Chapter 8: Depressive and Bipolar Disorders

Question 1

What are the characteristics of mood symptoms?

Answer 1

Affects a person’s well being, school, work, or social functioning
Continues for days, weeks, or months
Often occurs for no apparent reason
Involves extreme reactions not easily explained by what is happening in the person’s life

Question 2

What are the symptoms of depression?

Answer 2

Intense sadness and loss of interest in normally enjoyed activities

Question 3

What are the emotional symptoms of depression?

Answer 3

Feelings of sadness, emptiness, hopelessness, worthlessness, or low self-esteem

Question 4

What are the cognitive symptoms of depression?

Answer 4

Rumination, inability to concentrate, or suicidal thoughts

Question 5

What are the behavioral symptoms of depression?

Answer 5

Fatigue, social withdrawal, or reduced motivation

Question 6

What are the physiological symptoms of depression?

Answer 6

Appetite and weight changes, sleep disturbance, unexplained aches and pain, or an aversion to sexual activity

Question 7

What are the two intensity levels of bipolar disorder?

Answer 7

Hypomania (milder form)
Mania

Question 8

What are the symptoms of hypomania?

Answer 8

Increased levels of activity or energy combined with a self-important, expansive mood or an irritable, agitated mood
May appear quite distractible, change topics frequently, have many ideas, talk excessively, or dominate conversations
Impulsivity and risk taking may also appear

Question 9

What are the symptoms of mania?

Answer 9

Even more pronounced mood change than hypomania
Variety of behaviors from euphoria to extreme irritability
Cause marked impairment in social or occupational functioning
May involve psychosis or loss of contact with reality
Obvious to others that something is amiss

Question 10

What are the emotional symptoms of hypomania?

Answer 10

Unusually in high spirits, full of energy and enthusiasm, or uncharacteristically irritable
May overreact with anger or hostility

Question 11

What are the emotional symptoms of mania?

Answer 11

Emotional lability: unstable and rapidly changing emotions
Inappropriate use of humor, poor judgment in expressing feelings or opinions, and grandiosity

Question 12

What are the cognitive symptoms of hypomania?

Answer 12

Energized, goal-oriented behavior
May talk excitedly without concern about giving others an opportunity to speak
Unaware of inappropriateness of actions

Question 13

What are the cognitive symptoms of mania?

Answer 13

Difficulty maintaining focus
Pressured speech
Display a flight of ideas by changing topics frequently, or making irrelevant or illogical comments

Question 14

What are the behavioral symptoms of hypomania?

Answer 14

Energetic and productive, or agitated and angry
Uninhibited
Impulsivity and uncharacteristically risky behaviors
May have difficulty delaying gratification

Question 15

What are the behavioral symptoms of mania?

Answer 15

Rapid movement and incoherent speech
Paranoia, hallucinations, and delusions

Question 16

What are the physiological symptoms of hypomania/mania?

Answer 16

High levels of physiological arousal
Increased libido: May lead to reckless sexual activity
Decreased need for sleep: Often first sign of hypomanic or manic episode
Weight loss due to high energy expenditure

Question 17

What is major depressive disorder?

Answer 17

Occurrence of at least one major depressive episode (2-week duration)
No history of mania or hypomania

Question 18

What is persistent depressive disorder?

Answer 18

Depressed mood that has lasted for at least 2 years (with no more than 2 months symptom-free)
Two or more of the following symptoms: feelings of hopelessness, low self-esteem, poor appetite or overeating, low energy or fatigue, difficulty concentrating or making decisions, sleeping too little or too much

Question 19

What is premenstrual dysphoric disorder?

Answer 19

Severe depression, mood swings, anxiety, or irritability occurring before the onset of menses
Improvement of symptoms within a few days of menstruation and minimal or no symptoms following menstruation
At least five symptoms must be present: significant depressed mood or mood swings, anger, irritability, anxiety, tension, difficulty concentrating, social withdrawal, food cravings, insomnia or excessive sleeping, feeling overwhelmed, and lack of energy

Question 20

What is the DSM-5 criteria to diagnose MDD?

Answer 20

Impairment in functioning for most of the day, and nearly every day, for 2 weeks or more
Depressed mood, sadness, or emptiness
Loss of pleasure in previously enjoyed activities
At least four additional changes in functioning: Alteration in weight, atypical sleep patterns, restlessness, low energy, feelings of worthlessness, difficulty concentrating, or suicidal behaviors or thoughts

Question 21

What is MDD with a Seasonal Pattern?

Answer 21

Associated with daylight change with season, more often in Northern latitudes
Low energy
Increased sleep
Social withdrawal
Carbohydrate craving

Question 22

What is the difference between psychosis in manic episode and in schizophrenia?

Answer 22

In a manic episode, the psychosis ends after the episode or treatment and doesn’t exist as baseline
In schizophrenia, it exists as baseline even through treatment and is not episodic

Question 23

What are some normal reactions to loss?

Answer 23

Grief often involves feelings of emptiness associated with theloss
May last for several years
Frequency and intensity diminishes over time

Question 24

What is persistent complex bereavement disorder?

Answer 24

Condition undergoing study as a diagnostic category in the DSM-5
Must have a significant effect on the person’s interpersonal relationships or sense of identity
Need to carefully consider cultural, religious, and age-appropriate norms

Question 25

What are bipolar disorders?

Answer 25

Involve episodes of hypomania and mania, alternated with episodes of depression
Very strong genetic component
Respond to medications that have little effect with depressive disorders
Peak age of onset is teens and early twenties
Occur much less frequently than depressive disorders

Question 26

What is bipolar I disorder?

Answer 26

At least one manic episode (with or without a history of major depression)
Symptoms are present most of the day, nearly every day, for at least 1 week

Question 27

What is bipolar II disorder?

Answer 27

At least one major depressive episode (more than 2 weeks) and at least one hypomanic episode (more than 4 days)

Question 28

What is cyclothymic disorder?

Answer 28

Milder hypomanic symptoms consistently interspersed with milder depressed moods for at least 2 years

Question 29

What is mixed features in bipolar disorder?

Answer 29

Three or more symptoms of hypomania/mania or depression occurring during an episode from the opposite pole

Question 30

What is rapid cycling in bipolar disorder?

Answer 30

Four or more mood episodes per year
Increases chances that disorder will be chronic and symptoms more severe

Question 31

What is often comorbid with bipolar disorders?

Answer 31

Anxiety and substance-use disorders