Chapter 8: Mood Disorder
General Characteristics of Mood Disorders
• Mood disorders: involve disabling disturbances in emotion, from the
sadness of depression to the elation and irritability of mania. Mood
disorders are often associated with other psychological problems, such as
panic attacks, substance abuse, sexual dysfunction, and personality
Depression: Signs and Symptoms
• As illustrated by the case of John Bentley Mays, depression is an
emotional state marked by great sadness and feelings of worthlessness
and guilt. Additional symptoms include withdrawal from others and loss of
sleep, appetite, sexual desire, and interest, and pleasure in usual
• Paying attention is exhausting for depressed people.
• Depression in children often results in somatic complaints, such as
headaches or stomach aches. In older adults, depression is often
characterized by distractibility and complaints of memory loss.
• Psychologizers: people who emphasize the psychological aspects of
Mania: Signs and Symptoms
• Mania: is an emotional state or mood on intense but unfound elation
accompanied by irritability, hyperactivity, talkativeness, flight of ideas,
distractibility, and impractical, grandiose plans.
• The individual shifts rapidly from topic to topic.
Formal Diagnosis Listing of Mood Disorders
• Two major mood disorders listed in DSM-IV-TR: major depression, also
referred to as unipolar depression, and bipolar disorder.
Diagnosis of Depression
• Major depressive disorder (MDD) 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
Loss on interest and pleasure in usual activities
Difficulties in sleeping Shift in activity level, becoming either lethargic or agitated
Poor appetite and weight loss, on increased appetite and weight gain.
Loss of energy
Complaints or evidence of difficulty in concentrating such as slowed
thinking and indecisiveness.
Recurrent thought of death or suicide.
• Ruminative coping: A tendency to focus cognitively (perhaps to the point
of obsession) on the causes of depression and associated feelings rather
than engaging in forms of distraction.
• Brooding: A moody contemplation of depressive symptoms – “what am I
doing to deserve this?” – that is more common in females than males.
• An interpersonal form of rumination called corumination, in which friends,
typically female friends, discuss and brood over each other’s problems as
part of their friendship, has been linked with depression in adolescent girls
but, on a positive note it is also fosters stronger friendships.
• Feminist scholar Dana Jack suggests that females are more likely than
males to engage in silencing the self – a passive style of keeping upsets
and concerns to oneself in order to maintain important relationships (akin
to “suffering in silence”). A definitive longitudinal test of the hypothesis
remains to be conduced. Another explanation is objectification theory,
based on the premise that the tendency to be viewed as an object,
scrutinized and appraised by others, including appraisals of physical
appearance, has a greater negative, influence on the self-esteem of girls
• Kindling hypothesis: the notion that once a depression has already been
experienced, it takes relatively less stress to induce a recurrence.
Diagnosis of Bipolar Disorder
• Bipolar I disorder: as involving episodes of mania or mixed episodes that
include symptoms of both mania and depression.
• A formal diagnosis of a manic episode requires the presence of elevated
or irritable mood plus three additional symptoms (four if the mood is
• The symptoms must be sufficiently severe to impair social and
Increase in activity level at work, socially, or sexually
Unusual talkativeness; rapid speech
Flight of ideas or subjective impression that thought are racing
Less than the usual amount of sleep needed
Excessive involvement in pleasurable activities that are likely to have
undesirable consequences, such as reckless spending. Heterogeneity within the Categories
• Bipolar II disorder individuals have episodes of major depression
accompanied by hypomania (hypo comes from the Greek for “under”) a
change in behaviour and mood that is less extreme than full-blown mania.
• The term melancholic refers to a specific pattern of depressive symptoms.
People with melancholic features find no pleasure in any activity
(anhedonia) and are unable to feel better even temporarily when
something good happens. Their depressed mood is worse in the morning.
• Seasonal affective disorder (SAD): The “winter depressions” that stem
from reduced exposure to daylight.
• Reduced light does cause decreases in the activity of serotonin neurons of
the hypothalamus, and these neurons regulate some behaviours, such as
• Postpartum depression: The depression experienced by some mothers
after giving birth.
Chronic Mood Disorders
• In cyclothymic disorders: the personal has frequent period of depressed
mood and hypomania, which may be mixed with, may alternate with, or
may be separated by periods of normal mood lasting as long as two
• The person with dysthymic disorder, is chronically depressed – more than
half the time for at least two years – according to the DSM –IV-TR.
Besides feeling blue and losing pleasure in usual activities and pastimes,
the person experiences several other signs of depression, such as
insomnia or sleeping too much; feelings of inadequacy ineffectiveness,
and lack of energy; pessimism; an inability to concentrate and to think
clearly; and a desire to avoid the company of others.
