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1. Unipolar Depression: Mood disorders manifest across a spectrum from mania
to major depressive disorder (MDD).
prevalence highest (13.1%) among individuals aged 18-25 (MDD)
2. Common symptoms of MDD: depressed mood or loss of interest or pleasure in
daily activities, irritability, withdrawal, and problems with sleep, eating, energy, con-
centration, or self-worth. Clients with severe depression may experience thoughts
of suicide or psychotic symptoms.
3. Bipolar Disorders: a chronic condition characterized by extreme fluctuations in
mood, energy, and ability to function. The World Mental Health Survey Initiative
reported total lifetime prevalence estimates of 2.4%
Moods may be manic, hypomanic, or depressed and may include mixed mood or
psychotic features.
diagnosed when a client has one or more episodes of mania or hypomania with a
history of one or more major depressive episodes.
high risk for suicide
4. Bipolar Type I: Diagnosis: requires at least one episode of mania for at least one
week (or any duration if hospitalization due to symptoms is required).
Mania is characterized by a persistently elevated, expansive, or irritable mood.
5. symptoms of bipolar type I: Related symptoms may include inflated self-es-
teem, increased goal-directed activity or energy, including grandiosity, decreased
need for sleep, excessive talkativeness, racing thoughts, flight of ideas (FOI),
distractibility, psychomotor agitation, and a propensity to be involved in high-risk
activities. Mania leads to significant functional impairment and may include psychotic
features or necessitate hospitalization
6. Bipolar Type II Disorder
Diagnosis: requires a current or past hypomanic episode and a current or past
major depressive episode.
Symptoms last for at least 4 days but fewer than seven.
Anger and irritability are common. Clients often enjoy the elevation of mood and are
reluctant to report these symptoms, making bipolar more difficult to diagnose if the
client presents in the depression phase.
7. Cyclothymia:: involves the chronic presentation of hypomanic and depressive
symptoms that do not meet the diagnostic criteria for a major depressive or man-
ic/hypomanic episode.
8. Key point: Bipolar I depression may be misdiagnosed as major depressive dis-
order (MDD)
essential to rule out past episodes of hypomania or mania
Clients are reluctant to report mania or hypomania symptoms
If bipolar depression is mistaken for MDD, antidepressant therapy may precipitate a
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manic episode or induce rapid-cycling bipolar depression, which may contribute to
the increased incidence of death by suicide in children and adults younger than 25.
Antidepressants are used cautiously in clients with bipolar disorder and never as
monotherapy. Antidepressants should be combined with a mood stabilizer to prevent
the onset of a hypomanic or manic episode.
9. Decreased positive affect: DA,NE Dysfunction
Symptoms: depressed mood
loss of joy
lack of interest
loss of energy
decreased alertness
decreased self-confidence
appetite changes
10. Increased negative affect: 5HT, NE Dysfunction
Symptoms: depressed mood
guilt
fear/anxiety
hostility
irritability
loneliness
appetite changes
11. Genetics of MDD and BPD: Gene and genome-wide association studies have
identified candidate genes for contributing to both MDD and BPD; however, the
causes of mood disorders are complex and likely involve interactions between
genetic/epigenetic, biological, psychological, and social factors including:
dysfunctions in brain
imbalance of neurotransmitters
life events
abuse or trauma
substance use or medication
menstruation
season changes
12. Neural Networks of MDD and BPD: The classic monoamine hypothesis of
depression posits that depression occurs as a result of a deficiency of one or all three
monoamine transmitters (serotonin, norepinephrine, and dopamine), while mania
may result from an excess; however, this hypothesis has limitations. Stahl (2021)
acknowledged that depression is more complex than this simple theory but agrees
that the monoamine hypothesis is helpful to understand the physiological functioning
of these NTs. Emphasis is now shifted from the monoamines to their receptors and