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Questions and Answers
Which of the following are types of depressive episodes discussed in the text?
Which of the following are types of depressive episodes discussed in the text?
Persistent Depressive Disorder is a form of depression that typically lasts for at least two years.
Persistent Depressive Disorder is a form of depression that typically lasts for at least two years.
True
Which of the following is NOT recognized as a characteristic of a melancholic depressive episode?
Which of the following is NOT recognized as a characteristic of a melancholic depressive episode?
Catatonic features in depression are characterized by active engagement with the environment and frequent verbal communication.
Catatonic features in depression are characterized by active engagement with the environment and frequent verbal communication.
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Which of the following does NOT accurately describe Atypical Features (in the context of depressive episodes)?
Which of the following does NOT accurately describe Atypical Features (in the context of depressive episodes)?
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What are the main symptoms associated with a manic episode?
What are the main symptoms associated with a manic episode?
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The difference between bipolar I and bipolar II lies in the presence of a ______ episode, which is a milder form of mania.
The difference between bipolar I and bipolar II lies in the presence of a ______ episode, which is a milder form of mania.
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Cyclothymic Disorder is characterized by rapidly alternating, severe manic and depressive episodes.
Cyclothymic Disorder is characterized by rapidly alternating, severe manic and depressive episodes.
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An individual diagnosed with Persistent Depressive Disorder also meets the diagnostic criteria for Major Depressive Disorder.
An individual diagnosed with Persistent Depressive Disorder also meets the diagnostic criteria for Major Depressive Disorder.
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What is Learned Helplessness Theory's core explanation for depression?
What is Learned Helplessness Theory's core explanation for depression?
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Which of these is a major aspect of Beck's Cognitive Negative Triad?
Which of these is a major aspect of Beck's Cognitive Negative Triad?
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Interpersonal theories suggest that depression is primarily linked to genetic factors and neurological imbalances.
Interpersonal theories suggest that depression is primarily linked to genetic factors and neurological imbalances.
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What is rejection sensitivity?
What is rejection sensitivity?
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Which type of treatment approach for mood disorders combines a focus on behavioral changes, cognitive restructuring, and interpersonal skills?
Which type of treatment approach for mood disorders combines a focus on behavioral changes, cognitive restructuring, and interpersonal skills?
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Which of the following is NOT typically considered part of recommended lifestyle changes for managing mood disorders?
Which of the following is NOT typically considered part of recommended lifestyle changes for managing mood disorders?
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Suicide rates are exceptionally high among individuals under the age of 15, globally.
Suicide rates are exceptionally high among individuals under the age of 15, globally.
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According to the CDC, suicide is defined as death resulting from deliberate self-inflicted injury, poisoning, or suffocation.
According to the CDC, suicide is defined as death resulting from deliberate self-inflicted injury, poisoning, or suffocation.
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Suicide attempts are always successful, resulting in death.
Suicide attempts are always successful, resulting in death.
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What is the difference between suicide ideation, suicide attempts, and nonsuicidal self-injury?
What is the difference between suicide ideation, suicide attempts, and nonsuicidal self-injury?
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The term 'suicide cluster' refers to two or more suicides occurring in the same family.
The term 'suicide cluster' refers to two or more suicides occurring in the same family.
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According to Durkheim's theory of suicide, which type of suicide is associated with feelings of alienation and social isolation?
According to Durkheim's theory of suicide, which type of suicide is associated with feelings of alienation and social isolation?
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What does 'anomie' mean in the context of Durkheim's theory of suicide?
What does 'anomie' mean in the context of Durkheim's theory of suicide?
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The majority of individuals who commit suicide are diagnosed with a mental health disorder.
The majority of individuals who commit suicide are diagnosed with a mental health disorder.
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The most effective predictor of future suicidal thoughts and behavior is a family history of suicide.
The most effective predictor of future suicidal thoughts and behavior is a family history of suicide.
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Which of the following is NOT considered a key factor in the treatment and prevention of suicide?
Which of the following is NOT considered a key factor in the treatment and prevention of suicide?
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It is advised to avoid direct questions about suicidal thoughts and plans when interacting with someone who may be at risk of suicide.
It is advised to avoid direct questions about suicidal thoughts and plans when interacting with someone who may be at risk of suicide.
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Which of the following stresses life events is NOT consistently identified as a risk factor associated with suicide?
Which of the following stresses life events is NOT consistently identified as a risk factor associated with suicide?
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The concept of suicide contagiousness is a myth and has no scientific evidence.
The concept of suicide contagiousness is a myth and has no scientific evidence.
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Study Notes
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.
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