Lecture 2 - Major Depressive Disorder Affective disorders
This lecture will be seperated in two parts: first Freddy will talk about depression in general
and secondly he will present some of his own work in the field of depression.
Part one - general information about depression
Example: J.K. Rowling talking about depression. Freddy says depression is something we
mean when talking about having a bad mood or sad feelings. We should be aware of that,
clinical depression is a diagnosed mental illness. It is a state of mind that is different from
normal, this being you’re not able to function as you normally would.
DSM-V depressive disorders
- Disruptive mood dysregulation disorder
- Major depressive disorder (one that you’ll have to know for the exam)
- Persistent Depressive Disorder (Dysthymia) (one that you’ll have to know for
the exam): this form of depression has milder symptoms, but they last long.
- Premenstrual Dysphoric Disorder
- Substance/Medication Induced Depressive Disorder
- Depressive Disorder Due to Another Medical Condition
- Other Specified Depressive Disorder
- Unspecified Depressive Disorder
DSM-V symptoms MDD
One of the two core symptoms:
- depressed mood
- markedly diminished interest of pleasure (anhedonia)
At least 5 of the following symptoms:
- weight changes
- insomnia of hypersomnia
- psychomotor agitation or retardation
- loss of energy
- feelings of worthlessness
- diminished ability to think or concentrate
- recurrent thoughts of death, suicide, suicide attempts
MDD: at least 5 symptoms and 2 weeks.
Persistent Depressive Disorder: at least 3 symptoms and 2 years durability.
, Next to this these types of depression there are some additional problems that can be
present next to the main diagnosis:
- anxiety
- mixed features
- melancholic features
- atypical features
- psychotic features
- catatonia
- postpartum onset
- seasonal pattern
Depression with Melancholic Features: There is a clear inability to experience any
pleasure, a depressed mood that is regularly worse in the morning, early waking, clear signs
of agitation, significant weight loss or signs of anorexia and excessive or inappropriate guilt.
Depression with Atypical Features: This is a type of depression where you see some
strange features that are not seen in other types of depression, such as the ability to
experience positive reactions to positive events, which is normally not seen often with
depressed individuals, weight gain or increased appetite, prolonged duration of sleep (10+
hours), sensation of heaviness in the limbs, over-sensitivity to interpersonal rejection.
Depression with Psychotic Features: You have to have mood congruent delusions or
hallucinations. How can you distinguish this from schizophrenia or psychosis? Look at the
table below.
The differences between psychosis and psychotic depression. With a psychotic depression
you see more suicide and internalised behaviour. Hallucinations are more visual than
auditory, whereas with psychosis it is the other way around.
Etiology of depression
What are the underlying causes? There can be different reasons. It is of multicausal, in
which vulnerability plays an important role. It can often be a specific event that triggers
This lecture will be seperated in two parts: first Freddy will talk about depression in general
and secondly he will present some of his own work in the field of depression.
Part one - general information about depression
Example: J.K. Rowling talking about depression. Freddy says depression is something we
mean when talking about having a bad mood or sad feelings. We should be aware of that,
clinical depression is a diagnosed mental illness. It is a state of mind that is different from
normal, this being you’re not able to function as you normally would.
DSM-V depressive disorders
- Disruptive mood dysregulation disorder
- Major depressive disorder (one that you’ll have to know for the exam)
- Persistent Depressive Disorder (Dysthymia) (one that you’ll have to know for
the exam): this form of depression has milder symptoms, but they last long.
- Premenstrual Dysphoric Disorder
- Substance/Medication Induced Depressive Disorder
- Depressive Disorder Due to Another Medical Condition
- Other Specified Depressive Disorder
- Unspecified Depressive Disorder
DSM-V symptoms MDD
One of the two core symptoms:
- depressed mood
- markedly diminished interest of pleasure (anhedonia)
At least 5 of the following symptoms:
- weight changes
- insomnia of hypersomnia
- psychomotor agitation or retardation
- loss of energy
- feelings of worthlessness
- diminished ability to think or concentrate
- recurrent thoughts of death, suicide, suicide attempts
MDD: at least 5 symptoms and 2 weeks.
Persistent Depressive Disorder: at least 3 symptoms and 2 years durability.
, Next to this these types of depression there are some additional problems that can be
present next to the main diagnosis:
- anxiety
- mixed features
- melancholic features
- atypical features
- psychotic features
- catatonia
- postpartum onset
- seasonal pattern
Depression with Melancholic Features: There is a clear inability to experience any
pleasure, a depressed mood that is regularly worse in the morning, early waking, clear signs
of agitation, significant weight loss or signs of anorexia and excessive or inappropriate guilt.
Depression with Atypical Features: This is a type of depression where you see some
strange features that are not seen in other types of depression, such as the ability to
experience positive reactions to positive events, which is normally not seen often with
depressed individuals, weight gain or increased appetite, prolonged duration of sleep (10+
hours), sensation of heaviness in the limbs, over-sensitivity to interpersonal rejection.
Depression with Psychotic Features: You have to have mood congruent delusions or
hallucinations. How can you distinguish this from schizophrenia or psychosis? Look at the
table below.
The differences between psychosis and psychotic depression. With a psychotic depression
you see more suicide and internalised behaviour. Hallucinations are more visual than
auditory, whereas with psychosis it is the other way around.
Etiology of depression
What are the underlying causes? There can be different reasons. It is of multicausal, in
which vulnerability plays an important role. It can often be a specific event that triggers
