Abnormal

Quiz Information

• Quiz on Topic Two posted on Canvas

• Due by Friday at midnight

• Focus: Research methods

Different Types of Episodes Discussed

Major Depressive Episode

• Characteristics:

  • Sad mood most of the day, nearly every day

  • Feelings of discouragement, hopelessness, and being down in the dumps

  • Anhedonia: lack of interest in previously enjoyed activities

• Additional symptoms required to meet diagnosis:

  • Must have at least four other symptoms accompanying sad mood or anhedonia

Manic Episode

• Criteria:

  • Lasts one week or longer

  • Prevailing mood is abnormally and persistently elevated, expansive, or irritable

  • Significant change from typical mood presentations

• Symptoms:

  • Increased activity or energy

  • Increased goal-directed activity or psychomotor agitation

  • Excessive planning or participation in multiple activities

  • Pressure in speech: rapid and loud talking, can be difficult to interpret

  • Flight of ideas: racing thoughts jumping from topic to topic

  • Decreased need for sleep: may sleep very few hours and feel refreshed

  • Grandiosity: inflated self-esteem, beliefs in special talents or abilities

  • Distractibility: inability to screen out external stimuli

  • Engagement in high-risk behaviors: financial spending sprees, gambling, and risky sexual behavior

• Impairments and dangers:

  • Behavior leads to significant impairment in functioning and could necessitate hospitalization

  • Physical aggression may occur during manic episodes

Hypomanic Episode

• Characteristics:

  • Less severe than manic episodes

  • Lasts at least four days

  • Similar symptoms to mania but with less marked impairment

  • Elevated mood without extreme behavior changes

  • Decreased need for sleep but still has some sleep

  • Impulsive behavior may occur but typically less severe and organized

Mixed Episode

• Characteristics:

  • Lasts at least one week

  • Rapidly alternating symptoms of mania and depression

  • Increased agitation, insomnia, and appetite problems

  • Increased suicidal ideation is a significant concern

Mood Disorders

Major Depressive Disorder (MDD)

• Diagnosis requires:

  • History of at least one major depressive episode lasting two weeks or more

  • Must have either a sad mood or anhedonia plus additional symptoms

  • No history of manic, hypomanic, or mixed episodes

• Presentation:

  • Episodes are recurrent; most individuals will experience multiple episodes

  • Average length of untreated episode: 6 to 9 months

  • Typical presentation can be episodic, lasting longer periods of time without treatment

• Prevalence:

  • Lifetime prevalence rate: approximately 21% of the population

  • More common in women than men, two times more prevalent post-puberty

  • Higher diagnosis rates in white individuals compared to people of color

Persistent Depressive Disorder (Dysthymia)

• Characteristics:

  • Chronic depressed mood lasting for at least two years

  • One year for children and adolescents

  • Must not have more than two months symptom-free during the two-year period

• Presentation:

  • Duration averages about five years

  • Individuals may not readily report feeling depressed; chronic low-level symptoms are common

• Prevalence:

  • Lifetime prevalence rates range from approximately 1% to 6%

  • More common in women than men with a median age of onset at about 31 years

• Insidious onset:

  • Symptoms gradually develop over time rather than suddenly becoming present

Relationship Between Different Disorders

• Double Depression: Co-occurrence of persistent depressive disorder and major depressive disorder.

Causes of Depression

Biological Factors

• Family history: Severe depression more commonly has a genetic component.

• Genetic heritability estimates indicate that around one-third of the risk for developing depression may be attributed to genetic factors.

• Research on specific genes related to depression remains inconsistent.

Neurotransmitter Hypothesis

• Historical view: Depression may be linked to neurotransmitter imbalances (like serotonin).

• Current view: This perspective is considered oversimplified; depression likely results from multiple interacting factors, not solely chemical imbalances.

Comorbidity

• Depression is often comorbid with other psychological disorders, particularly anxiety.

• Major depressive disorder has associations with increased mortality rates and health complications with various medical conditions.

Risk Factors for Recurrence

• Duration and severity of first episodes are predictors of future episodes.

• Life stressors are linked to prolonged bouts of depression.

• Statistics from study of 400 individuals:

  • 30% had another episode within 2 years,

  • 60% had recurrent episodes in 5 years,

  • 75% in 10 years, and

  • 87% in 15 years.

Treatment Considerations

• Severity linked to the course of treatment; milder forms may require different approaches than severe forms.

• Treatment prediction also connected with the presence of other psychological disorders, gender differences, and age-related factors in symptom presentation.