Textbook Notes (290,000)
CA (170,000)
UTSC (20,000)
Psychology (10,000)
PSYB32H3 (1,000)
Chapter 10

Chapter 10 Notes

Course Code
Konstantine Zakzanis

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General Characteristics of Mood Disorders
-mood disorders involve disabling disturbances in emotion from the sadness of depression to the
elation and irritability of mania
-depression is an emotional state marked by great sadness and feelings of worthlessness and guilt
-additional symptoms include withdrawal from others, loss of sleep, appetite, sexual desire and interest
and pleasure in usual activities
-often associated with other psychological problems such as panic attacks, substance abuse, sexual
dysfunction and personality disorders
-paying attention is exhausting for people with depression and conversation becomes a chore as they
will speak slowly and low voice
-make numerous complaints of somatic symptoms with no apparent physical basis
-depression in children results in somatic complaints such as headaches or stomach ache but in older
adults, it is characterized by distractibility and complaints of memory loss
-depression is less prevalent in China than in North America and this is due to cultural mores that make
it less appropriate for a Chinese to display their emotional symptoms
-western cultures emphasize emotional symptoms for depression while non western cultures like
Chinese emphasize somatic symptoms
-only 15% of depressed primary care patients in Canada are referred to as psychologizers; emphasize
the psychological aspects of depression
-one third of the people suffer from chronic depression
-mania is an emotional state or mood of intense but unfounded elation accompanied by irritability,
hyperactivity, distractibility and impractical grandiose plans
-people who experience episodic depression may become maniac at times
-experiencing mania without depression is very rare
-they will shift from topic to topic and the speech will be difficult to interpret and may become
-anything that stops them will bring anger and rage
-mania comes over suddenly over a period of day or two
-two major mood disorders are listed in DSM-IV TR, major depression referred to as unipolar
depression and bipolar disorder
Diagnosis of Depression-formal DSM-IV TR diagnosis of a major depression also referred to as
unipolar depression requires the presence of five of the following symptoms for at least two weeks
-either depressed mood or loss of interest and pleasure must be one of the five symptoms
sad, depressed mood, most of the day, nearly every day
loss of interest pleasure in usual activites
difficulties in sleeping (insomnia)
shift in activity level
poor appetite and weight loss or increased appetite and weight gain

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loss of energy, fatigue
negative self concept; feel worthless and guilt
complaints or evidence of difficulty in concentrating
thoughts of death or suicide
-major depression is one of the most prevalent disorders as rate of depression can be compare to the
rates of chronic medical conditions such as heart disease, diabetes and thyroid problems
-can also vary in culture
-two times more common in women than men (only rises in adolescence) and higher rates among
younger people than older persons
-occurs more frequently among members of the low socioeconomic classes
-girls are more likely than boys to have certain risk factors of depression even before adolescence but it
is only when these risk factors interact with the challenges of adolescence, that the gender differences
in depression emerge
-gender differences in ruminative coping versus distraction when feelings of depression are
-females more likely to engage in ruminative coping as they focus their attention on their depressive
symptoms while males are more likely rely on distraction; doing something that diverts their attention
eg engaging in physical activity, watching tv
-rumination was more common in women and is the key to the gender differences in depressive
-women more likely to be involved in childhood sexual abuses and that history of abuse is a risk factor
for depression
-depression tends to be a recurrent disorder
-12% became chronic when the disorder lasts more than two years
Diagnosis of Bipolar Disorder-DSM-IV-TR defines bipolar disorder as involving episodes of mania
or mixed episode that includes symptoms of both mania and depression
-formal diagnosis of manic episode requires the presence of elevated or irritable mood plus three
additional symptoms
-euphoria (feeling of well being not based on reality) is not a core symptom of mania but irritable mood
and depressive features are more common
-the symptoms listed here must be sufficiently severe to impair social and occupational functioning
increase in activity level at work, socially , sexually
unusual talkativeness; rapid speech
flight of ideas or subjective impression that thoughts are racing
less than usual amount of sleep needed
inflated self esteem; belief that one has special powers, abilities
distractibility attention easily diverted
excessive involvements in pleasurable activities that are likely to have undesirable
consequences such as reckless spending
-occurs less often than major depression with a lifetime prevalence rate of 1% of the population
-average age on onset is 20s and occurs equally often in men and women
-episodes of depression more common in women and epsidoes of mania more common in men
-tends to reoccur
-they hardly recover to daily functioning beings

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-problem in classification of mood disorders is that there is great heterogeneity- that is people with the
same diagnosis can vary greatly from one another
-some bipolar patients experience full range of symptoms of both mania and depression almost every
day termed mixed episode
-other patients have symptoms of only or only depression during a clinical episode
-bipolar II disorder patients have episodes of major depression accompanied by hypomania, a
change in behaviour and mood that is less extreme than full-blown mania
-some depressed patients maybe diagnosed as having delusion and hallucinations and this appears to be
a useful distncition among people with unipolar depression
-depressed patients with delusion don't respond well to usual drug therapies for depression but respond
well to these drugs when they are combined with drugs that are used to treat schizophrenics
-some patients with depression may have melancholic features which refers to a specific pattern of
depressive symptoms
-patients with melancholic features find no pleasure in any activity and are unable to feel better even
temporarily when something good happens
-their depressed mood is the worst in the morning
-they awaken about two hour too early, lose appetite and weight and either lethargic (inactive) or
agitated (troubled emotionally)
-they had no personality disturbance prior to their first episode of depression and respond well to
biological therapies
-it is considered more severe type of depression since it has more comorbidity with anxiety disorders
and frequent episodes
-both manic and depressive episodes may be characterized as having catatonic features, such as motor
immobility or excessive purposeless activity
-both manic and depression can occur within 4 weeks of childbirth
-both bipolar and unipolar disorders can be subdiagnosed as seasonal if there is regular relationship
between an episode and a particular time of the year
-winter is associated with depression because of the decrease in the number of daylight hours which is
called seasonal affective disorder SAD
-symptoms varied in response to changes in climate and latitude in a manner that suggested that
reduced exposure to sunlight was causing their depressions
-reduced light does cause decreases in the activity of serotonin neurons of the hypothalamus and these
neurons regulate behaviours such as sleep, that are part of of the syndrome of SAD
-exposure to bright, white light known as phototherapy is highly effective treatment for SAD
-these patients do recover and longer light exposure is associated with better outcomes
-DSM-IV lists two long lasting or chronic disorders in which mood disturbances are predominant but
they are not severe enough to warrant a diagnosis of a major depressive or manic episode
-cyclothymic disorder, the person has frequent periods of depressed mood and hypomania (not serious
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