Mood Disorders
Mood Disorders
A category of mental disorders in which
significant and chronic disruption in mood
is the predominant symptom, causing
impaired cognitive, behavioral, and
physical functioning
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Major depression
Dysthymic disorder
Bipolar disorder
Cyclothymic disorder
Major Depression
A mood disorder characterized by extreme and
persistent feelings of despondency,
worthlessness and hopelessness
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Prolonged, very severe symptoms
Passes without remission for at least 2 weeks
Global negativity and pessimism
Very low self-esteem
Symptoms of Major Depression
Must Exhibit for 2 Weeks or Longer
• Emotional—sadness, hopelessness, guilt, turning
away from others
• Behavioral—tearfulness, dejected facial expression,
loss of interest in normal activities, slowed
movements and gestures, withdrawal from social
activities
• Cognitive—difficulty thinking and concentrating,
global negativity, preoccupation with death/suicide
• Physical—appetite and weight changes, excess or
diminished sleep, loss of energy, global anxiety,
restlessness
Prevalence and Course
of Major Depression
• Most common of psychological disorders. It
affects about 12 million Americans annually.
• Women are twice as likely as men to be diagnosed
with major depression
• Untreated episodes can become recurring and
more serious
• Seasonal affective disorder (SAD)—onset with
changing seasons
Self-Rating Depression Scale
Scoring Your Self-Rating Depression Scale
• Reverse Your responses (1=5, 2=4, 3=3, 4=2, 5=1)
to items: 2, 5, 6, 11, 12, 14, 16, 17, 18, 20
• Now add up all your numbers (including the new
reversed scores) to find you total score.
• Range of total scores will be 20 to 80.
• Scores of 50-59 suggest mild to moderate depression
• Scores of 60-69 indicate moderate to severe
depression
• Scores 70 and above indicate severe depression.
Dysthymic Disorder
• Similar to major depressive disorder but
less severe and shorter in duration
• Chronic, low-grade depressed feelings
that are not severe enough to be major depression
• May develop in response to trauma, but does not
decrease with time
• Some people with dysthymic disorder
experience double depression, characterized
by one or more episodes of major depression
on top of their ongoing dysthymia.
Seasonal Affective Disorder
• Cyclic severe depression and elevated
mood
• Seasonal regularity
• Unique cluster of symptoms
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intense hunger
gain weight in winter
sleep more than usual
depressed more in evening than morning
Bipolar Disorder
• A mood disorder in which the person
alternates between the hopelessness of
depression and the overexcited and
unreasonably optimistic state of mania
• Used to be called manic-depressive
disorder
• Many times will follow a cyclical pattern
Bipolar Disorders
• Cyclic disorder (manic-depressive disorder)
• Mood levels swing from severe depression to
extreme euphoria (mania)
• No regular relationship to time of year (SAD)
• Must have at least one manic episode
Mania
• Period of abnormally high emotion
and activity
– Supreme self-confidence - delusional
– Grandiose ideas and movements – too
many goals in too little time
– Flight of ideas – rapid and loosely
shifting thoughts that jump from topic to
topic.
Depression
• Extended period of feeling sad,
listless, and drained of energy
Cyclothymic Disorder
Cyclothymic—mood disorder characterized
by moderate but frequent mood swings that
are not severe enough to qualify as bipolar
disorder
Prevalence and Course of Bipolar
Disorder
•Onset usually in young adulthood (early twenties)
•Mood changes more abrupt than in major depression
•No sex differences in rate of bipolar disorder
•Affects about 2 million Americans annually.
•Commonly recurs every few years
•A small percentage of people with the disorder
display rapid cycling, experiencing four or more
manic or depressive episodes every year.
•Can often be controlled by medication (lithium)
Biological Factors
• Mood disorders have a hereditary
nature to them.
• Depressed individuals tend to have
depressed brains.
– PET scans indicate less activity
during periods of depression.
