3/22/20111What is Depression?Mood DisordersChapter 8Class ObjectivesDepressive Disorders‐ What are Mood Disorders?‐ What is Major Depressive Disorder?‐ What is Post Partum Disorder?Next class:What are Unipolar Mood Disorders?‐ What is Mania?Moods…THINK on your own… What are some everyday moods people can experience?3/22/20112Moods…This is an entire diagnostic category that focuses on disturbances of mood.Mood DisordersMood disorders are a group of disorders involving severe and enduring disturbances in mood ‐ The normal functioning of mood is disrupted Spectrum of MoodThe further mood moves from base line (normal mood) the more profound the symptoms of the disorder become.3/22/20113Have you ever felt depressed? What does depression feel like?“Depression is like falling into a deep, dark hole that you cannot climb out of. You scream as you fall, but it seems like no one hears you. Some days you float upward without even trying; on other days you wish that you would hit bottom so that you would never fall again.” Review the following video clip and evaluate the behaviors of the clientWhat symptoms of depression did you see? Divide these features into physical and cognitive symptoms.3/22/20114Major DepressionCognitive Symptoms of DepressionFeelings of worthlessnessLoss of interest in activities normally pleasurable ‐ Inability to experience “fun” from life (Anhedonia)Diminished ability to concentrateRecurrent thoughts of death and dyingDid you notice the client’s belief that she was the “devil?”When a person moves too far away from “normal” mood, whether too high on the spectrum or too low, they can experience psychosis. -Delusions and/or hallucinations can occur which indicate a severe disturbance in cognition.3/22/20115Physical symptoms of DepressionNoticeable loss of energy- (fatigue)‐ Physical disturbance (vegetative symptoms)Changes in appetite and weightSleep disturbance‐ Insomnia‐ HypersomniaDepressive DisordersDSM IV criteria indicate an extremely depressed mood state that lasts at least two weeks ‐ Social, occupational, educational or other important functioning must also be negatively impaired by the change in moodThe most easily recognized mood disorder is Major Depressive Disorder Major Depressive DisorderThis disorder is defined by the absence of manic or hypo-manic episodes and can be diagnosed as either single episodeor recurrent.‐ The occurrence of just one isolated depressive episode in a lifetime is rare.‐ About 60% of single episode cases will experience a second episode 70% will have a third, and 90% will have a fourth and meet criteria for recurrentIf two or more major depressive episodes occur, separated by a period of two months of non-depression, then the diagnosis is recurrent.3/22/20116How long will the depression last?An important feature of major depressive episodes is that they are time limited‐ Typically lasting from 2 weeks to 9 months (untreated).Almost all depressive episodes will diminish on their own without treatment‐ However, about 10% last 2 years or longerThe average age of onset for major depressive disorder is 25-29 years.Meet ThomasWhen Thomas was 26 he began displaying mild signs of depression. Over the next 6 months his symptoms gradually worsened and Thomas stopped working or going out with friends. Thomas gained 45 pounds, was chronically unshaven and disheveled, often not bathing for a week or more. Thomas often slept for more than 20 hours a day or was awake for several days on end. Thomas became completely reclusive for the next 6-9 months and rarely left his home. A year later he bumped into some friends who were shocked to see his appearance. Thomas looked wonderful, he lost 60 pounds by riding 30 miles a day on his bike, was working a full-time job and was symptom-free of depression. Thomas’ friends were thrilled at his transformation and asked “What happened? Did you get help? Are you in therapy or taking medication?” Thomas said, “No, I just got into my own head and fixed myself.”Comorbidity?Anxiety is commonly comorbid with Major Depression. ‐ About one-half of those with a primary diagnosis of major depression also have an anxiety disorder (Barbee, 1998).Anxiety and Depression go together like peanut butter and jelly!3/22/20117How serious is depression?Research suggests that the incidence of depression and consequent suicide seem to be steadily increasing.Approximately 750,000 people attempt suicide each year in the U.S.“Suicide is not chosen; it happenswhen pain exceeds resources for coping with pain.” The odds of suicide increase when depression develops at earlier ages. College students are very at risk for depression and suicide. If you or someone you know is battling with feelings of suicide please refer them to a professional.Help is always available:1-800-SUICIDE1-800-273-TALK3/22/20118True or False?More suicides occur during the winter and holiday seasons.True or False?More suicides occur during the winter and holiday seasons.FALSE! Suicide rates in the United States are lowest in the winter and highest in the spring In 2007, there were 34,598 suicides in the U.S.‐ 94.8 suicides per day; 1 suicide every 15.2 minutes. Who’s At Risk?Suicide is the eleventh overall leading cause of death.Males complete suicide at a rate 3.6 times that of females. However, females attempt suicide three times more often than males.Suicide ranks third as a cause of death among young (15-24) Americans behind accidents and homicides.Elderly adults have rates of suicide close to 50% higher than that of the nation as a whole (all ages).3/22/20119“I’m not crazy…I’ve just been in a bad mood for the last 30 years!”Dysthymic disorder shares many of the same symptoms of major depressive disorder, but it differs in its course.Long-lasting DepressionThis disorder is defined as a persistently depressed mood that continues for at least two years.‐ During this time, patients experience milder and unchanged symptoms for long periods of time.Dysthymic disorders are chronic and may last 20-30 years, with the median duration of 5 years.‐ These individuals are never symptom-free for an interval longer than 2 monthsPostpartum depression is often associated with feelings of inadequacy and sadness experienced by mothers of newborns.Experienced by 10-20 % of new mothers3/22/201110Think on your own…What do you know about Post-Partum Depression?Is it different