M4. Lesson 4.1: Mood Disorders

Question 1

What are mood disorders?

Answer 1

Mood disorders are characterized by a constellation of symptoms that causes people significant distress or impairs their everyday functioning.

Question 2

Are brief periods of sadness, irritability, or euphoria mood disorders?

Answer 2

No. This is different than having a mood disorder, such as MDD or BD.

Question 3

What is a major depressive episode?

Answer 3

A major depressive episode (MDE) refers to symptoms that co-occur for at least two weeks and cause significant distress or impairment in functioning, such as interfering with work, school, or relationships.

Question 4

What are core symptoms of a major depressive episode?

Answer 4

Core symptoms include feeling down or depressed or experiencing anhedonia—loss of interest or pleasure in things that one typically enjoys.

Question 5

What are the symptoms of a MDE according to the DSM-5?

Answer 5

According to the fifth edition of the Diagnostic and Statistical Manual (DSM-5; APA, 2013), the criteria for an MDE require five or more of the following nine symptoms, including one or both of the first two symptoms, for most of the day, nearly every day:

1. depressed mood
2. diminished interest or pleasure in almost all activities
3. significant weight loss or gain or an increase or decrease in appetite
4. insomnia or hypersomnia
5. psychomotor agitation or retardation
6. fatigue or loss of energy
7. feeling worthless or excessive or inappropriate guilt
8. diminished ability to concentrate or indecisiveness
9. recurrent thoughts of death, suicidal ideation, or a suicide attempt

These symptoms cannot be caused by physiological effects of a substance or a general medical condition (e.g., hypothyroidism).

Question 6

What is a manic or hypomanic episode?

Answer 6

The core criterion for a manic or hypomanic episode is a distinct period of abnormally and persistently euphoric, expansive, or irritable mood and persistently increased goal-directed activity or energy. The mood disturbance must be present for one week or longer in mania (unless hospitalization is required) or four days or longer in hypomania.

Question 7

What are the symptoms of a manic or hypomanic episode?

Answer 7

Concurrently, at least three of the following symptoms must be present in the context of euphoric mood (or at least four in the context of irritable mood):

1. inflated self-esteem or grandiosity
2. increased goal-directed activity or psychomotor agitation
3. reduced need for sleep
4. racing thoughts or flight of ideas
5. distractibility
6. increased talkativeness
7. excessive involvement in risky behaviors

Question 8

How are manic episodes distinguished from hypomanic episodes?

Answer 8

Manic episodes are distinguished from hypomanic episodes by their duration and associated impairment; whereas manic episodes must last one week and are defined by a significant impairment in functioning, hypomanic episodes are shorter and not necessarily accompanied by impairment in functioning.

Question 9

What are two major types of unipolar disorders?

Answer 9

Two major types of unipolar disorders described by the DSM-5 (APA, 2013) are major depressive disorder and persistent depressive disorder (PDD; dysthymia).

Question 10

What is MDD?

Answer 10

MDD is defined by one or more MDEs, but no history of manic or hypomanic episodes.

Question 11

What is the criteria for PDD according to the DSM-5?

Answer 11

Criteria for PDD are feeling depressed most of the day for more days than not, for at least two years. At least two of the following symptoms are also required to meet criteria for PDD:

1. poor appetite or overeating
2. insomnia or hypersomnia
3. low energy or fatigue
4. low self-esteem
5. poor concentration or difficulty making decisions
6. feelings of hopelessness

Like MDD, these symptoms need to cause significant distress or impairment and cannot be due to the effects of a substance or a general medical condition. To meet criteria for PDD, a person cannot be without symptoms for more than two months at a time.

Question 12

PDD is completely different from MDD. True or False.

Answer 12

False. PDD has overlapping symptoms with MDD. If someone meets criteria for an MDE during a PDD episode, the person will receive diagnoses of PDD and MDD.

Question 13

What are three major types of bipolar disorders?

Answer 13

1. Bipolar I
2. Bipolar II
3. Cyclothymic disorder

Question 14

What is Bipolar I Disorder?

Answer 14

Bipolar I Disorder (BD I), which was previously known as manic-depression, is characterized by a single (or recurrent) manic episode.

Question 15

A depressive episode is necessary for BD I to be diagnosed. True or False.

Answer 15

False. A depressive episode is not necessary but commonly present for the diagnosis of BD. I.

Question 16

What is Bipolar II characterized by?

Answer 16

Bipolar II Disorder is characterized by single (or recurrent) hypomanic episodes and depressive episodes.

Question 17

What is cyclothymic disorder characterized by?

Answer 17

Another type of BD is cyclothymic disorder, characterized by numerous and alternating. To qualify for cyclothymic disorder, the periods of depression cannot meet full diagnostic criteria for an MDE; the person must experience symptoms at least half the time with no more than two consecutive symptom-free months; and the symptoms must cause significant distress or impairment.

Question 18

What are bipolar disorders characterized by?

Answer 18

Bipolar disorders are characterized by cycles of high energy and depression, lasting at least two years.