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PSYC 3140
Joel Goldberg

Chapter 9 bipolar disorder was once known as manic-depression mania, great energy and enthusiasm for everything, fizzing over with ideas, talking and thinking so fast that her friends could not keep up with her.\Bipolar disorder is one of the two major types of mood disorders. The other type is unipolar depression, in which people experience only depression, without mania Bipolar Depression Symptoms of Depression Emotional Symptoms The most common emotion in depression is sadness another is irritability many people diagnosed with depression report that they have lost interest in everything in life a symptom referred to as anhedonia Physiological and Behavioural Symptoms changes in appetite, sleep, and activity levels can take many forms early morning wakening, awaken at 3 or 4 a.m. every day and cannot go back to sleep Behaviourally, many people with depression are slowed down, a condition known as psychomotor retardation:walk more slowly, gesture more slowly, talk more slowly and quietly Many people with depression lack energy and report feeling chronically fatigued.Asmall number of people with depression have psychomotor agitation :They feel physically agitated, cannot sit still, and may move around or fidget aimlessly Catatonia (unusual behaviors ranging from complete lack of movement to excited agitation) Cognitive Symptoms The thoughts of people with depression may be filled with themes of worthlessness, guilt, hopelessness, and even suicide. They often have trouble concentrating and making decisions Delusions are beliefs with no basis in reality, and hallucinations involve seeing, hearing, or feeling things that are not real The Diagnosis of Unipolar Depressive Disorders The DSM-IV-TR recognizes two categories of unipolar depression diagnosis of major depression requires that person experience either depressed mood or loss of interest in usual activities, plus at least four other symptoms of depression chronically for at least two weeks, symptoms must be severe enough to interfere with person's ability to function in everyday life Dysthymic disorder- less severe form of depressive disorder than major depression, but is more chronic. To be diagnosed with dysthymic disorder, person must be experiencing depressed mood plus two other symptoms of depression for at least 2 years. During these 2 years, person must never have been without the symptoms of depression for more than a two-month period experience both major depression and dysthymic disorder- double depression People with double depression are chronically dysthymic, and then occasionally sink into episodes of major depression People with double depression also are less likely to respond to treatments The DSM-IV-TR also recognizes several subtypes of depression The first subtype of depression is depression with melancholic features, in which the physiological symptoms of depression are particularly prominent depression with psychotic features, in which people experience delusions and hallucinations during a major depressive episode. people with depression with catatonic features show the strange behaviours collectively known as catatonia, which can range from a complete lack of movement to excited agitation. depression with atypical features. The criteria for this subtype are an assortment of symptoms fifth subtype is depression with postpartum onset- diagnosis given to women when onset of a major depressive episode occurs within four weeks of delivery of a child. More rarely, women develop mania postpartum and are given diagnosis of bipolar disorder with postpartum onset The final subtype of major depressive disorder is depression with seasonal pattern, sometimes referred to as seasonal affective disorder, or SAD- People with SAD have a history of at least two years of experiencing major depressive episodes and fully recovering from them symptoms seem to be tied to the number of daylight hours in a day. People become depressed when the daylight hours are short and recover when the daylight hours are long. To be diagnosed with seasonal affective disorder, a person's mood changes cannot be result of psychosocial events. Rather, the mood changes must seem to come on without reason or cause Prevalence and Course of Depression older adults may be less willing than younger adults to report the symptoms of depression, because they grew up in a society less accepting of the disorder older people more likely to have mild to severe cognitive impairment, and it is often difficult to distinguish between a depressive disorder and the early stages of a cognitive disorder data indicate that the differences in prevalence rates of major depression become smaller with advancing age, with increasingly higher rates for men who never married as they age Depression in Childhood and Adolescence Depression is less common among children than among adults The Scars of Childhood Depression self-concept is still being developed in childhood and adolescence, much more so than in adulthood.period of significant depressive symptoms while a person's self-concept is undergoing substantial change can have long-lasting effects on the content or structure of a person's self-concept children and adolescents are dependent on and connected with other people to greater extent than adults, so an episode of depression that impairs social skills can have long-term effects on social relationships Stress-generation models suggest that the symptoms of depression an interfere with youngsters' functioning in all domains of their lives Effects of Puberty Girls' rates of depression escalate dramatically during puberty, but boys' rates do not Body dissatisfaction appears to be more closely related to low self-esteem and depression in girls than in boys U.S. research has shown that the pubertal increase in depression for girls may occur only among European-American girls and not amongAfrican-American and Latino girls Bipolar Mood Disorders Symptoms of Mania The moods of people who are manic can be elated, but that elation is often mixed with irritation and agitation Elevated, expansive, or irritable mood The manic person is filled with a grandiose self-esteem, meaning that his view of himself is unrealistically positive and inflated Decreased need for sleep, More talkative than usual, a pressure to keep talking, Flight of ideas or sense that your thoughts are racing, Distractibility, Excessive involvement in potentially dangerous activities The Diagnosis of Mania To be diagnosed with mania, an individual must show an elevated, expansive, or irritable mood for at least one week, plus at least three of the other symptoms listed People who experience manic episodes meeting these criteria are said to have bipolar Idisorder Most of these people eventually fall into a depressive episode. For some people with bipolar I disorder, the depressions are as severe as major depressive episodes, whereas others have episodes of depression that are relatively mild and infrequent. People with bipolar II disorder experience severe episodes of depression that meet the criteria for major depression, but their episodes of mania are milder and are known as hypomania Hypomania has the same symptoms as mania, in hypomania, these symptoms are not severe enough to interfere with daily functioning and do not involve hallucinations or delusions there is a less severe but more chronic form of bipolar disorder, known as cyclothymic disorder. Aperson with cyclothymic disorder alternates between episodes of hypomania and moderate depression chronically over at least a two-year period. During hypomania, person may be able to function reasonably well in daily life. periods of depression significantly interfere with daily functioning If a person has four or more cycles of mania and depression within a year, this is known as rapid cycling bipolar disorder. Prevalence and Course of Bipolar Disorder Bipolar disorder is less common than unipolar depression The best predictors of recovery were full compliance with medication taking and higher social class, which may have afforded people better after care and social support Creativity and bipolar disorder Some theorists have argued that the symptoms of mania can actually benefit certain people, especially highly intelligent or talented people the melancholy of depression is often seen as inspirational for artists Writers, artists, and composers of music h
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