Mood Disorder (overview)

Mood Disorder Subtypes
Types Characteristic
Dysthymia • Depressed mood
• Loss of interest or pleasure
• Chronic (at least 2 years)
(nonpsychotic bipolar)
• Alternating states
• Chronic
• Often not recognized by affected person
Seasonal affective disorder (SAD) • Depressive symptoms during winter months (shortest days, so least amount of light)
• Caused by abnormal melatonin metabolism
• Treat with bright light therapy
Unipolar depression
(major depression)
• Symptoms for at least 2 weeks
• Must be a change from previous functioning
• May be associated with anhedonia, no motivation, feelings of worthlessness, decreased concentration, weight loss or gain, depressed mood, recurrent thoughts, insomnia or hypersomnia, psychornotor agitation or retardation, somatic complaints, delusions or hallucinations (mood congruent}, loss of sex drive
• Diurnal improvement as day progresses
Suicide: 60% of depressed patients have suicidal ideation; 15% die by suicide
Sleep: REM in first half of sleep, REM latency, stage 4 sleep, REM time overall, early morning wakening
Bipolar disorder
• Symptoms of major depression and symptoms of mania (period of abnormal and persistent elevated, expansive, or irritable mood)

• Subtypes:
- Bipolar I: mania more prominent
- Bipolar II: recurrent depressive episodes, plus hypomanic episodes
- "Rapidly cycling bipolar disorder": if alternates within 48-72 hours

Manic symptoms:
- self-esteem or grandiosity
- Low frustration tolerance
- need for sleep
- Flight of ideas
- Sxcessive involvement in activities
- Weight loss and anorexia
- Erratic and uninhibited behavior
- ↑


Normal Grief VS Depression
Normal Grief Depression
Normal up to 1 year Longer than 1 year, sooner if symptoms severe
Crying, libido, weight loss, insomnia Same
Longing, wish to see loved one, may think they hear or see loved
one in a crowd
Abnormal over-identification, personality change
Loss of other Loss of self
Suicidal ideation rare Suicidal ideation common
Self-limited, usually <6 months Symptoms do not stop (may persist for years)
Antidepressants not helpful Antidepressants helpful