Chapter 9: Overview of Mood Disorders and Treatments

Affect

Observable expression of emotion, often seen in facial expressions.

Anhedonia

Loss of interest or pleasure in usual activities.

Avolition

Lack of motivation to pursue goal-directed tasks.

Cyclothymia

Mood disorder with alternating periods of hypomanic and depressive symptoms not meeting full criteria.

Depression

Persistent sadness or loss of interest that impairs daily functioning.

Flight of Ideas

Rapid shifting from one idea to another without logical connection.

Grandiosity

Exaggerated belief in one's importance or abilities.

Hypomania

Elevated mood that is less severe than mania, does not cause marked impairment.

Mania

Elevated, expansive, or irritable mood with increased goal-directed activity, lasting at least 1 week.

Psychosis

Loss of contact with reality, often includes hallucinations or delusions.

Major Depressive Disorder (MDD)

Mood disorder with at least one major depressive episode lasting at least 2 weeks.

Bipolar I Disorder

Characterized by at least one manic episode, may include depressive episodes.

Bipolar II Disorder

Characterized by at least one hypomanic episode and one major depressive episode.

Mixed Features

Symptoms of depression and mania occurring simultaneously.

Mood Episode

Distinct period of mood disturbance meeting specific diagnostic criteria.

Mood Disorders

Category of mental health disorders involving significant disturbances in mood.

Specifiers (Mood Disorders)

Descriptors that provide further detail about course, severity, or features.

Seasonal Pattern Specifier

Mood episodes that occur at a specific time of year, often winter.

Peripartum Onset Specifier

Onset of mood episodes during pregnancy or within 4 weeks postpartum.

Rapid Cycling Specifier

Four or more mood episodes within a 12-month period.

Biological Etiology (MDD)

Abnormalities in neurotransmitters like serotonin, dopamine, and norepinephrine.

Psychosocial Etiology (MDD)

Life events, trauma, or chronic stress contribute to onset.

Neuroanatomy of Mood Disorders

Limbic system, amygdala, and prefrontal cortex implicated.

DSM-5 Criteria for MDD

At least five symptoms during the same 2-week period, including depressed mood or anhedonia.

DSM-5 Criteria for Mania

Distinct period of abnormally elevated mood and increased activity lasting at least 1 week.

DSM-5 Criteria for Hypomania

Elevated mood and activity for at least 4 consecutive days.

How is function affected in MDD

Impairments in work, school, relationships, and self-care.

Function in Bipolar I

Impairment during manic episodes may require hospitalization.

Function in Bipolar II

Functional impairments due to depressive symptoms more than hypomanic.

Occupational Performance (Mood Disorders)

Disruption in roles, routines, and meaningful activities.

CBT

Cognitive Behavioral Therapy helps patients reframe negative thought patterns.

IPT

Interpersonal Psychotherapy focuses on interpersonal relationships and social functioning.

Psychoeducation

Teaching clients and families about symptoms, treatment, and relapse prevention.

Pharmacological Treatment (MDD)

SSRIs, SNRIs, tricyclics, and MAOIs used to manage symptoms.

Mood Stabilizers

Medications like lithium and valproate used in bipolar disorder.

Atypical Antipsychotics

Used to treat manic episodes or as adjunct in depression.

ECT

Electroconvulsive Therapy, used for treatment-resistant depression.

TMS

Transcranial Magnetic Stimulation, a non-invasive treatment for MDD.

Course of MDD

May be single or recurrent; untreated episodes can last months.

Course of Bipolar I

Chronic with recurring episodes; onset often in adolescence or early adulthood.

Course of Bipolar II

Often misdiagnosed as depression due to hypomania being overlooked.

Suicide Risk

Elevated in all mood disorders, especially with comorbid conditions.

Onset of MDD

Often appears in mid-20s but can occur at any age.

Onset of Bipolar Disorders

Typically emerges in late teens to early 20s.

Comorbidity

Anxiety disorders, substance use, and ADHD commonly co-occur.

Gender Differences

MDD more common in women; bipolar disorders equally distributed.

Functional Impact

Reduced ability to work, study, care for self, and maintain relationships.

Relapse Risk

Higher if treatment is not maintained or psychosocial stressors are present.