Mood Disorders and Suicide
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| Anergia | Lack of energy., exhaustion, agitation, noise intolerance, and slowed thinking processes
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| Euthymic mood | Feeling of being "on top of the world"
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| Pressured speech | Unrelenting, rapid, often loud talking without pauses
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| Flight of Ideas | Racing, often unconnected thoughts
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| Mood Disorders "Affective Disorders" | Pervasive alterations in emotions that are manifested by depression, mania or both. They interfere with a person's life, plaguing him or her with drastic and long-term sadness, agitation or elation
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| Accompanying self-doubt | guilt, and anger alter life activities, especially those that involve self-esteem, occupation, and relationships
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| Mood disorders | Most common psychiatric diagnoses associated with suicide; depression is one of the most important risk factors for it
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| Primary Mood Disorders | Major depressive disorder and bipolar disorder
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| Major depressive episode | lasts at least 2 weeks, during which the person experiences a depressed mood or loss of pleasure in nearly all activities.
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| Symptoms of major depression(part 1) | changes in eating habits resulting in weight loss or gain, hypersomnia or insomnia, impaired concentration, decision-making or problem-solving abilities, inability to cope with daily life,
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| Symptoms of major depression(part 2) | feelings of worthlessness, hopelessness, guilt or despair, thoughts of death/suicide, overwhelming fatigue, rumination with negative, pessimistic thinking with no hope of improvement
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| Bipolar disorder is diagnosed | When a person's mood fluctuates to extremes of mania and/or depression
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| Mania | Distinct period during which mood is abnormally and persistently elevated, expansive or irritable. Typically lasts about 1 week
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| Manic episodes | Include inflated self-esteem or grandiosity; decreased sleep; excessive and pressured speech; flight of ideas; distractibility; increased activity or psychomotor agitation; excessive involvement in pleasure seeking or risk taking activities
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| Hypomania | Period of abnormally and persistently elevated, expansive, or irritable mood and some other milder symptoms of mania. Does not impair persons ability to function and there are no psychotic features
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| Mixed Episode | Diagnosed when the person experiences both mania and depression nearly everyday for at least 1 week. Often called rapid cycling
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| Bipolar I | One or more manic or mixed episodes usually accompanied by major depressive episodes
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| Bipolar II | One or more major depressive episodes accompanied by at least one hypomanic episode
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| Dysthymic Disorder | Chronic, persistent mood disturbance characterized by symptoms such as insomnia, loss of appetite, decreased energy, low self-esteem, difficulty concentrating, and feelings of sadness and hopelessness that are milder than those of depression
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| Cyclothymic Disorder | Mild mood swings between hypomania and depression without loss of social or occupational functioning
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| Substance-Induced depressive or bipolar disorder | Significant disturbance in mood that is direct physiologic consequence of ingested substances such as alcohol, other drugs or toxins
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| Seasonal Affective Disorder (SAD): Two subtypes | Winter depression (Fall onset) & Spring onset
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| Winter depression SAD | increased sleep, appetite, and carbohydrate cravings; weight gain; interpersonal conflict; irritability; and heaviness in the extremities beginning in the late autumn and abating in the spring and summer
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| Spring-onset SAD | less common, insomnia, weight loss, and poor appetite lasting from late spring or early summer until early fall
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| Treatment of SAD | Often treated with light therapy
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| Postpartum "maternity" blues | Mild, predictable mood disturbance occurring in the first several days after delivery of a baby.
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| Symptoms of postpartum blues | labile mood and affect, crying spells, sadness, insomnia, and anxiety. Symptoms subside without treatment, but mothers do benefit from support and understanding from others
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| Postpartum depression | Most common complication of pregnancy in developed countries. Symptoms consistent with those of depression with onset within 4 wks of delivery
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| Postpartum psychosis | Severe and debilitating psychiatric illness with acute onset in the days following childbirth.
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| Symptoms of psychosis | Fatigue, sadness, emotional lability, poor memory, and confusion and progress to delusions, hallucinations, poor insight and judgment, and loss of contact with reality. Considered a medical emergency
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| Premenstrual dysmorphic disorder | Recurrent, moderate psychological and physical symptoms that occur during the week before menses and resolve with menstruation.
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| Symptoms of premenstrual dysmorphic disorder | Affective/somatic sx that can cause severe dysfunction in social /occupational functioning: labile mood, irritability, increased interpersonal conflict, difficulty concentrating, overwhelmed, unable to cope & feelings of anxiety, tension or hopelessness.
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| Nonsuicidal self-injury | Involves deliberate, intentional cutting, burning, scraping, hitting or interference with wound healing. Reports of reasons: alleviation of negative emotions, self punishment, seeking attention or escaping a situation or responsibility
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| Genetic theories | Implicate the transmission of major depression in first-degree relatives, who are at twice the risk for developing depression compared with the population
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| Neurochemical Theories | Influences of the neurotransmitters focus on serotonin and norepinephrine implicated in mood disorders.
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| Dysregulation of acetylcholine and dopamine | acetylcholine seems to be implemented in depression and mania
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| Neuroendocrine Influences | Hormonal fluctuations being studied in relation to depression. Mood disturbances have been documented in people with endocrine disorders such as those of the thyroid, adrenal, parathyroid, and pituitary glands
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| Psychodynamic Theories: Freud | Self-depreciation of people with depression and attributed that self-reproach to anger toward inward related to either a real or perceived loss.
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| Psychodynamic Theories: Bibring | Believed that one's ego (self) aspires to be ideal (good and loving, superior or strong) and that to be loved and worthy, one must achieve these high standards. Depression results when the person is not able to achieve these ideas
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| Psychodynamic Theories: Jacobson | Compared the state of depression with a situation in which the ego is powerless, helpless child victimized by the superego, much like a powerful and sadistic mother who takes delight torturing the child
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| Mania is viewed as | A "defense" against underlying depression, with the id taking over the ego and acting as an undisciplined hedonistic being (child)
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| Major Depressive Disorder | Typically involves 2 or more weeks of a sad mood or lack of interest in life activities with at least four other symptoms of depression: anhedonia, changes in weight, sleep, energy, concentration, decision making, self-esteem and goals
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| Five or more of the symptoms according to the DSM-5 (Part 1) | Depressed mood most of the day, nearly every day; Markedly diminished interest or pleasure; Significant weight loss when not dieting or weight gain; decrease or increase in appetite
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| Five or more of the symptoms according to the DSM-5 (Part 2) | Insomnia or hypersomnia nearly every day, Psychomotor agitation or retardation nearly every day, Fatigue or loss of energy nearly every day, Feelings of worthlessness or excessive inappropriate guilt
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| Five or more of the symptoms according to the DSM-5 (Part 3) | Diminished ability to think or concentrate or indecisiveness nearly every day, Recurrent thoughts of death, recurrent suicidal ideation without a specific plan or a suicide attempt or specific plan
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| Psychopharmacology for Major Depression | Cyclic antidepressants, MAOIs, SSRIs, and atypical antidepressants
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| Evidence is increasing that: | Antidepressant therapy should continue for longer than the 3 to 6 months originally believed necessary. Fewer relapses occur with depression who receive 18 to 24 months of antidepressant therapy
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