• Double depression: A comorbid condition that applies to someone
characterized by both dysthymia and major depression.
Psychological Theories of Mood Disorders
Cognitive Theories of Depression
Beck’s Theory of Depression
• Aaron Beck is responsible for the most important contemporary theory that
regards thought processes as causative factors in depression. His central
thesis is the depressed individuals feel as they do because their thinking is
biased toward negative interpretations.
• Negative schemata, together with cognitive biases or distortions, maintain what Beck called the negative triad: negative views of the self, the world,
and the future.
• Arbitrary inference – a conclusion drawn in the absence of sufficient
• Selective abstraction – conclusion drawn on the basis of only one of many
elements in a situation.
• Overgeneralization – an overall sweeping conclusion drawn on the basis
of a single, perhaps trivial, event.
• Magnification and minimization – exaggerations in evaluating
• First, depressed individuals, relative to non-depressed individuals,
endorse more negative words and fewer positive words as self-
descriptive. Secondly, they exhibit a cognitive bias: they have greater
recall of adjectives with depressive content, especially if the adjectives
were rated as self-descriptive.
• Depressed and non-depressed people do not differ in whether their
schemas involve positive or negative content; rather, they differ in
cognitive processing. Depressed people pay greater attention to negative
stimuli and can more readily access negative than positive information.
• Differences in cognitive processing are assessed via the Stroop task.
Participants are provided with a series of words in different colours and
are asked to identify the colour of each word and ignore the actual word
itself. The Stroop task assesses the latency or length of time it takes to
• People who had a history of depression but were in a neutral mood tended
to divert their attention when presented with negative stimuli, once again
suggesting the presence of a protective bias.
• We must address two key issues when evaluating Beck’s theory. The first
is whether depressed people actually think in the negative ways
enumerated by Beck.
• The second issue represents perhaps the greatest challenge for cognitive
theories of depression: whether it could be that the negative beliefs of
depressed people do not follow the depression but in fact cause the
• In this section we discuss the evolution of an influential cognitive theory of
depression – actually, three theories: the original learned helplessness
theory; its subsequent, more cognitive, attributional version; and its
transformation into the learned hopelessness theory. Learned Helplessness:
• The basic premise of the learned
helplessness theory is that an
individual’s passivity and sense of being
unable to act and control his or her own
life is acquired through unpleasant
experiences and traumas that the
individual tried unsuccessfully to control.
• Aaron Beck taking a cognitive perspective, proposed that depression is
associated with two personality styles: sociotropy and autonomy.
Sociotropic individuals are dependent on others. They are especially
concerned with pleasing others, avoiding disapproval, and avoiding
separation. Autonomy is an achievement-related constructs that focuses
on self-critical goal striving, a desire for solitude and freedom from control.
• Congruency hypothesis: The prediction that people are likely to be
depressed if they have a personality vulnerability that is matched by
congruent life events (e.g. perfectionists who experience a failure to
achieve). It is derived from research on personality, stress, and
Attribution and Learned Helplessness:
• Depressive paradox: A cognitive tendency for depressed individuals to
accept personal responsibility for negative outcomes despite feeling a lack
of personal control.
• The essence of the revised theory is the concept of attribution – the
explanation a person has for his or her behaviour. When a person has
experienced failure, he or she will try to attribute the failure to some cause.
• Abramson, Seligman, and Teasdale formulation to various ways in which
a university student might attribute a low score on the mathematics portion
of the Graduate Record Examination (GRE). The formulation is based on
answers to three questions:
1. Are the reasons for failure believed to be internal (personal) or external
2. Is the problem believed to be stable or unstable?
3. How global or specific is the inability to succeed perceived to be?
• Depressogenic inferential style the tendency to perceive negative events
as having disastrous consequences.
• Depressive predictive certainty: the concept that people become prone to
depression when they perceive that an anticipated state of helplessness in
certain to occur. It is derived from the hopelessness theory of depression. • The measurement of stress generation involves making the distinction
between independent events (i.e. not due to oneself) and dependent
events (i.e. stemming from personal choices or actions depend on the
• Stress generation predicted depression in adolescent girls but not in boys.
Biological Theories of Mood Disorders
• Research on genetic factors in bipolar disorder and MDD has used twin,
family, and adoption methods. Bipolar disorder is one of the most heritable
• Bipolar disorder results from a dominant gene on the 11 chromosome.
• Brain-derived neurotropic factor (BDNF) gene appears to predict risk of
developing rapid cycling.
• People who possess one or two copies of the short variant of the 5-
HTTLPR (serotonin transporter) gene, which is involved in modulating
serotonin levels, experienced higher levels of depression and suicidality
following a recent stressful event.
• Non-depressed children homozygous for the 5-HTTLPR short allele