4. Mood Disorders & Suicide

What are mood disorders?

A type of disorder characterized by disturbances of mood that can take various forms.

What are the types of mood disorders?

Mood episodes, depressive disorders, bipolar disorders, and other mood disorders.

What characterizes Major Depressive Disorder (MDD)?

A severe mood disorder characterized by major depressive episodes without a history of manic episodes.

List four key characteristics of MDD.

Depressed mood, lack of interest or pleasure in usual activities, lack of energy or motivation, changes in appetite or sleep patterns.

What is the DSM-5 criteria for diagnosing MDD?

At least 5 symptoms must be present during the same 2-week period, including either depressed mood or loss of interest or pleasure.

What is one symptom of MDD related to mood?

Depressed mood most of the day, nearly every day.

What is one symptom of MDD related to interest?

Markedly diminished interest or pleasure in almost all activities most of the day.

What is one symptom of MDD related to appetite?

Significant weight loss or gain, or changes in appetite nearly every day.

What is a symptom of MDD related to sleep?

Insomnia or hypersomnia nearly every day.

What is a symptom of MDD related to energy levels?

Fatigue or loss of energy nearly every day.

What are recurrent thoughts associated with MDD?

Recurrent thoughts of death, suicidal ideation, or a specific plan for committing suicide.

When are changes in mood considered abnormal?

When they are persistent or severe, or involve cycles of extreme elation and depression.

What age group has the highest prevalence of depressive disorders in Canada?

Adolescents and young adults (15-24 years of age).

How does the prevalence of depressive disorders differ between genders?

Women have a higher prevalence of depressive disorders compared to men, especially in adolescence and adulthood.

What are some specifiers for MDD?

With anxious distress, mixed features, melancholic features, atypical features, mood-congruent psychotic features, mood-incongruent psychotic features, catatonia, peripartum onset, and seasonal pattern.

What is Seasonal Affective Disorder (SAD)?

MDD with seasonal pattern, characterized by fatigue, excessive sleep, carbohydrate cravings, and weight gain.

Who is more affected by Seasonal Affective Disorder?

Women are affected more often than men.

What is postpartum depression?

MDD with peripartum onset, characterized by persistent and severe mood changes following childbirth.

What is a common risk factor for developing MDD?

Being in young adulthood (20s and 30s) is a common risk factor.

How does socioeconomic status relate to MDD?

Socioeconomic status is a risk factor for developing depressive disorders.

What coping styles can influence the risk of MDD?

Different coping styles can affect the likelihood of developing major depression.

What is the prevalence of peripartum depression?

10 to 15%.

What is Persistent Depressive Disorder previously known as?

Dysthymic Disorder.

What characterizes Persistent Depressive Disorder?

It is a milder form of depression that follows a chronic course, often beginning in childhood or adolescence.

What is the DSM-5 criterion A for Persistent Depressive Disorder?

Depressed mood for most of the day, for more days than not, for at least 2 years (1 year for children/adolescents).

What are two symptoms required for the diagnosis of Persistent Depressive Disorder according to criterion B?

Poor appetite or overeating, insomnia or hypersomnia, low energy or fatigue, low self-esteem, poor concentration, feelings of hopelessness.

What is criterion C for Persistent Depressive Disorder?

The individual has never been without symptoms in criteria A and B for more than 2 months at a time during the 2-year period.

What characterizes Premenstrual Dysphoric Disorder?

Mood changes that revolve around a woman's menstrual cycle.

What is criterion A for Premenstrual Dysphoric Disorder?

At least 5 symptoms must be present in the final week before menses, improve a few days after, and be minimal or absent in the week post menses.

What are two symptoms required for Premenstrual Dysphoric Disorder according to criterion B?

Marked affective lability (mood swings) and marked irritability or anger.

What additional symptoms are required for Premenstrual Dysphoric Disorder according to criterion C?

Decreased interest in usual activities, subjective difficulty in concentration, lethargy, marked change in appetite, hypersomnia or insomnia, a sense of being overwhelmed, or physical symptoms.

What defines Bipolar Disorder I?

Features states of extreme elation (manic episodes) and major depressive episodes.

What is criterion A for Bipolar Disorder I?

Criteria have been met for at least one manic episode.

What is criterion B for Bipolar Disorder I?

The occurrence of manic and major depressive episodes isn't better explained by other psychotic disorders.

What defines Bipolar Disorder II?

Features states of hypomania and major depressive episodes.

What is criterion A for Bipolar Disorder II?

Criteria have been met for at least one hypomanic episode and at least one major depressive episode.

What is criterion B for Bipolar Disorder II?

There has never been a manic episode.

What is criterion D for Bipolar Disorder II?

The symptoms of depression or unpredictability from alternating periods of depression and hypomania cause clinically significant distress or impairment.

What characterizes a manic episode?

