Understanding Mood Disorders, Substance Abuse, Psychosis and Their Treatments

Depression

A mood disorder characterized by persistent sadness.

Mania

An elevated mood state often seen in bipolar disorder.

DSM-5-TR

Diagnostic manual for mental health disorders.

Unipolar Depression

Depression without manic episodes, affecting mood only.

Bipolar Disorder

Mood disorder with alternating episodes of mania and depression.

Cultural Challenges

Difficulties in comparing depression and anxiety across cultures.

Risk Factors for Suicide

Age and gender significantly influence suicide risk.

Unipolar

Mood disorder with only depression or mania.

Mixed features

Simultaneous manic and depressive symptoms present.

Emotion

Affect with physiological, cognitive, and behavioral components.

Mood

Prolonged emotion influencing perceptions and behavior.

Mood disorder

Prolonged, abnormal mood affecting daily functioning.

Major depressive disorder

Depression without manic or hypomanic episodes.

Recurrent MDD

Multiple depressive episodes separated by two months.

Major depressive episode

Severe depression lasting at least two weeks.

Anhedonia

Loss of pleasure in previously enjoyed activities.

Cultural influences

Variations in symptom expression across cultures.

Children's symptoms

Physical complaints and irritability due to emotion misunderstanding.

Elderly symptoms

Depression linked to physical complaints and isolation.

Severity continuum

Symptoms range from mild to severe, affecting impairment.

Psychotic features

Delusions or hallucinations accompanying severe depression.

Delusions

Fixed false beliefs, often related to guilt or persecution.

Hallucinations

Sensory experiences without external stimuli, often auditory.

Mood congruent

Delusions matching the individual's depressed mood.

Mood incongruent

Delusions not aligning with depressive symptoms.

Persistent depressive disorder

Chronic depression lasting at least two years.

Double depression

MDD episodes occurring on top of PDD.

Impairment

Reduced functioning due to mood disorder symptoms.

Comorbidity

Presence of multiple disorders simultaneously.

Treatment responsiveness

Effectiveness of treatment varies by disorder type.

Chronicity

Duration of symptoms crucial for diagnosing depression.

Specifiers

Criteria that further define mood disorders.

Psychotic features

Presence of hallucinations and delusions in mood disorders.

Somatic delusions

Physical sensations believed to be caused by illness.

Peripartum onset

Depression occurring before or after childbirth.

Seasonal pattern

Episodes occurring during specific seasons, like winter.

Seasonal Affective Disorder (SAD)

Depression linked to seasonal changes, often winter.

Excessive sleep

Common symptom in seasonal affective disorder.

Acute grief

Intense grief that evolves into integrated grief.

Integrated grief

Adjustment to loss after initial acute grief.

Suicidal thoughts

Increased risk when grief persists beyond a year.

Premenstrual Dysphoric Disorder (PMDD)

Severe emotional reactions before menstruation.

Controversial diagnosis

PMDD's classification may lead to stigma.

Prevalence of PMDD

Affects 2 to 5% of women.

Clinical description of PMDD

At least 5 symptoms before menses, improving after.

Affective lability

Mood swings and sensitivity to rejection.

Marked irritability

Increased anger and interpersonal conflicts.

Depressed mood

Feelings of hopelessness or self-deprecation.

Anxiety and tension

Feelings of being on edge or keyed up.

Disruptive Mood Dysregulation Disorder

Diagnosis for children with severe mood swings.

Broader diagnostic criteria

Used for diagnosing bipolar disorder in youth.

Chronic Irritability

Persistent irritability leading to aggression and tantrums.

Mood Disorders

Psychological disorders affecting emotional states.

Lifetime Prevalence

4-12% in adults, 2.5% in children.

Adolescent Prevalence

8.3% of adolescents experience mood disorders.

Gender Risk

Girls are twice as likely to be affected.

Subclinical Symptoms

25% of girls and 10% of boys show mild symptoms.

Age of Onset

Average onset age is 25 years.

Interpersonal Factors

Social exits often trigger mood episodes.

Suicide Risk

Increased risk of suicide among affected individuals.

Occupational Dysfunction

Impairment in work due to mood disorders.

Episode Duration

First episode lasts 2 to 9 months.

Remission Rate

40% remit within 3 months, 90% within 12 months.

Biological Contributors

Genetic and neurological factors influencing mood disorders.

Heritability

32-37% heritability in mood disorders.

Neurological Correlates

Brain regions associated with mood regulation.

Prefrontal Cortex

Decreased thickness linked to affect regulation.

Hippocampus Size

9-13% smaller in women with MDD.

Neurotransmitter Dysregulation

Imbalance of serotonin, norepinephrine, and dopamine.

Monamine Theory

Balance of neurotransmitters is crucial for mood.

HPA Dysregulation

Chronic stress elevates HPA activation.

Biological Treatments

Medications like TCAs and SSRIs for mood disorders.

Tricyclics

Increase serotonin and epinephrine, block reuptake.

MAO-inhibitors

Prevent breakdown of neurotransmitters in synapse.

SSRIs

First choice antidepressants with fewer side effects.

Ketamine Infusions

Promote neural growth, short-term effects.

Electroshock Therapy (EST)

Effective for treatment-resistant depression.

Transmagnetic Stimulation

Non-invasive procedure targeting specific brain areas.

Social Contributors

Stressful life events often precede depressive episodes.

Interpersonal interactions

Social exchanges between individuals affecting relationships.

Romantic partner selection

Choosing a partner based on personal preferences.

Marital discord

Conflict or disagreement within a marriage.

Intergenerational transmission of depression

Passing depressive traits from parents to children.

Depressed mother effects on daughter

Daughters may develop similar depressive symptoms.

Dysfunctional relationships within daughters

Unhealthy relationship patterns observed in daughters.

Marrying alcoholics

Daughters more likely to choose partners with alcoholism.

Increased likelihood of depression

Daughters at higher risk for developing depression.

Interpersonal Psychotherapy (IPT)

Therapy focusing on current interpersonal issues.

Structured therapy sessions

IPT typically involves 15-20 weekly sessions.

Role disputes

Conflicts arising from differing roles in relationships.

Relationship loss

Emotional impact of losing a significant relationship.

Relationship initiation

Beginning new romantic or social relationships.

Deficient social skills

Lack of abilities to effectively interact socially.

Resolution of disputes

Actions taken to resolve interpersonal conflicts.

Negotiation stage

Partners actively try to resolve their disputes.

Impasse stage

Dispute unresolved, leading to underlying resentment.

Resolution stage

Partners take decisive actions like separation.

Cognitive Processes (AT Beck)

Cognitive therapy focusing on thought patterns.

Cognitive content

Thoughts involving self-criticism and comparisons.