder
• MOOD STABILIZERS - prevent symptoms from developing; overcome depressive
episodes;continued doses may help to reduce risk of future depressive episode and
suicide attempt
• COMBINATION OF MOOD STABILIZERS AND ANTIDEPRESSANTS - a great treatment of
bipolar disorder
• ADJUNCTIVE PSYCHOTHERAPY - helps reduce hospitalizations, improves social functioning,
andincreases patient's ability to obtain and hold a job.
 SUICIDE
SUICIDE | CADA, BEN JOHN
Definition | Parasuicide and Suicide
The pioneer in this field, Edwin Schneidman, defined suicide as an intentional death—a self-inflicted
death in which one takes an intentional, direct, and conscious effort to end his or her life.
Intentional deaths can take many forms. There have parasuicide and suicide. Parasuicide is defined as an
attempt to suicide that does not result in death. Parasuicide is a result of miscalculations of the plan and
result to failed attempt. Suicide is defined as a self-inflicted or voluntary death in which the individual
acts purposefully, directly, and consciously.

Schneidman’s Four Types of Suicide Seekers

Death Seeker
It is defined as the individual that are clearly want to end their lives. This is the individual who
intentionally acts in such a way as to bring about his death. In this case, methods how to and their lives
are unimportant. What matters is that the person acts in such a way that it is nearly hard for others to
help him/her.

Death Initiators
The individual who is aware that his or her days are coming or that he or she is suffering and is unable to
deal with this. In other words, they intend to commit suicide because they believe their death is
approaching. This is common on those who have serious diseases and elders.

Death Ignorers
The one who thinks that after committing suicide, he will continue to live in some other way, such as the
afterlife. Example of this is the cult called heaven’s gate, they believed that death will bring them
somewhere to meet a UFO, basically they believed that death will bring them to a better life.

Death Darers
This is the one who is, in essence, playing "Russian Roulette" with his life. This individual engages in
"dare-devil" activities where he has a minimal chance of survival due to a lack of expertise required to
succeed. This individual is "flirting with death."

Retrospective Analysis
The strategy that they commonly use in investigating suicide is the retrospective analysis – it is a
psychological autopsy in which clinicians and researchers put together information from the suicide
victim's background. Like their past statements, discussions, and actions that provide insight on a suicide
may be remembered by relatives, friends, therapists, or physicians. Suicide notes, which some victims
leave behind, may also give retrospective information. Using retrospective analysis, investigators may
conclude the reasons why the victim commit suicide.

Such sources of information, however, are not always available or dependable. Approximately half of all
suicide victims have never received psychotherapy, and only around one-third leave notes (Maris, 2001).
Therefore, retrospective data is not always reliable.
Suicide’s Patterns and Statistics
Suicide patterns and statistics may differ depending on gender, ethnicity, age, religious belief, marital
support, social support, and more.

In Philippines, the Philippines' Mental Health Act was approved in 2018, and by 2020, there had been a
149% rise in the average monthly calls for urgent help received by the National Center for Mental
Health. Nonetheless, the Philippine Statistics Authority stated that suicide rates increased by 57.3
percent from 2020 to 2021. Given these statistics, there is no doubt that the country is experiencing a
mental health crisis.

What are the things that triggers suicide?

Suicidal behavior may be motivated by previous events or current situations in a person's life. Although
these factors may not be the primary motive for the suicide, they might worsen it. Stressful situations,
mood and mood swings, alcohol and other drug use, mental disorders, and modeling are all common
triggering factors.

Stressful Situation
• death of loved ones, societal and peer pressure, stress, and depression.
Changes In Thought Patterns
• People may get obsessed with their concerns, lose perspective, and believe that suicide is the
only viable answer to their problems.
• hopelessness, or the pessimistic belief that their current circumstances, issues, or mood will not
change.

Alcohol and Drug Addiction

Alcohol and drug addiction are also factors that contribute to suicide. According to studies, up to 70% of
persons who attempt suicide consume alcohol soon before doing their suicide attempt. According to
autopsies, approximately one-quarter of these victims were legally intoxicated. Alcohol usage may
reduce a person's fear of committing suicide, release hidden violent emotions, or impair judgment and
problem-solving skills. Other types of drug usage, according to research, may have a similar link to
suicide, particularly in teens and young adults. A significant level of heroin, for example, was discovered
in Kurt Cobain's blood at the time of his suicide in 1994.

Mental disorders
Suicidal attempters may be unhappy or nervous, but they may not always have a psychological problem.
However, the majority of suicide attempters suffer from such a mental disorder. According to research,
up to 70% of all suicide attempters were suffering from severe depression, 20% from chronic drinking,
and 10% from schizophrenia. Similarly, up to 25% of patients suffering from each of these diseases
attempt suicide.
Modelling or Suicide Contagion
this is the exposure to suicide or suicidal behaviors in one's family, peer group, or through suicide media
stories. One suicide act might serve as a model for another. This suicidal act might be committed by a
family member, a celebrity, or friends. Influential individuals in another person's life might serve as an
example for them to follow.

