Mood Disorders, Bipolar Disorder, and Schizophrenia

Mood Disorders

• Mood disorders involve significant and persistent disruptions in mood or emotions, leading to impaired cognitive, behavioral, and physical functioning.
• Most people experience occasional mood swings, but mood disorders are more severe and enduring.

Major Depressive Disorder

• Classified in the DSM-5 as the presence of at least five symptoms over a 2-week period, including depressed mood or reduced interest.
• Symptoms include:
  • Depressed mood most of the time.
  • Dramatically reduced interest or enjoyment in most activities most of the time.
  • Significant challenges regulating appetite and weight.
  • Significant challenges regulating sleep.
  • Physical agitation or lethargy.
  • Feeling listless or with much less energy.
  • Feeling worthless or unwarranted guilt.
  • Problems in thinking, concentrating, or making decisions.
  • Repetitive thoughts of death and suicide.

The Vicious Cycle of Depressed Thinking

1. Stressful experiences.
2. Negative explanatory style.
3. Depressed mood.
4. Cognitive and behavioral changes.

Explanatory Style and Depression

• How individuals explain events influences their coping mechanisms.
• Dimensions of explanatory style:
  • Stable vs. Temporary: \text{Stable: "I'll never get over this."} , \text{Temporary: "This is hard to take, but I will get through this."}
  • Global vs. Specific: \text{Global: "Without my partner, I can't seem to do anything right."} , \text{Specific: "I miss my partner, but thankfully I have family and other friends."}
  • Internal vs. External: \text{Internal: "Our breakup was all my fault."} , \text{External: "It takes two to make a relationship work and it wasn't meant to be."}
• A negative explanatory style (stable, global, internal) leads to depression, while a positive style (temporary, specific, external) facilitates successful coping.

Bipolar Disorder

• Characterized by alternating periods of depression (despondency and lethargy) and mania (extreme euphoria, excitement, physical energy, wild optimism, rapid thoughts and speech).
• Mania can include thought derailment and delusions of grandiosity.
• Many writers, poets, and composers have been known to suffer from bipolar disorder.
• Creativity surged during manic phases but not during depressed phases.

Cognitive, Emotional, and Motor Characteristics

• Manic Phase:
  • Emotional: Elation, euphoria, extreme sociability, expansiveness, impatience.
  • Cognitive: Distractibility, desire for action, impulsiveness, talkativeness, grandiosity, inflated self-esteem.
  • Motor: Hyperactivity, decreased need for sleep, sexual indiscretion, fluctuating appetite.
• Depressive Phase:
  • Emotional: Gloominess, hopelessness, social withdrawal, irritability, indecisiveness.
  • Cognitive: Slowness of thought, obsessive worrying about death, negative self-image, delusions of guilt, difficulty in concentrating.
  • Motor: Decreased motor activity, fatigue, difficulty in sleeping, decreased sex drive, decreased appetite.

Schizophrenia

• A psychological disorder characterized by delusions, hallucinations, disorganized speech, and/or diminished, inappropriate emotional expression.
• It is the chief example of a psychotic disorder, marked by irrationality, distorted perceptions, and loss of contact with reality.
• With treatment and a supportive environment, over 40% of people with schizophrenia will have periods of a year or more with normal life experience.
• Only 1 in 7 of those diagnosed will make a complete and enduring recovery.
• Symptoms are categorized as positive or negative:
  • Positive symptoms: Presence of inappropriate behavior.
  • Negative symptoms: Absence of appropriate behavior.

Symptoms of Schizophrenia

• Disturbed Perceptions and Beliefs:
  • Hallucinations: Hearing, seeing, feeling, tasting, smelling things that exist only in the mind.
  • Delusions: False beliefs that are not true in reality, including persecution, grandiosity, and mind control.
  • Breakdown in selective attention leading to thought derailment (difficulty maintaining focus/easily distracted).
• Disorganized Speech:
  • Word salad (senseless speech).
• Diminished and Inappropriate Emotions:
  • Emotions that do not match the situation.
  • Flat affect: Emotionless, a state of no apparent feeling.
  • Impaired theory of mind: Difficulty reading other peoples’ facial emotions and states of mind.
• Inappropriate or disruptive motor behavior; motionless catatonia; or senseless, compulsive actions.

Risk of Developing Schizophrenia

• The chance of developing schizophrenia varies based on relationship.
• Identical twins have a higher risk than fraternal twins.
• The risk for identical twins of those diagnosed with schizophrenia is approximately 50%.
• The risk for fraternal twins is lower.