Mood Disorders and Suicide - Lecture 8

Definition: Mood disorders are characterized by disturbances in mood as their prominent feature.
Mood: Sustained feelings and emotions through which a person interprets life.
Mood disorders are defined and diagnosed by the occurrence of one or more mood episodes, which are periods of abnormal happiness or sadness.

Formerly known as Affective Disorders.
Features:
- Extremes of emotion, or affect, are common to all mood disorders, ranging from deep depression (major depressive episodes) to soaring elation (mania).
- Other symptoms, such as panic attacks or co-occurring disorders (e.g., anxiety disorders, substance use disorders), may also be present. However, abnormal mood is the defining feature.

Severity Spectrum:
  - Severe mania
  - Hypomania (mild to moderate mania)
  - Normal/balanced mood
  - Mild to moderate depression
  - Severe depression

Unipolar Mood Disorders:
- Characterized by only depressive symptoms.
Bipolar Disorders:
- Characterized by depressive symptoms, manic symptoms, and hypomanic symptoms.

Five or more symptoms must be present during the same 2-week period:
  1. Depressed mood (irritable mood in children)
  2. Loss of interest or pleasure
  3. Significant weight loss/gain
  4. Insomnia/hypersomnia
  5. Psychomotor agitation/retardation
  6. Fatigue or loss of energy
  7. Feelings of worthlessness or guilt
  8. Diminished ability to concentrate
  9. Recurrent thoughts of death, suicidal ideation, or a suicide plan

Definition: A major depressive episode without manic, hypomanic, or mixed episodes.
It can be a single episode or recurrent.
Onset: Can begin at any point in the lifespan, though incidence rises during adolescence.
Gender Differences: More common in females than males.
Symptoms typically last 6 months or more if untreated but some evidence suggests recovery is not as common as once thought. - About 50% of major depression sufferers recover over the period of 1 year.
Relapse likelihood increases if episodes are brief and age of onset is early.
The incidence of depression and suicide is increasing.

Formerly known as Dysthymic Disorder.
Definition: A mild to moderate form of depression with normal moods occurring intermittently (a few days/weeks).
Diagnostic Criteria:
  - Persistently depressed mood most of the day for at least 2 years.
  - Plus two or more of the following:
    - Poor appetite or overeating
    - Insomnia/hypersomnia
    - Low energy/fatigue
    - Poor concentration/decision making
    - Hopelessness
Lifetime Prevalence: Ranges from 2.5% to 6%.
Duration: Average of 4–5 years, but can last 20+ years.
Double Depression: Occurs when both Major Depressive Disorder and Persistent Depressive Disorder occur simultaneously.

Premenstrual Dysphoric Disorder: Symptoms appear in the week leading up to menstruation. Symptoms include affective lability, depressed mood, irritability, anger, anxiety, and lethargy.
Disruptive Mood Dysregulation Disorder: Characterized by regular temper outbursts (verbal and/or physical aggression), persistent anger, and irritability.

Research Findings: 62% of individuals experience severe depression following the death of loved ones.
Grief may only be classified as a disorder if severe symptoms manifest, such as suicidal ideation or chronicity of less severe symptoms.

Definition: A chronic, heightened state of mourning characterized by:
  - Extreme focus on the loss and reminders of the loved one.
  - Intense longing or pining for the deceased.
  - Problems accepting the death.

Definition: Severe, long-lasting depression experienced after childbirth.
About 13% of women giving birth meet criteria for major depression during the postpartum period (first 4 weeks after childbirth).
Women with a history of depression are at increased risk for postpartum depression.
Rare cases may involve a severe mood disorder called postpartum psychosis following childbirth.

Definition: Mood disorders that emerge in relation to seasonal changes, particularly in response to reduced sunlight.
Prevalence Rates: Approximately 4-6%, occurring more frequently in northern latitudes.
Symptoms often include increased appetite, weight gain, and more sleep, which are opposite to those found in major depression.

Terminology: "Cause" can be considered too strong a term; instead, discuss contributing or predisposing factors.
Types:
  - Biological Factors
  - Psychological Factors
  - Social Factors

Genetics: Family and twin studies indicate a hereditary component.
Neurotransmitter Activity: Abnormal levels of dopamine and serotonin have been identified.
Hormonal and Immune System Abnormalities: Issues with cortisol activity can affect stress response.
Neurophysiology: Low activity in areas such as the left prefrontal cortex and amygdala.
Sleep Patterns: Disruption in typical sleep cycles, such as decreased deep sleep and early onset of REM sleep.

Stressful Life Events: Often precede episodes of depression.
Diathesis-Stress Model:
  - Diathesis refers to pre-existing vulnerabilities (e.g., low self-esteem).
  - Stress refers to environmental events (e.g., divorce).
  - The higher the vulnerability (diathesis), the less stress is needed to trigger depression.
Personality Vulnerabilities: Such as neuroticism, self-criticism, maladaptive perfectionism, and past experiences.

Cognitive Vulnerabilities:
- Negative attributional style leads individuals to explain events in terms that are internal (about the self), stable (persist across time), and global (extend beyond specific situations).
Learned Helplessness Theory of Depression: Suggests that a lack of perceived control over life events may lead to depression. Evidence is mixed regarding whether learned helplessness is a cause or side effect of depression.

Marital Relations:
  - Dissatisfaction in marriage is strongly related to depression.
  - Research indicates that remaining married is more important to men than women.
  - Chronic depression may lead to marital split.
  - Relationship issues can cause depression among women, whereas they may lead men to withdraw and disrupt marriages.

Contributing factors include lower control, power, resources, social and economic status, discrimination, and physical vulnerability.
Restrictive roles often offer fewer alternatives to the role of