AND ANSWERS LATEST UPDATE
Major Depressive Disorder (MDD) common symptoms
depressed mood, loss of interest or pleasure in daily activities, irritability, withdrawal,
and problems with sleep eating, energy, concentration, or self worth. Clients with severe
depression may experience thoughts of suicide or psychotic symptoms.
Bipolar Disorder
chronic condition characterized by extreme fluctuations in mood, energy, and ability to
function. May experience recurrent episodes and remissions. Moods may be manic,
hypomanic, or depressed. May be a mixed mood or psychotic features. Most bipolar
depression clients experience depression symptoms and may have only one manic
episode in their lifetime. Diagnosed when a client has one or more episodes of mania or
hypomania with a history of one or more major depressive episodes. Associated with
significant morbidity and mortality. High risk for suicide. Correct and early diagnosis is
essential to prevent complications and maximize treatment response.
Bipolar I
Requires at least one episode of mania for at least one week (or any duration if
hospitalized due to symptoms is required).
Mania
characterized by a persistently elevated, expansive, or irritable mood. Related
symptoms may include inflated self esteem, increased goal directed activity or energy,
including grandiosity, decreased need for sleep, excessive talkativeness, racing
thoughts, flight of ideas, distractibility, psychomotor agitation, and a propensity to be
involved in high risk activities. Leads to significant functional impairment and may
include psychotic features or necessitate hospitalization.
Bipolar II
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 7. Hypomanic
symptoms are not sufficient duration or severity to cause significant functional
impairment, psychosis, or hospitalization. Anger ad 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.
Cyclothymia
involves the chronic presentation of hypomanic and depressive symptoms that do not
meet the diagnostic criteria for a major depressive or main/hypomanic episode.
Mood Related Symptoms
may be characterized as having too little positive affect, or too much negative affect.
Positive affect
Dopamine (DA) Norepinephrine (NE) dysfunction
Negative Affect
5-Hydroxytrpytamine (5HT) Norepinephrine (NE) Dysfunction
Decreased positive Affect: DA, NE Dysfunction
Depressed mood
loss of joy
lack of interest
loss of energy
decreased alertness
decreased self confidence
appetite changes
Increased Negative Affect: 5HT, NE Dysfunction
depressed mood
guilt
fear/anxiety
hostility
irritability
loneliness
appetite changes
Neurobiological Basis: Genetics
MDD and BD are heritable disorders. Genetic factors contribute 31-42% of the disease
risk in MDD and 59-85% in BD. Causes of mood disorders are complex and likely
involve interaction between genetic/epigenetic, biological, psychological, and social