MHM91.pdf

11/12/23, 9:02 PM Realizeit for Student Introduction Everyone occasionally feels sad, low, and tired, with the desire to stay in bed and shut out the world. These episodes are often accompanied by anergia (lack of energy), exhaustion, agitation, noise intolerance, and slow thinking processes, all...

11/12/23, 9:02 PM Realizeit for Student Introduction Everyone occasionally feels sad, low, and tired, with the desire to stay in bed and shut out the world. These episodes are often accompanied by anergia (lack of energy), exhaustion, agitation, noise intolerance, and slow thinking processes, all of which make decisions difficult. Work, family, and social responsibilities drive most people to proceed with their daily routines, even when nothing seems to go right and their irritable mood is obvious to all. Such “low periods” pass in a few days, and energy returns. Fluctuations in mood are so common to the human condition that we think nothing of hearing someone saying, “I’m depressed because I have too much to do.” Everyday use of the word “depressed” does not actually mean that the person is clinically depressed but rather that the person is just having a bad day. Sadness in mood can also be a response to misfortune; death of a friend or relative, financial problems, or loss of a job may cause a person to grieve. At the other end of the mood spectrum are episodes of exaggeratedly energetic behavior. The person has the sure sense that he or she can take on any task or relationship. In an elated mood, stamina for work, family, and social events is untiring. This feeling of being “on top of the world” also recedes in a few days to a euthymic mood (average affect and activity). Happy events stimulate joy and enthusiasm. These mood alterations are normal and do not interfere meaningfully with the person’s life. Mood disorders, also called affective disorders, are pervasive alterations in emotions that are manifested by depression or mania or both. They interfere with a person’s life, plaguing him or her with drastic and long-term sadness, agitation, or elation. Accompanying self-doubt, guilt, and anger alter life activities, especially those that involve self-esteem, occupation, and relationships. From early history, people have suffered from mood disturbances. Archeologists have found holes drilled into ancient skulls to relieve the “evil humors” of those suffering from sad feelings and strange behaviors. Babylonians and ancient Hebrews believed that overwhelming sadness and extreme behavior were sent to people through the will of God or other divine beings. Biblical notables King Saul, King Nebuchadnezzar, and Moses suffered overwhelming grief of heart, unclean spirits, and bitterness of soul, all of which are symptoms of depression. Abraham Lincoln and Queen Victoria had recurrent episodes of depression. Other famous people with mood disorders were writers Virginia Woolf, Sylvia Plath, and Eugene O’Neill; composer George Frideric Handel; musician https://herzing.realizeithome.com/RealizeitApp/Student.aspx?Token=0Dn26kXyU%2f6F5gOCz4%2f2IXuwWUmQfGm4h3qb9d1OVNy5lAp1kIKpU7q0Q1KeARb… 1/3 11/12/23, 9:02 PM Realizeit for Student Jerry Garcia; artist Vincent van Gogh; philosopher Friedrich Nietzsche; television commentator and host of 60 Minutes Mike Wallace; and actress Patty Duke. Until the mid-1950s, no treatment was available to help people with serious depression or mania. These people suffered through their altered moods, thinking they were hopelessly weak to succumb to these devastating symptoms. Family and mental health professionals tended to agree, seeing sufferers as egocentric or viewing life negatively. Although there are still no cures for mood disorders, effective treatments for both depression and mania are now available. Mood disorders are the most common psychiatric diagnoses associated with suicide; depression is one of the most important risk factors for it (Rhimer & Pompili, 2017). It is important to note that clients with schizophrenia, substance use disorders, antisocial and borderline personality disorders, and panic disorders are also at increased risk for suicide and suicide attempts. Categories of Mood Disorders The primary mood disorders are major depressive disorder and bipolar disorder (formerly called manic-depressive illness). A major depressive episode lasts at least 2 weeks, during which the person experiences a depressed mood or loss of pleasure in nearly all activities. Symptoms include changes in eating habits, resulting in unplanned weight gain or loss; hypersomnia or insomnia; impaired concentration, decision-making, or problem-solving abilities; inability to cope with daily life; feelings of worthlessness, hopelessness, guilt, or despair; thoughts of death and/or suicide; overwhelming fatigue; and rumination with pessimistic thinking with no hope of improvement. These symptoms result in significant distress or impairment of social, occupational, or other important areas of functioning. About 20% have delusions and hallucinations; this combination is referred to as psychotic depression (Akiskal, 2017). Bipolar disorder is diagnosed when a person’s mood fluctuates to extremes of mania and/or depression, as described previously. Mania is a distinct period during which mood is abnormally and persistently elevated, expansive, or irritable. Typically, this period lasts about 1 week (unless the person is hospitalized and treated sooner), but it may be longer for some individuals. Manic episodes include inflated self-esteem or grandiosity; decreased sleep; excessive and pressured speech (unrelenting, rapid, often loud talking without pauses); flight of ideas (racing, often unconnected, thoughts); distractibility; increased activity or psychomotor agitation; and excessive involvement in pleasure-seeking or risk-taking activities with a high potential for painful consequences. https://herzing.realizeithome.com/RealizeitApp/Student.aspx?Token=0Dn26kXyU%2f6F5gOCz4%2f2IXuwWUmQfGm4h3qb9d1OVNy5lAp1kIKpU7q0Q1KeARb… 2/3 11/12/23, 9:02 PM Realizeit for Student The person’s mood may be excessively cheerful, enthusiastic, and expansive, or the person may be irritable, especially when he or she is told no or has rules to follow. The person often denies any problems, placing the blame on others for any difficulties he or she experiences. Some people also exhibit delusions and hallucinations during a manic episode. Hypomania is a period of abnormally and persistently elevated, expansive, or irritable mood and some other milder symptoms of mania. The difference is that hypomanic episodes do not impair the person’s ability to function (in fact, he or she may be quite productive), and there are no psychotic features (delusions and hallucinations). A mixed episode is diagnosed when the person experiences both mania and depression nearly every day for at least 1 week. These mixed episodes are often called rapid cycling (Akiskal, 2017). For the purpose of medical diagnosis, bipolar disorders are described as follows: Bipolar I disorder—one or more manic or mixed episodes usually accompanied by major depressive episodes Bipolar II disorder—one or more major depressive episodes accompanied by at least one hypomanic episode People with bipolar disorder may experience a euthymic or normal mood and affect between extreme episodes, or they may have a depressed mood swing after a manic episode before returning to a euthymic mood. For some, euthymic periods between extremes are quite short. For others, euthymia lasts months or even years. https://herzing.realizeithome.com/RealizeitApp/Student.aspx?Token=0Dn26kXyU%2f6F5gOCz4%2f2IXuwWUmQfGm4h3qb9d1OVNy5lAp1kIKpU7q0Q1KeARb… 3/3