Untitled Quiz

Mood Disorders and Suicide

• Mood disorders are a group of conditions characterized by significant shifts in mood, impacting emotional stability
• Major Depressive Disorder (MDD) involves intense or overwhelming depressive symptoms persisting for more than two weeks
• Persistent Depressive Disorder (PDD) is a more chronic form of depression characterized by depressed mood most of the day for at least two years.
• Seven subtypes of depressive episodes, including anxious distress, mixed features, melancholic features, psychotic features, catatonic features, atypical features, seasonal pattern, and peripartum onset
• Manic episode involves a period of persistently elevated, expansive, or irritable mood, together with increased activity or energy lasting at least a week
• Bipolar I disorder is marked by the presence of both manic and depressive episodes.
• Bipolar II disorder features severe depressive episodes alternating with hypomanic episodes (less severe than manic episodes)
• Cyclothymic disorder is a less severe, chronic type of bipolar disorder that involves a fluctuating mood pattern of hypomanic and depressive symptoms
• Disruptive mood dysregulation disorder is a condition predominantly diagnosed in children characterized by severe temper outbursts and persistent irritability.
• Suicide is a significant issue worldwide, particularly among young adults (15-44).
• Factors contributing to suicidal thoughts or behaviors include various mood disorders.

Characteristics of Depressive Episodes

• Anhedonia refers to a loss of interest or pleasure in once-enjoyed activities. It can be physical (affecting sensory pleasures like food or sex) or social (involving difficulties enjoying social interactions)
• Appetite changes (overeating or loss of appetite) and sleep disturbances (hypersomnia or insomnia) are often present.
• Behavioral changes like psychomotor agitation or retardation may occur.
• Feelings of sadness, guilt, worthlessness, hopelessness, and suicidal thoughts are common symptoms.
• Unexplainable physical pain in the body can be a symptom of depression.
• Some individuals might experience hallucinations or delusions.

Diagnosing Depressive Disorders

• Major Depressive Disorder (MDD) requires five or more symptoms of depression present during the same two-week period, including depressed mood or loss of interest.
• DSM-5 diagnostic criteria for MDD specify symptoms such as depressed mood, diminished interest, significant weight change, insomnia or hypersomnia, psychomotor agitation, fatigue, feelings of worthlessness, suicidal thoughts etc.
• PDD is diagnosed when a person experiences depressed mood for the majority of days for at least two years, meeting specific DSM-5 criteria for depressive episodes.
• There's no difference between MDD and PDD, meeting criteria for MDD for two years will also be diagnosed as PDD

Subtypes of Major Depressive Episodes

• Anxious distress: Prominent anxiety symptoms
• Mixed features: Presence of at least three manic/hypomanic symptoms.
• Melancholic features: Inability to experience pleasure, worse mood in the morning and marked psychomotor retardation
• Psychotic features: Mood-congruent or mood-incongruent delusions or hallucinations.
• Catatonic features: Catatonic behaviors: not actively relating to environment, mutism, posturing, mimicking "another's speech or movements"
• Atypical features: Positive mood reactions to some events, weight gain, and increase in appetite, hypersomnia, heavy or leaden feelings in arms or legs, long-term sensitivity to interpersonal rejection
• Seasonal pattern: Recurring depressive episodes during specific seasons, often winter, and remission when the season changes.
• Peripartum onset: Onset of major depressive episode during pregnancy or in the four weeks following childbirth

Premenstrual Dysphoric Disorder

• Significant increases in distress during the premenstrual phase of the menstrual cycle. Symptoms often include depression, anxiety, irritability, and anger.
• Physical symptoms such as breast tenderness, bloating, weight gain, and joint/muscle pain are common.

Prevalence and Course of Depressive Disorders

• Women are more likely to experience depressive symptoms than men, which can range from mild to severe.
• Young adults are affected by depressive disorders as 1 reported in 10 (8.9%) experience it in the Philippines.
• Treatment for mood disorders can result in quick recovery and a decreased risk of relapse.
• Factors contributing to lack of help-seeking among those with depression include financial considerations, expectation of spontaneous recovery, and perceptions of the lack of significant impacts of the disorder.

Characteristics of Bipolar Episodes

• Mood can fluctuate between elated and irritable, while also being mixed with irritation and agitation.
• Inflated self-esteem and grandiose thoughts are usual symptoms of mania.
• Racing thoughts, impulses, and delusions may accompany manic episodes.
• Rapid speech and efforts to communicate a "rapid stream of fantastic thoughts" are typical.
• Impulsive behaviors, like sexual indiscretions or shopping sprees, often occur.

