Week 6: Mood Disorders and Depression

Mood Disorders

• Involve pervasive emotional changes affecting life and relationships.

• Depression and mania are key manifestations.

• Historical and modern treatments highlight the evolution in understanding mood disorders.

Mood

A sustained emotional state (internal).

Affect

Emotional reaction (external).

Depression

A mood that manifests as prolonged sadness, loss of interest, and somatic symptoms like changes in sleep and appetite.

Anergia

• A lack of energy that affects daily routines.

• Affects daily functioning across various areas of life.

• Distinction between common sadness and clinical depression.

Categories and Related Mood Disorders

• Categories include Major Depressive Disorder, Bipolar Disorder, Dysthymic Disorder, etc.

• Include substance-induced mood disturbances, Seasonal Affective Disorder (SAD), nonsuicidal self-injury, and hormonal-related conditions (postpartum conditions).

Etiology of Mood Disorders

Often linked to suicide risk and can arise from genetic, neurochemical, and psychosocial factors.

• Genetics play a role, evident in family heritability studies.

• Focus on neurotransmitters like serotonin and norepinephrine in mood regulation.

• Hormonal changes, such as hypothyroidism, but particularly cortisol levels, are linked to depression.

• Depression may stem from family dynamics and learned helplessness.

Major Depressive Disorder (MDD)

Lasts at least two weeks and can include symptoms such as fatigue, feelings of worthlessness, anhedonia, and suicidal thoughts.

Symptoms of MMD

• Depressed mood

• Loss of pleasure in activities (people around you may notice this and point it out to you)

• Changes in eating habits

• Hypersomnia or insomnia

• Impaired concentration

• Feelings of worthlessness

• Thoughts of death or suicide

• Fatigue

• Rumination: the process of continuously thinking about the same thoughts, often negative.

  • This can exacerbate feelings of hopelessness and contribute to the severity of depressive symptoms.

  • And contribute to a lack of sleep.

• Significant distress or impairment in functioning.

• 10% to 20% experience psychotic features.

Treatment Options

Include various antidepressants (SSRIs, cyclic antidepressants, MAOIs), psychotherapy, and for severe cases, Electroconvulsive Therapy (ECT).

Community-based care and mental health promotion are key in managing these disorders, focusing on improving self-esteem and reducing hopelessness.

Medications

Medication therapy should be extended post-symptom (longer than 6 months) for improvement.

• SSRIs are first-line treatments; side effects include anxiety and sexual dysfunction.

• Cyclic Antidepressant: Administer cyclically; known for various side effects.

• Atypicals provide additional options for treatment, pending details.

• MAOIs have dietary restrictions due to potential hypertensive crises.

SSRI Side Effects

• Anxiety, agitation, insomnia, and sexual dysfunction.

• Risk of serotonin syndrome when combined with other medications.

  • Head (hyperthermia)

  • Master (myoclones) (autonomic instability/not being able to manage BP or HR) (shock) (tremors) (encepalopothy) (rigidity/hyperreflexia).

Cyclic Antidepressant Side Effects

Known for anticholinergic effects, orthostatic hypotension, sedation, and other side effects.

MAOIs Side Effects

Include daytime sedation, weight gain, and risk of hypertensive crisis with certain foods (tyramine).