Mood Disorders and Suicide

mood disorder

gross deviations in mood

Major Depressive Episode

a clinical period lasting at least two weeks characterized by persistent low mood or loss of interest/pleasure (anhedonia) in daily activities

Anhedonia

the reduced or lost ability to experience pleasure, joy, or interest in previously enjoyed activities, often resulting in emotional numbness, social withdrawal, and a feeling of emptiness.

DSM-5 Criteria: Major Depressive Episode

1. five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure

2. Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful)

3. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others)

4. Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day.

5. etc…

Manic episode

a distinct period of abnormally, persistently elevated or irritable mood and high energy, lasting at least one week

Hypomanic episode

• shorter, less severe version of manic episodes

• last at least four days

• have fewer and milder symptoms

• associated with less impairment than a manic episode (e.g., less risky behavior)

• May not be problematic in and of itself, but usually occurs in the context of a more problematic mood disorder

“Mixed features”

term for a mood episode with some elements reflecting the opposite valence of mood

ex: depressive episode with some manic features

ex: manic episode with some depressed/anxious features

Unipolar mood disorder

only one extreme of mood is experienced (e.g., only depression or only mania)

Bipolar mood disorder

both depressed and elevated moods are experienced (e.g., some depressive episodes and some manic or hypomanic episodes)

Major Depressive Disorder

One or more major depressive episodes separated by periods of remission.

What is the difference between Major Depressive Disorder and Major Depressive Episode

MDD is a chronic mental health condition, whereas a MDE is the specific period of time during which symptoms occur

Persistent Depressive Disorder

• at least two years of depressive symptoms

  • depressed mood most of the day on more than 50% of days

  • no more than 2 months symptom free

  • May include periods of more severe major depressive symptoms

DSM-5 Criteria: Persistent Depressive Disorder (Dysthymia)

• Depressed mood for most of the day, for more days than not, as indicated by either subjective account or observation by others, for at least 2 years.

• Presence, while depressed, of two (or more) of the following

  • Poor appetite or overeating

  • insomnia or hypersomnia

  • low energy or fatigue

  • low self-esteem

  • poor concentration or difficulty making decisions

  • feelings of hopelessness

• etc…

Acute grief

occurs immediately after loss

integrated grief

eventual coming to terms with meaning of the loss

Complicated grief

persistent acute grief and inability to come to terms with loss

Premenstrual Dysphoric Disorder

significant depressive symptoms occurring prior to menses during the majority of cycles, leading to distress or impairment

Disruptive Mood Dysregulation Disorder

severe temper outbursts occurring frequently, against a backdrop of angry or irritable mood, 3+ times/week. Diagnosed only in children 6 to 18

Bipolar I Disorder

Alternations between major depressive episodes and manic episodes

Bipolar II Disorder

Alternations between major depressive episodes and hypomanic episodes

Cyclothymic disorder

alternations between less severe depressive and hypomanic periods

Learned Helplessness

Lack of perceived control over life events leads to decreased attempts to improve own situations

Self-efficacy

an individual’s personal belief in their capability to execute behaviors necessary to produce specific performance attainments

Internal attribution - depressive attributional sytle

negative outcomes are one’s own fault

stable attributions - depressive attributional style

believing future negative outcomes will be one’s fault

Global attribution - depressive attributional style

believing negative events will disrupt many life activities

Suicidal plan

specific means and setting for carrying out suicidal intent

suicidal intent

conscious decision to act upon suicidal thoughts

suicidal ideations

thoughts about suicide or ending one’s life