Depressive Disorders 03/13

Formally known as Mood Disorders. About 1 out of every 6 adults will have depression at some time in their life. Characterized by significant and chronic disruption in mood is the predominant symptom, causing impaired cognitive, behavioral, and physical functioning.

What is sadness? A normal human emotion that every single person will experience at stressful or somber times. Usually passes with time. If it lasts longer than 2 weeks, then seek medical attention.

Depression: “the common cold” of psychological disorder. The number-one reason people seek mental health services. There are 8 forms.

Major Depressive Disorder (MDD)

Severe depression. Can last for a couple of weeks to a matter of months. Typical-2 solid weeks of symptoms. It’s not everyday but the brain has episodes that last at least 2 weeks. In children, teens, and younger adults the mood may be irritable/angry rather than sad. To be diagnosed with MDD there are at least 5 out of the 9 symptoms.

Symptoms: thinking repetitively of death and suicide, change in weight and appetite, less energetic, unwarranted guilt, uninterested in most activities, really hard to think and make decisions.

Four major areas: emotional, behavior, cognition, and physical.

Persistent Depressive Disorder (PDD) (Dysthymia)

Depressed mood that occurs for most of the day, over a 2-year period. Moderate depression “low spirits”. 1 year for children and teens and 2 years for adults. During this period, individuals are depression-free for no longer than 2 months at a time. PDD does not lead to thoughts of depression. Can evolve into MDD. To be diagnosed with PDD there are at least 2 out of the 6 symptoms. Symptoms appearing prior to 21 years of age are diagnosed as “early onset”, while symptoms beginning after 21 are diagnosed as “late onset”. Persistent depressive disorder appears to be more common in females than in males. Typically not common in teans.

Double Depression

The occurrence of two separate depressive disorders. Major depression episodes may occur before or during persistent disorder, The major difference between MDD on its own and MDD with persistent depressive disorder is what happens during the time between depressive episodes. Someone with MDD will have episodes that last at least two weeks. When symptoms are low, a person with MDD can report good moods. With DD, continue to feel chronic symptoms like sadness and low motivation between major depressive episodes. There’s no break given to the brain. This can be treated.

Symptoms: Sadness and low motivation between major depressive episodes.

Physiological Abnormalities found in MDD and PDD

MDD: Hippocampus is smaller than that of a person without disorder. There’s less gray matter.

PDD: Orbitofrontal cortex and the hippocampus are smaller in people who have PDD than who don’t.

Possible Causes for all Depressive Disorders

1) Biological Factors: abnormalities in the brain and not enough serotonin. Less gray matter, brain has less access to specific neurotransmitters. Typically takes two weeks to relieve depressive symptoms. Up to four weeks in younger brains.

ex: prozac and zoloft

2)Genetics: Depression that results from a person’s biology or genetic inheritance is sometimes referred to as endogenous depression.

3) Cogntive Model of Depression: Beginning in childhood, person develops negative self-thoughts and perceptions.

4) Environmental factors: Experiencing a trauma, loss, or hardship may trigger depressive symptoms in people who have an inherited susceptibility to developing the disorder.

Depression is Treatable!

Depression isn’t a sign of weakness. It’s not something you can just “snap out of”. It’s an illness hat requires professional treatment. Yet with the right care, people can feel better.

1) Antidepressant Medications: Can be helpful for reducing depression symptoms in some people, especially in people with severe depression.

2) Psychotherapy: Also an effefctive treatment, either alone or in combination with medication. Psychotherapy can have an enduring effect that protects against symptoms returning even after treatment is ended.

Two of the most common evidence-based therapies for depression

1) Cognitive Behavioral Therapy (CBT): A type of therapy in which patients learn to identify and manage negative thought and behavior patterns that can contribute to their depression.

2) Interpersonal Therapy (IPT): A form of therapy in which patients learn to improve their relationships with others by better expressing their emotions and solving problems in healthier ways.