Section 3 Learning Objectives Chapter 7 Mood Disorders and Suicide 1 Key Terms a Depression state marked by either a sad mood or a loss of interest in one s usual activates as well as feelings of hopelessness suicidal ideation psychomotor agitation or retardation and trouble concentrating b Depressive disorders a set of disorders characterized by depressed mood and or anhedonia and not mania c Premenstrual dysphoric disorder a set of symptoms occurring immediately prior to onset of menses characterized by a mixture of depression anxiety and tension and irritability and anger may occur in mood swings during the week before onset of menses and subside once menses has begun d Disruptive mood dysregulation disorder a disorder in children characterized by immature and inappropriate temper outbursts that are grossly out of proportion to a situation in intensity and duration e Non suicidal self injury NSSI act of deliberately cutting burning puncturing or otherwise significantly injuring one s skin with no intent to die f Egoistic suicide suicide committed by people who feel alienated from others and who lack social support g Anomic suicide suicide committed by people who experience a severe disorientation and role confusion because of a large change in their relationship to society h Altruistic suicide suicide committed by people who believe that taking their own life will benefit society 2 What are the symptoms of a Major Depressive Episode textbook and lecture a Major Depressive Disorder a severe bout of depressive symptoms lasting two weeks or more requires that a person experience either depressed mood or loss of interest in usual activities plus at least four other symptoms of depression chronically for two weeks must be severe enough to interfere with the person s ability to function in everyday life i At least 5 of the following symptoms depressed mood anhedonia appetite or weight changes sleep problems psychomotor agitation or retardation loss of energy feelings of worthlessness or inappropriate guilt concentration problems ii Major depressive disorder single episode people who experience only one depressive episode iii Major depressive disorder recurrent episode two or more episodes separated by at least 2 consecutive months without symptoms 3 What are the diagnostic features of Major Depression and its associated subtypes Dysthymic Disorder Persistent Depressive Disorder and double depression How are these disorders similar and different lecture textbook a Major Depression i Presence of a major depressive episode ii Not better accounted for by another disorder iii No history of manic mixed or hypomanic episode iv Specifiers subtypes 1 Anxious distress worrying brooding 2 Mixed some evidence of mania hypomania 3 Melancholic features prominent physiological symptoms and anhedonia 4 Psychotic features delusions and hallucinations a Strongly held beliefs that aren t true 5 Catatonic features lack of movement disturbed speech 6 Atypical features assortment of odd symptoms a Mood brightens in response to events that are abnormal such as increased appetite 7 Peripartum onset within 4 weeks of delivery of child 8 Seasonal patterns Seasonal Affective Disorder SAD a Seasonal Affective Disorder depression with seasonal pattern ii i Have at least 2 years history of experiencing and fully recovering from major depressive episodes In order to be diagnosed with SAD a person s mood changes cannot be the result of psychosocial events such as regularly being unemployed during winter Rather the mood changes must seem to come on without reason or cause b Dysthymic Disorder Persistent Depressive Disorder depressed mood for most of the day for more days than not for at least 2 years i In children and adolescents persistent depressive disorder requires depressed or irritable mood for at least 1 year ii also requires presence of two or more of the following symptoms poor appetite insomnia or hypersomnia low energy or fatigue low self esteem poor concentration hopelessness iii during the 2 years a person must never been without a symptoms of depression for longer than a 2 month period less severe but more chronic iv c Double Depression 4 How do rates of unipolar depression vary as a function of age gender and culture What are the proposed explanations for these differences discussed in class and the textbook see sociocultural theories of depression Lecture textbook a Cohort effects effect that occurs when people born in one historical period are at different risk for a disorder than are people born in another historical period i Younger generations have unrealistically high expectations for themselves that older generations didn t have b Gender Differences i Women are 2X more likely than men to suffer from depression ii women tend to be more interpersonally oriented then men leading them to ruminate more whereas men go to alcohol for their problems iii sexual abuse especially in childhood contributes to depression in women throughout their lifetime c Ethnicity Racial Differences i In the U S Hispanics show higher rates of depression may reflect relatively high rates of poverty unemployment and discrimination among Hispanics ii African Americans have lower rates of depression than Caucasians 1 African Americans have higher rates of anxiety disorders suggesting the stress of their social status may make them especially prone to anxiety disorders rather than depression iii Extremely high rates of depression among native Americans especially the young tied to poverty hopelessness and alcoholism 5 What are the symptoms of mania What are the similarities and differences between mania and hypomania Lecture textbook a Bipolar I Disorder i Mania state of persistently elevated mood feelings of grandiosity overenthusiasm racing thought rapid speech and impulsive actions Impulsive behaviors such as sexual indiscretions or spending sprees 1 2 Must show an elevated expansive or irritable mood for at least 1 week as well as at least three other symptoms inflated self esteem or grandiosity decreased need for sleep more talkative flight of ideas distractibility increase in goal directed activity or psychomotor agitation excessive involvement in pleasurable activities 3 Almost all these people will fall into a depressive episode mania without any depression is rare b Bipolar II Disorder i Hypomania state in which an individual shoes mild symptoms of mania but not severe enough to interfere with daily functioning do
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