Ups & Downs of Bipolar Disorder
PET scans show that brain energy consumption
rises and falls with the patient's emotional
switches. Red areas are where the brain rapidly
consumes glucose. Blue areas are low areas of
activity.
Explaining Mood Disorders
• Neurotransmitter theories
– dopamine
– norepinephrine
– Serotonin
• Antidepressants increase the availability of
norepinephrine and serotonin.
• They relieve the symptoms of major depression in
about 80% of the people who take them
• Lithium has been used to treat bipolar disorder and to
prevent its recurrence. It appears to regulate the
availability of the neurotransmitter glutamate.
• Genetic component
– more closely related people show similar histories of
mood disorders
The Role of Stress & Genetics
Effect of stress was greater for those who were more genetically predisposed
for depression (based on the status of their twin sisters, as shown in the key)
than for those who were less genetically predisposed. (Adapted from Kendler &
others, 1995)
Cognitive Bases for Depression
• A.T. Beck: depressed people hold pessimistic
views of
– themselves
– the world
– the future
• Depressed people distort their experiences in
negative ways
– exaggerate bad experiences
– minimize good experiences
Cognitive Bases for Depression
• Hopelessness theory
– depression results from a pattern of thinking
– person loses hope that life will get better
– negative experiences are due to stable, global
reasons
• e.g., “I didn’t get the job because I’m stupid
and inept” vs. “I didn’t get the job because the
interview didn’t go well”
Negative Automatic Thoughts
Finding Your Score
• Add up your total score.
• Scores will fall from 30 (no depression) to 150 (maximum
depression).
• Mean (average) score is 79.6 for depressed people and 48.6
for nondepressed people.
• This “test” looks for specific measures of depression:
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Personal dissatisfaction & desire for change (items 14 & 20)
Negative Expectations (items 3 & 24)
Low Self-Esteem (items 17 & 18)
Helplessness (items 29 & 30)
Social-Cognitive Factors
• Depression may be a variation of learned
helplessness.
• Depressed individuals attribute events
using the following characteristics:
– Stable: the bad situation will last for a
long time
– Internal: they are at fault
– Global: all of life is bad
Attributions
Attributions
Attributions
Attributions
Explanatory Style and Depression
Situational Bases for Depression
• Positive correlation between stressful life
events and onset of depression
– Does life stress cause depression?
• Most depressogenic life events are losses
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spouse or companion
long-term job
health
income
Bio-Psycho-Social Model of Depression
Seriously depressed moods result from a combination of factors,
which affect each other. Altering any one component can alter the
others.
Depression’s Vicious Cycle
SUICIDE
Who Commits Suicide?
• Each year 500,000 people require emergency room
treatment as a result of a suicide attempt.
• Suicide took the lives of 30,622 people in 2001
• Suicide is the third leading cause of death among young
people ages 15 to 24.
• Twice as many Americans die each year from suicide
than from homicide.
• Women outnumber men 3 to 1 in suicide attempts
• Men outnumber women 4 to 1 in suicide deaths
• Suicide rate has increased by over 300% over the last
four decades
• Highest suicide rate occurs in those over age 75.
Why do people attempt suicide?
• To escape the pain of a chronic illness or the slow,
agonizing death of a terminal disease.
• Feelings of hopelessness, depression, guilt,
rejection, failure, humiliation, or shame.
Risk Factors Associated with
Suicidal Behavior
• Recent relationship problems or lack of significant
relationships
• Poor coping and problem solving skills
• Poor impulse control and impaired judgment
• Rigid thinking or irrational beliefs
• Having another major psychological disorder
• Alcohol or Substance Abuse
• Childhood physical or sexual abuse
• Prior self-destructive behavior or a family history of
suicide.
• Presence of a firearm in the house
Suggestions for Helping Someone
Feeling Hopeless & Suicidal
• Actively listen as the person talks and vents
his/her feelings
• Don’t deny or minimize the person’s suicidal
intentions
• Identify other potential solutions
• Ask the person to delay their decision
• Encourage the person to seek professional help.
• To access more information on suicide prevention
please click HERE.