DSM-5 Criteria for Manic Episodes

• Criteria A: A distinct period of abnormally elevated or irritable mood and elevated activity and energy, lasting at least a week.
• Criteria B: Three or more specific symptoms during the mood disturbance showing significant change in personality.
• Criteria C: The severity of the mood disturbance leading to social or occupational impairment, hospitalization, or psychotic features
• Criteria D: The episode is not caused by substance abuse or another medical condition.

Bipolar Disorders

• Bipolar I: Features both manic and depressive episodes. Mania without a previous depressive episode is rare
• Mania and at least three symptoms of MDD occurring in one day, every day, for at least one week.
• Bipolar II: Features milder manic episodes (hypomania) and severe depressive episodes. Hypomania symptoms are not severe enough to interfere significantly with daily life.
• Cyclothymic disorder: A chronic mood disorder characterized by alternating hypomanic and depressive periods over at least two years.

Rapid Cycling Bipolar Disorder

• Four or more mood episodes (manic, hypomanic, or major depressive) occurring within a single year.

Disruptive Mood Dysregulation Disorder

• Characterized by severe temper outbursts in children that are disproportionate to the situation and inconsistent with their developmental level.
• Outbursts are a common occurrence and often involve verbal and physical aggression.
• Diagnosis requires at least three temper outbursts per week for a year occurring in at least two settings (such as home and school).

Theories in Depression

• Biological Theories:
• Genetic Factors: Family history and twin studies reveal a genetic component. Early-onset depression has a stronger genetic influence than late-onset depression.
• Neurotransmitters: Insufficient norepinephrine, serotonin, or dopamine are implicated.
• Psychological Theories:
• Learned Helplessness: Uncontrollable negative events can lead to a belief of helplessness
• Cognitive Triad: Negative views of the self, world, and future contribute to depression.
• Negative thinking perpetuates depression, which is demonstrated in studies.

Interpersonal Theories

• Depressed individuals tend to have more chronic conflict in their relationships, including those with family, friends, and colleagues.
• Some have heightened need for affection and support from others while exhibiting sensitivity to rejection.

Gender Differences

• Women are roughly twice as likely as men to experience depression.
• Men more frequently turn to alcohol to cope, while women more often ruminate about their problems.

Treatment of Mood Disorders

• Medications: Mood stabilizers, atypical antipsychotics, selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), atypical antidepressants, and tricyclic antidepressants are used.
• Psychotherapy: Cognitive Behavioral Therapy (CBT), Mindfulness-based Cognitive Therapy (MBCT), Acceptance and Commitment Therapy (ACT), Interpersonal Psychotherapy (IPT), and Dialectical Behavioral Therapy (DBT) are employed.

Suicide

• Suicide is among the leading causes of death worldwide, predominantly among 15-44 year olds
• The Centers for Disease Control and Prevention (CDC) defines suicide as a death where there is evidence of self-harm with the person intending to kill themself.
• Suicide attempts might not always be successful.
• Suicide ideation involves thoughts about suicide.
• Nonsuicidal self-injury (NSSI) involves behaviors like cutting, burning, or puncturing oneself, without suicidal intent.
• Psychological factors like Impulsivity and Hopelessness are factors that contribute to suicidal thoughts.

Historical Perspective on Suicide

• Emil Durkheim identified three types of suicide: egoistic, anomic, and altruistic, based on societal conditions.

Suicide Clusters

• Suicide clusters are when two or more suicides or attempts are not random, occurring in the same time and place, possibly linked by publicized suicide.
• Suicide rates might increase in response to a well-publicized suicide.

Psychological Disorders and Suicide

• A majority (over 90%) of individuals who commit suicide have a diagnosable mental health disorder.
• Depression significantly increases the likelihood of suicide attempts.
• Bipolar disorder further increases the risk of suicide attempts.

Stress Life Events and Suicide

• Stressful events, such as loss of a loved one, divorce, or major life changes, can raise the risk of suicide or attempting suicide.
• Interpersonal violence, particularly sexual abuse, has consistently been linked to suicidal thoughts and attempts.
• Economic hardship is a significant factor contributing to increased vulnerability to suicide.

Personality and Cognitive Factors

• Impulsivity and hopelessness are key personality and cognitive traits that are closely linked to suicidality.

Biological Factors in Suicide

• Suicide tends to run in families. Low levels of serotonin have been linked to an increased risk of committing suicide.
• People with a family history of suicide are potentially more susceptible to serotonin regulating gene abnormalities.

Treatment and Prevention

• Crisis intervention, lithium, and Dialectical Behavior Therapy (DBT) are vital treatment approaches.

Assessing and Responding to Suicidal Thoughts:

• It is important to take suicidal thoughts and behaviors seriously and intervene accordingly regardless of other psychological issues.
• Taking actions like seeking professional help and providing concrete support are crucial interventions.
• People who are experiencing suicidal crisis should be directed to healthcare providers or emergency services.