Mood Final Copy

Perez, Raphael Ray L.Prof. Serafina P. Maxino BSCP/ 3rd yr.- 3sAbnormal Psychology Mood Disorders (Also called Affective Disorders, Depressive Disorders) Description of the Disability Mood disorders are a disturbance of the emotions, which spills over into almost every other aspect of life. Mood disorders affect how people think, how they behave, how they care for themselves, and their overall health. In that sense, mood disorders are total body disorders. On the one hand, mood disorders are one of the easiest disabilities for others to relate to because most of us have experienced something like it. On the other hand, this makes it difficult for people to grasp how different the intensity of clinical depression is from the mild depression that most people occasionally experience. It becomes very easy to think the person with depression should just snap out of it or try to think about something else, but their situation is not that simple. Most people experiencing depression are profoundly more affected by their moods than the average person ever is. The depression most people experience is a mild, reactive and short-term depression – a response to some event or series of events in their life that disrupts their feelings, but only for a little while. This type of reactive depression responds well to psychotherapy, if needed, or to talking to a friend and waiting for the mood to pass. Clinical mood disorders are not reactive: although they may be triggered by an event or sequence of events, they are disproportionately intense, last for weeks or months at a time, and do not respond to talking and other simple fixes. Mood disorders leave individuals debilitated and unable to function in basic ways. Along with substance abuse, mood disorders are one of the most commonly coexisting disabilities. There are three basic types of mood disorders: Depression, Dysthymia, and Bipolar Disorder. ,[object Object],To be considered clinically depressed, the DSM IV requires that a person be depressed for at least 2 weeks with symptoms present nearly every day. The central features are feeling sad or down and not enjoying anything. The person also usually feels profoundly tired, even if they can’t sleep. They find the smallest tasks to be too much work, including things such as dressing, showering, and answering the phone. There is a large set of other secondary symptoms, including: ,[object Object]

Feelings of helplessness or worthlessness

Excessive or inappropriate guilt, sometimes almost delusional in scale

Excessive crying Agitation (difficulty sitting still, pacing, hand wringing)

Psychomotor retardation (slowed speech, thinking, movement; long pauses before responding; softened speech; minimal response to conversations)

Sleep disturbance (usually insomnia, sometimes excessive sleep)

Difficulty concentrating, easily distracted

Change in eating habits, change in weight

Abnormal thoughts about death Thoughts about suicide, plans to commit suicide, or suicide attempt(s)

