Chapter 8: Depressive and Bipolar Disorders Flashcards
What are the characteristics of mood symptoms?
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
What are the symptoms of depression?
Intense sadness and loss of interest in normally enjoyed activities
What are the emotional symptoms of depression?
Feelings of sadness, emptiness, hopelessness, worthlessness, or low self-esteem
What are the cognitive symptoms of depression?
Rumination, inability to concentrate, or suicidal thoughts
What are the behavioral symptoms of depression?
Fatigue, social withdrawal, or reduced motivation
What are the physiological symptoms of depression?
Appetite and weight changes, sleep disturbance, unexplained aches and pain, or an aversion to sexual activity
What are the two intensity levels of bipolar disorder?
Hypomania (milder form)
Mania
What are the symptoms of hypomania?
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
What are the symptoms of mania?
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
What are the emotional symptoms of hypomania?
Unusually in high spirits, full of energy and enthusiasm, or uncharacteristically irritable
May overreact with anger or hostility
What are the emotional symptoms of mania?
Emotional lability: unstable and rapidly changing emotions
Inappropriate use of humor, poor judgment in expressing feelings or opinions, and grandiosity
What are the cognitive symptoms of hypomania?
Energized, goal-oriented behavior
May talk excitedly without concern about giving others an opportunity to speak
Unaware of inappropriateness of actions
What are the cognitive symptoms of mania?
Difficulty maintaining focus
Pressured speech
Display a flight of ideas by changing topics frequently, or making irrelevant or illogical comments
What are the behavioral symptoms of hypomania?
Energetic and productive, or agitated and angry
Uninhibited
Impulsivity and uncharacteristically risky behaviors
May have difficulty delaying gratification
What are the behavioral symptoms of mania?
Rapid movement and incoherent speech
Paranoia, hallucinations, and delusions
What are the physiological symptoms of hypomania/mania?
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
What is major depressive disorder?
Occurrence of at least one major depressive episode (2-week duration)
No history of mania or hypomania
What is persistent depressive disorder?
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
What is premenstrual dysphoric disorder?
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
What is the DSM-5 criteria to diagnose MDD?
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
What is MDD with a Seasonal Pattern?
Associated with daylight change with season, more often in Northern latitudes
Low energy
Increased sleep
Social withdrawal
Carbohydrate craving
What is the difference between psychosis in manic episode and in schizophrenia?
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
What are some normal reactions to loss?
Grief often involves feelings of emptiness associated with theloss
May last for several years
Frequency and intensity diminishes over time
What is persistent complex bereavement disorder?
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
What are bipolar disorders?
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
What is bipolar I disorder?
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
What is bipolar II disorder?
At least one major depressive episode (more than 2 weeks) and at least one hypomanic episode (more than 4 days)
What is cyclothymic disorder?
Milder hypomanic symptoms consistently interspersed with milder depressed moods for at least 2 years
What is mixed features in bipolar disorder?
Three or more symptoms of hypomania/mania or depression occurring during an episode from the opposite pole
What is rapid cycling in bipolar disorder?
Four or more mood episodes per year
Increases chances that disorder will be chronic and symptoms more severe
What is often comorbid with bipolar disorders?
Anxiety and substance-use disorders
