mood disorders

Mood DisordersTwo key emotions :DepressionLow, sad state in which life seems dark and its challenges overwhelmingManiaState of breathless euphoria or frenzied energy

Mood DisordersMost people with a mood disorder suffer only from depressionThis pattern is called unipolar depressionPerson has no history of mania Mood returns to normal when depression liftsOthers experience periods of mania that alternate with periods of depressionThis pattern is called bipolar disorder

How Common Is Unipolar Depression?Around 8% of adults in the U.S. suffer from severe unipolar depression in any given year As many as 5% suffer from mild formsAround 19% of all adults experience unipolar depression at some time in their livesThe prevalence is similar in Canada, England, France, and many other countriesThe rate of depression is higher among poor people than wealthier people

What Are the Symptoms of Unipolar Depression?Five main areas of functioning may be affected:

Diagnosing Unipolar DepressionCriteria 1: Major depressive episodeMarked by five or more symptoms lasting two or more weeksIn extreme cases, symptoms are psychotic, including HallucinationsDelusionsCriteria 2: No history of mania

Diagnosing Unipolar DepressionTwo diagnoses to consider:Major depressive disorderCriteria 1 and 2 are metDysthymic disorderSymptoms are mild but chronicDepression is longer lasting but less disablingConsistent symptoms for at least two yearsWhen dysthymic disorder leads to major depressive disorder, the sequence is called double depression

What Causes Unipolar Depression?Stress may be a trigger for depressionPeople with depression experience a greater number of stressful life events during the month just before the onset of their symptomsSome clinicians distinguish reactive (exogenous) depression from endogenous depression, which seems to be a response to internal factors

What Causes Unipolar Depression? The Biological View

What Causes Unipolar Depression? The Psychological Views Three main models:

What Causes Unipolar Depression? The Psychological Views

What Causes Unipolar Depression? The Psychological ViewsCognitive viewsTwo main theories:Negative thinkingLearned helplessness

What Causes Unipolar Depression? The Psychological Views

What Causes Unipolar Depression? The Sociocultural ViewSociocultural theorists propose that unipolar depression is greatly influenced by the social context that surrounds peopleThis belief is supported by the finding that depression is often triggered by outside stressorsThere are two kinds of sociocultural views:The family-social perspectiveThe multicultural perspective

What Causes Unipolar Depression? The Sociocultural View

Bipolar DisordersPeople with a bipolar disorder experience both the lows of depression and the highs of maniaMany describe their lives as an emotional roller coaster

What Are the Symptoms of Mania?Unlike those experiencing depression, people in a state of mania typically experience dramatic and inappropriate rises in mood Five main areas of functioning may be affected:

Diagnosing Bipolar DisordersCriteria 1: Manic episodeThree or more symptoms of mania lasting one week or moreIn extreme cases, symptoms are psychotic Criteria 2: History of maniaIf currently experiencing hypomania or depression

Diagnosing Bipolar DisordersDSM-5 distinguishes two kinds of bipolar disorder:Bipolar I disorderFull manic and major depressive episodesSome experience an alternation of episodesOthers have mixed episodesBipolar II disorderHypomanic episodes alternate with major depressive episodes

Diagnosing Bipolar DisordersWithout treatment, the mood episodes tend to recur for people with either type of bipolar disorderIf people experience four or more episodes within a one-year period, their disorder is further classified as rapid cycling

Diagnosing Bipolar DisordersRegardless of particular pattern, individuals with bipolar disorder tend to experience depression more than mania over the yearsIn most cases, depressive episodes occur three times as often as manic ones, and last longer

Diagnosing Bipolar DisordersBetween 1% and 2.6% of all adults in the world suffer from a bipolar disorder at any given time, and as many as 4% over the course of their livesBipolar I seems to be a bit more common than Bipolar IIThe disorders are equally common in women and menWomen may experience more depressive episodes and fewer manic episodes than men and rapid cycling is more common in womenThe disorders are more common among people with low incomes than those with high incomes

Diagnosing Bipolar DisordersA final diagnostic option:When a person experiences numerous episodes of hypomania and mild depressive symptoms, a diagnosis of cyclothymic disorder is assignedMild symptoms for two or more years, interrupted by periods of normal moodAffects at least 0.4% of the populationMay eventually blossom into bipolar I or II disorder

What Causes Bipolar Disorders?Throughout the first half of the 20th century, the search for the cause of bipolar disorders made little progressMore recently, biological research has produced some promising cluesThese insights have come from research into NT activity, ion activity, brain structure, and genetic factors

What Causes Bipolar Disorders?NeurotransmittersAfter finding a relationship between low norepinephrine and unipolar depression, early researchers expected to find a link between high norepinephrine levels and maniaThis theory is supported by some research studies; bipolar disorders may be related to overactivity of norepinephrine

What Causes Bipolar Disorders?NeurotransmittersBecause serotonin activity often parallels norepinephrine activity in unipolar depression, theorists expected that mania would also be related to high serotonin activityAlthough no relationship with high serotonin has been found, bipolar disorder may be linked to low serotonin activity, which seems contradictory

What Causes Bipolar Disorders?Neurotransmitters This apparent contradiction is addressed by the permissive theory about mood disorders:Low serotonin may open the door to a mood disorder and permit norepinephrine activity to define the particular form the disorder will take:Low serotonin + Low norepinephrine = DepressionLow serotonin + High norepinephrine = Mania

What Causes Bipolar Disorders?Ion activityIons, which are needed to send incoming messages to nerve endings, may be improperly transported through the cells of individuals with bipolar disorderSome theorists believe that irregularities in the transport of these ions may cause neurons to fire too easily (mania) or to stubbornly resist firing (depression) There is some research support for this theory

What Causes Bipolar Disorders?Brain structureBrain imaging and postmortem studies have identified a number of abnormal brain structures in people with bipolar disorder; in particular, the basal ganglia and cerebellum among othersIt is not clear what role such structural abnormalities play

What Causes Bipolar Disorders?Genetic factorsMany theorists believe that people inherit a biological predisposition to develop bipolar disordersFamily pedigree studies support this theory:Identical (MZ) twins = 40% likelihoodFraternal (DZ) twins and siblings = 5% to 10% likelihoodGeneral population = 1 to 2.6% likelihood

What Causes Bipolar Disorders?Genetic factorsResearchers have conducted genetic linkage studies to identify possible patterns of inheritanceOther researchers are using techniques from molecular biology to further examine genetic patterns in large familiesSuch wide-ranging findings suggest that a number of genetic abnormalities probably combine to help bring about bipolar disorders

People of any age may suffer from unipolar depressionWomen are at least twice as likely as men to experience severe unipolar depressionLifetime prevalence: 26% of women vs. 12% of menAmong children, the prevalence is similar among boys and girlsApproximately 85% of people with unipolar depression recover, some without treatmentAround 40% will experience another episode later in their lives

Symptoms may vary from person to person

Today's clinicians usually concentrate on recognizing both the situational and the internal aspects of any given caseThe current explanations of unipolar depression point to biological, psychological, and sociocultural factors

Some theorists have refined the helplessness model yet again in recent years; they suggest that attributions are likely to cause depression only when they further produce a sense of hopelessness in an individual

Depressed people in non-Western countries are more likely to be troubled by physical symptoms of depression than by cognitive onesAs countries become more Westernized, depression seems to take on the more cognitive character it has in the West

Onset usually occurs between the ages of 15 and 44 yearsIn most cases, the manic and depressive episodes eventually subside, only to recur at a later timeGenerally, when episodes recur, the intervening periods of normality grow shorter and shorter

mood disorders

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