Periods of unrealistically heightened euphoria, extreme restlessness, and excessive activity, marked by disorganized behavior and impaired judgment.

What is the duration requirement for a manic episode?

At least 1 week, or any duration if hospitalization is necessary.

What are the criteria for a manic episode regarding mood and activity?

A distinct period of abnormally and persistently elevated, expansive, or irritable mood and increased goal-directed activity or energy.

How many symptoms must be present during a manic episode?

Three (or more) symptoms must be present to a significant degree, or four if the mood is only irritable.

List three symptoms of a manic episode.

1. Inflated self-esteem or grandiosity. 2. Decreased need for sleep. 3. More talkative than usual.

What is pressured speech?

An outpouring of speech in which words surge urgently for expression, typical in a manic state.

What is rapid flight of ideas?

A characteristic of manic behavior involving rapid speech and frequent changes of topics.

What is the minimum duration for a hypomanic episode according to DSM-5 criteria?

At least 4 consecutive days.

What distinguishes a hypomanic episode from a manic episode?

A hypomanic episode is not severe enough to require hospitalization or cause major disruption.

What are the observable changes associated with a hypomanic episode?

An unequivocal change in functioning that is uncharacteristic of the individual when not symptomatic.

What is cyclothymic disorder?

A chronic pattern of mild mood swings between depression and mania that are not severe enough to be classified as bipolar disorder.

How long must symptoms persist for cyclothymic disorder?

Numerous periods of hypomanic and depressive symptoms for at least 2 years.

What is a key requirement for the symptoms of cyclothymic disorder?

The symptoms must impair the person's ability to socialize, work, or function in other areas of life.

What is the maximum duration a person can be symptom-free for cyclothymic disorder?

No longer than 2 months.

What must be ruled out for a diagnosis of cyclothymic disorder?

Symptoms must not be due to another mental health condition or caused by a medical condition or substance.

What is the significance of the mood disturbance in a hypomanic episode?

It must be observable by others.

What is the impact of excessive involvement in activities during a manic episode?

It can lead to high potential for painful consequences, such as unrestrained spending or risky business investments.

What is distractibility in the context of a manic episode?

A symptom where the individual has difficulty maintaining focus, as reported or observed.

What is the difference in sleep patterns during a manic episode?

Individuals may feel rested after only 3 hours of sleep.

What is the role of goal-directed activity in a manic episode?

An increase in goal-directed activity or psychomotor agitation is a key symptom.

What is the significance of grandiosity in a manic episode?

It reflects inflated self-esteem, which is a common symptom.

What is the relationship between stress and mood disorders?

There is a strong correlation, with childhood experiences potentially emerging as risk factors later in life.

What protective factors can mitigate stress related to mood disorders?

Strong social supports and a healthy coping style.

According to the Psychodynamic Perspective, what happens to anger directed at an internalized love object?

It is inwardly directed, leading to feelings of loss and mourning.

What characterizes uncomplicated mourning in the Psychodynamic Perspective?

It is healthy and represents a form of psychological separation.

How does ambivalence contribute to pathological mourning?

Ambivalence, characterized by feelings of anger and guilt, can make mourning pathological.

What behavior do chronically depressed patients exhibit following loss or failure?

They engage in excessive self-focusing, often thinking 'If only I…'

What does the Humanistic Perspective suggest about depression?

Depression may result from the inability to find meaning and purpose in one's life.

What key concepts are associated with the Learning Perspective on depression?

Reinforcement, learned helplessness, and reciprocal interaction (Interactional Theory by James Coyne).

What is learned helplessness according to the Cognitive Perspective?

It is a condition where individuals feel unable to control their environment, leading to depression.

What does Aaron Beck's Cognitive Theory emphasize regarding emotions and behaviors?

They are influenced by an individual's interpretations of events rather than the events themselves.

What is the Depressive Triad in Cognitive Theory?

Negative views of self, environment, and future.

What are some cognitive distortions identified in the notes?

All-or-nothing thinking, overgeneralization, mental filter, disqualifying the positive, jumping to conclusions, magnification/minimization, emotional reasoning, 'should' statements, labeling/mislabelling, personalization.

What are some psychodynamic approaches to treating depression?

Interpersonal Therapy (IPT), which contextualizes depression within relationships.

What is the focus of Behavioral Approaches in treating depression?

Engaging in enjoyable activities to overcome depression and anxiety (Behavioral Activation).

What types of treatments fall under Biological Approaches for depression?

Antidepressant drugs, lithium, and Electroconvulsive Therapy (ECT).

What is St. John's Wort and its relevance to depression treatment?

A herbal remedy used for centuries, with early studies suggesting benefits for mild to moderate depression.

What percentage of deaths in Canada for 15-24 year olds is attributed to suicide?

24%.

What is one of the leading causes of death in both men and women from adolescence to middle age?

Suicide.

What factors are considered in predicting suicide?

Theoretical perspectives on suicide and factors such as concussions.