Reduced interest in daily activitiesIt is important to note that, although suicide attempts are not very common, there is no way to predict whether someone with suicidal thoughts will or will not attempt suicide. Any indication of suicidal thoughts or plans should be passed along for attention by a therapist. No one knows what causes depression. There is a host of theories, but none is especially dominant. The cause is probably a combination of genetics, brain/body neurochemistry, personality type, patterns of thought, and other factors. Effective treatment usually addresses both psychological and medical approaches to understanding depression. In addition, effective treatment will take time. The individual has typically spent a lifetime learning or developing the disorder (depending on your perspective of the cause), and it takes time to alter how their emotional system is used to functioning. People experiencing depression usually have difficulty organizing things and making decisions. This can impact the rehabilitation and employment processes, so it is important for VR counselors understand this and not rush the individuals. Many VR counselors report that individuals with mood disorders ask the counselor to make the decisions for them. They may also have difficulty concentrating on instructions or options given to them, so counselors may need to repeat things or confirm through conversation that the person understands what the counselor has said. There are several possible patterns to the depressive episodes. Some individuals have only one episode in their life. Others have episodes many years apart or clusters of episodes with years between the clusters. Some individuals have a pattern of increasing frequency as they grow older. If left untreated, a major depressive episode can last between 6 months and one year. With treatment, most episodes end within three months. Children can also be clinically depressed, although their symptoms can be somewhat different. They may pretend to be sick, refuse to go to school, or show separation anxiety by clinging to a parent or worrying about what will happen if a parent dies. Older children may sulk, feel misunderstood, get into trouble at school, and act irritable. Unfortunately, each of these symptoms can also occur innocently as a phase of a normal childhood, making it difficult to know if the child is actually depressed. Usually only a parent or teacher can tell when a child is “not him self
and the difference is enough to suggest professional assessment. Major Depressive Episode Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.Note: Do not include symptoms that are clearly due to a general medical condition, or mood-incongruent delusions or hallucinations. depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful). Note: In children and adolescents, can be irritable mood. markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation mad by others) significant weight loss when not dieting or weight gain (e.g. a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. Note: In children, consider failure to make expected weight gains. insomnia or hypersomnia nearly every day psychomotor agitation or retardation nearly every day (observable by others, no merely subjective feelings of restlessness or being slowed down) fatigue or loss of energy nearly every day feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick) diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others) recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide The symptoms do not meet criteria for a Mixed Episode. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g. hypothyroidism) The symptoms are not better accounted for by Bereavement, i.e., after the loss of a loved one, the symptoms persist for long than 2 months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation. Manic Episode A distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week (or any duration if hospitalization is necessary). During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree: inflated self-esteem or grandiosity decreased need for sleep (e.g., feels rested after only 3 hours of sleep) more talkative than usual or pressure to keep talking flight of ideas or subjective experience that thoughts are racing distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli) increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments) The symptoms do not meet the criteria for a Mixed Episode. The mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features. The symptoms are not due to the direct physiological effects of a substance (e.g. a drug of abuse, a medication or other treatment) or a general medical condition (e.g., hyperthyroidism).Note: Manic-like episodes that are clearly caused by somatic antidepressant treatment (e.g., medication, electroconvulsive therapy, light therapy) should not count toward a diagnosis of Bipolar I Disorder. Mixed Episode The criteria are met both for a Manic Episode and for a Major Depressive Episode (except for duration) nearly every day during at least a 1-week period. The mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatment) or a general medical condition (e.g., hyperthyroidism).NOTE: Mixed-like episodes that are clearly caused by somatic antidepressant treatment (e.g., medication, electroconvulsive therapy, light therapy) should not count toward a diagnosis of Bipolar I Disorder. Hypomanic Episode A distinct period of persistently elevated, expansive, or irritable mood, lasting throughout at least 4 days, that is clearly different from the usual nondepressed mood. During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree: inflated self-esteem or grandiosity decreased need for sleep (e.g., feels rested after only 3 hours of sleep) more talkative than usual or pressure to keep talking flight of ideas or subjective experience that thoughts are racing distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli) increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g., the person engages in unrestrained buying sprees, sexual indiscretions, or foolish business investments) The episode is associated with an unequivocal change in functioning that is uncharacteristic of the person when not symptomatic. The disturbance in mood and the change in functioning are observable by others. The episode is not severe enough to cause marked impairment in social or occupational functioning, or to necessitate hospitalization, and there are no psychotic features. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatment) or a general medical condition (e.g., hyperthyroidism).NOTE: Hypomanic-like episodes that are clearly caused by somatic antidepressant treatment (e.g., medication, electroconvulsive therapy, light therapy) should not count toward a diagnosis of Bipolar II Disorder. Major Depressive Disorder, Single Episode Presence of a single Major Depressive Episode. The Major Depressive Episode is not better accounted for by Schizoaffective Disorder and is not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified. There has never been a Manic Episode, a Mixed Episode, or a Hypomanic Episode. Note: This exclusion does not apply if all of the manic-like, mixed-like, or hypomanic-like episodes are substance or treatment induced or are due to the direct physiological effects of a general medical condition. Major Depressive Disorder, Recurrent Presence of a two or more Major Depressive Episodes. The Major Depressive Episodes are not better accounted for by Schizoaffective Disorder and is not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified. There has never been a Manic Episode, a Mixed Episode, or a Hypomanic Episode. Note: This exclusion does not apply if all of the manic-like, mixed-like, or hypomanic-like episodes are substance or treatment induced or are due to the direct physiological effects of a general medical condition. ,[object Object],Dysthymia is milder than major depression, but the DSM IV requires that it have lasted for at least 2 years. Individuals with dysthymia are not as seriously debilitated as individuals with major depression, but they are functioning at a significantly reduced level. They often describe it as living in a constant cloud of gloom. In addition to sadness, the person may experience: ,[object Object]

Fatigue Sleep disturbance (usually insomnia, sometimes excessive sleep)

Difficulty concentrating, easily distracted Difficulty making decisions

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