Suicide contagion can occur as a result of the suicide of a celebrity, a family member, or a peer, and it
frequently corresponds with media coverage of the suicide. Suicide spread is more frequent among
young adults and adolescents.

Underlying Causes of Suicide

The underlying causes of suicide can be determined from three perspectives. The psychodynamic
perspective, Durkheim’s sociocultural perspective, and the biological perspective.

➢ Psychodynamic Perspective
Suicide, according to psychodynamic perspective, is the outcome of an internal struggle that causes
aggressiveness and depression to arise within an individual. As a result, one commits suicide in order to
escape the severe unhappiness that has built up in his or her system.

➢ Durkheim’s Sociocultural Perspective

This perspective takes into consideration the influence that society plays in a person's decision to
commit suicide.

➢ Biological Perspective
This perspective takes into consideration of biological processes that contributes to suicide like low level
of serotonin or imbalances.

TREATMENT AND SUICIDE PREVENTION | JACOBE, KATRINA

Is Suicide Linked to Age?
Although people of all ages may try to kill themselves, the likelihood of committing suicide steadily
increases with age up through middle age, then decreases during the early stages of old age, and
then increases again beginning at age 85.

1. CHILDREN
Researchers have found that suicide attempts by the very young are commonly preceded by such
behavioral patterns as running away from home; accident-proneness; aggressive acting out; temper
tantrums; self-criticism; social withdrawal and loneliness; extreme sensitivity to criticism by others;
low tolerance of frustration; sleep problems; dark fantasies, daydreams, or hallucinations; marked
personality change; and overwhelming interest in death and suicide.
Suicide triggers among children;
• Loss of a loved one
• Family Stress
• School Stress
 • Parent's Unemployment
• Abuse by Parent's
• Victimization by Peers (Bullying)
• A Clinical Level of Depression

2. ADOLESCENTS
According to official records, approximately 1,400 teenagers (age 13 to 18), or 7 of every 100,000,
commit suicide in the United States each year. In addition, at least 12 percent of teenagers have
persistent suicidal thoughts and 4 percent make suicide attempts. Suicide has become the third
leading cause of death in this age group, after accidents and homicides. Around 10 percent of all
adolescent deaths are the result of suicide.
Suicide triggers among adolescents;
• Clinical Depression
• Low self-esteem
• Feelings of hopelessness
• Struggle with anger and impulsiveness
• Serious alcohol or drug problems
• Family conflict
• Social isolation
• Parent’s unemployment
• Medical illness
• Financial Stress
• School stress
• Social loss such as a breakup with a boyfriend or girlfriend

Adolescence is a period of rapid growth that is often marked by conflicts, depressed feelings,
tensions, and difficulties at home and school. Adolescents tend to react to events more sensitively,
angrily, dramatically, and impulsively than individuals in other age groups; thus the likelihood of their
engaging in suicidal acts during times of stress is higher. Finally, the suggestibility of adolescents and
their eagerness to imitate others, including others who attempt suicide, may set the stage for suicidal
action.

3. THE ELDERLY
More than 15 of every 100,000 people over the age of 65 in the United States commit suicide, a rate
that rises to 18 per 100,000 among the very elderly, as you read earlier (AFSD, 2014). Elderly people
commit over 19 percent of all suicides in the United States, yet they account for only 14 percent of
the total population (U.S. Census Bureau, 2014).
Suicide triggers among the elderly;
• Illness
• Loss of friend or relative
• Loneliness
• Depression
• Bereavement
Such experiences may result in feelings of hopelessness, loneliness, depression, “burdensomeness,”
or inevitability among aged persons and so increase the likelihood that they will attempt suicide.
Elderly people are typically more determined than younger people in their decision to die and give
fewer warnings, so their success rate is much higher.

4. TREATMENT AND SUICIDE

Treatment of suicidal people falls into two major categories: treatment after suicide has been
attempted and suicide prevention.
• Treatment after suicide has been attempted

A. Therapy - The goals of therapy for those who have attempted suicide are to keep the
individuals alive, reduce their psychological pain, help them achieve a non-suicidal state of
mind, provide them with hope, and guide them to develop better ways of handling stress.
B. Psychotherapy - or talk therapy, during which you work with a therapist to explore why
you’re feeling suicidal and how to cope.
C. Family therapy and education - Involving loved ones in treatment can help them better
understand what you're going through, learn the warning signs, and improve family
dynamics.
D. Lifestyle changes - managing stress, improving sleep, eating, and exercise habits, building a
solid support network, and making time for hobbies and interests.
E. Medications to treat any underlying depression causing your suicidal ideation - This may
include antidepressants, antipsychotic medications, or anti-anxiety medications.

Suicide Prevention
Suicide prevention programs include 24-hour-a-day hotlines and walk-in centers staffed largely by
paraprofessionals. During their initial contact with a suicidal person, counselors try to establish a
positive relationship, to understand and clarify the problem, to assess the potential for suicide, to
assess and mobilize the caller’s resources, and to formulate a plan for overcoming the crisis. Beyond
such crisis intervention, most suicidal people also need longer-term therapy. In a still broader
attempt at prevention, suicide education programs for the public are on the increase.