Mood Disorders

Question 1

What are mood disorders?

Answer 1

A whole category of diagnosis that mainly affect mood (as opposed to thoughts or behaviours) and are pathological

pathological - a disease/illness

Question 2

What is Major Depressive Disorder?

(MDD)

Answer 2

DSM: One or more major depressive episodes W/OUT mania.

Question 3

What is an “Episode” ?

Answer 3

Chucks of time that are at least 2 weeks in length where a person experience’s at least 5 of these symptoms…

• Depressed mood, self reported or expressed by others (non-professional 3rd parties get to weigh in)
• Anhedonia, loss of ability to feel pleasure
• Substantial weight loss/gain
• Insomnia or hypersomnia
• fatigue or loss of energy
• feelings of worthlessness or excessive guilt
• diminished ability to think or concentrate (indecisiveness)
• reoccurring thoughts of death
• reoccurring thoughts of suicide

Question 4

What was the Bereavement Exclusion?

Answer 4

Said that if a person had a loved one who died within the last 5 weeks you could not diagnose them with Depression (MDD or PDD)

This was removed in the DSM 5 - many people did not like this

• Medicalizes grief/normal human experiences?
• Doesn’t take into account cultural death and grieving rituals
• also, if disorders are somatic in nature, things like death shouldn’t affect mental illness at all

Question 5

What is Persistent Depressive Disorder?

(PDD)

Answer 5

A chronic but milder form of depression

Question 6

What makes Depression different from sadness?

Answer 6

• Depression is pervasive and persistent
• Doesn’t have to clear/ understandrable stimulus
• Involves impeller social / occupational function
• A person feels different s” like being consumed by dark cloud”
• are there biomarkers for depression?
  No there aren’t, some people say we’ll find them

Question 7

Bipolar Depression (BD)

Answer 7

Cycling b/t depressive and manic episodes.

• Mania many things a person will exp. such as
  – Abnormal and persistently elevated or irritable mood.
  – Unrealistic belief in one’s own abilities, creativity.
• Decreased need for sleep.
• Increase in goal-directed activity (e.g. socially or professionally)
  or psychomotor agitation.
• Excessive involvement in pleasurable activities w/ high potential
  for painful consequences.

Question 8

What is “Manina”

Answer 8

Refers to many experiences a person has such as
– Abnormal and persistently elevated or irritable mood.
– Unrealistic belief in one’s own abilities, creativity.
- Gregariousness, flirtatiousness.
- Decreased need for sleep.
- Flight of ideas, racing thoughts, distractibility.
- Increase in goal-directed activity (e.g. socially or professionally)
or psychomotor agitation.
- Excessive involvement in pleasurable activities w/ high potential
for painful consequences.

Question 9

“Benefits” to mental illness/disorders

• Although typically framed as “negative,” can these experiences contain value?

– Does mania inspire greatness?
– Does depression give pause
for thought?
– “Tortured genius.”

• Others see these suggestions
  as selective, unrealistic, and
  harmful.

Question 10

Premenstrual Dysphoric Disorder (PMDD)

Answer 10

Most menstrual cycles experience several symptoms such as

• Affective liability
  – Irritability
  – Depressed mood
  – Anxiety
  – Change in appetite, overeating, or specific food cravings
  – Physical symptoms (breast tenderness or swelling, joint or muscle pain, a sensation of “bloating,” weight gain)

** These experiences are normal and common, reflects difficulty in delineating b/t “normal” and “abnormal” or “healthy” and “ill.”

PMDD was only added to the DSM as a diagnosis after Sarafem was a solution for this “issue”

Sarafem is actually Prozac (an anti-depressant) whose contract was expiring and was able to be renewed when they said it’d be a “Treatment for PMDD”

i.e. medicalization of menstruation makes a normal body function a disorder to sell people medication

Question 11

Disruptive Mood Dysregulation Disorder (DMDD)

Answer 11

• New to DSM-5.

– Recurrent temper outbursts “grossly disproportionate” to the situation.

– B/t outbursts, children irritable and angry.

– Observed in 2 of 3 settings: parents, teachings, peers.

– Child must be aged 6-18, and symptoms must develop by 10

Controversies:
- Is this part of a broader trend of medicalizing childhood?

Diagnostic increases from 1990

ADHD x 3 Autism x 20 BPD x 40

Do we “need” it? ODD: “an ongoing pattern of anger guided
disobedience, hostilely defiant behavior toward authority figures
that goes beyond the bounds of normal childhood behavior”?

Question 12

Women and Mood Disorders

• How should we understand the fact that women are 3x
  more likely to be diagnosed w/ depression, and slightly
  more likely to be diagnosed w/ bipolar disorder (a 3:2
  ratio)?
  – Gender differences in seeking treatment?
  – Biological?
  – More likely to experience stressful life events?
  – Less fulfilling roles.
  – Diagnostic bias?