Mood Disorders

1. Mood Disorders Presented by Richard, Amber, Joe, Celia, and Jane

2. Mood Disorders Mood disorders are mental disorders that have mood disturbance as their main feature. They have two forms: Depressive disorders, and bipolar disorder.

3. Clinical Depression Clinical depression is a mood disorder in which sadness, anger, or frustration interfere with everyday life for a long period of time.

4. What Are The Signs Of Clinical Depression? • Depressed mood most of the day, nearly every day • Loss of interest or pleasure in most activities • Significant weight loss or gain • Sleeping too much or not being able to sleep nearly every day • Slowed thinking or movement that others can see • Fatigue or low energy nearly every day • Feelings of worthlessness or inappropriate guilt • Loss of concentration or indecisiveness • Recurring thoughts of death or suicide • Depression Is also known to run in families.

5. Treatment It is important to get treatment when suffering from depression. If your feelings last for more than a few weeks you may be clinically depressed. Treatment options include psychotherapy and medication. Those suffering from clinical depression may need one or both types of treatment depending on the severity.

6. Conclusion Depression can lead to more severe problems such as other mental illnesses, self harm, and suicide. It is important to remember that depression is a treatable illness, and if you think that you may be clinically depressed that you seek and get the help that you need.

7. Gender Differences in Major Depressive Disorder Overall men are more likely to develop externalizing issues such as substance abuse, anti-social problems related to increased aggressive, impulsive, coercive and non-compliant behaviors. Women are more likely to develop internalizing issues with mood components such as anxiety and depression. It has been suggested that 15-20% or 1 in 5 of the female population suffer from depression Eaton et al, 2012

8. Symptoms • Men, more often than women, manage their depression by acting out. Acting out behaviors are self-destructive and lead men impulsively into high-risk situations and to thoughtlessly consume whatever is immediately available. Acting out behaviors take the form of sexual addiction and high risk sexual behavior, aggression against others, and substance abuse. • Women have higher incidences of atypical symptoms of depression including: increased appetite and weight gain, sleep disturbance, particularly hypersomnia or sleeping all the time, fatigue, and psychomotor retardation. (Amen, 2003)

9. Risk Factors • Major Depressive Disorder is twice as common in adolescent and adult females than in their male counterparts. • Prior to puberty depression is equally distributed between males and females. • Genetic Factors: • There may be a difference in genetic vulnerability for developing depression between men and women. • Sex Hormones: • The link between increased rates of depression and puberty, mood and the menstrual cycle as well as mood and pregnancy suggests a role of gonadal hormones in depression. Basically, the cyclical nature of hormonal changes in women daily, monthly and even every moment suggests a unique influence of hormonal change not present in men, and due to an increased sensitivity to this some women are more likely to suffer from mood disturbances due to these changes. • Pregnancy & post-partum period is the time when women are most at risk for getting depression for the first time or suffering from a relapse. • Life, Stress, and Trauma: • Studies show that 80% of cases of depression were preceded by a traumatic event including physical and sexual abuse, and domestic abuse. Statistically women are more likely to be victims of trauma compared to men. • Marriage: • Single women and married men report highest level of satisfaction. • Married women with children report the highest level of emotional stress. • Single men are not as unhappy as married women, but become happier once married. • Health: • Head injuries such as concussions, strokes and heart attacks occur more commonly among males than females. The risk of depression remains elevated for as long as 2 years after one of these events. (Amen, 2003; DSM-IV-TR 2000; Eaton et. a; 2012)

10. References • Amen, D. (2003) Healing Anxiety and Depression. New York: G.P. Putnam’s Sons. • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed. text revision). Washington, DC: Author • Eaton, N., Kruger, R., Keyes, K., Hasin, D., Balsis, S., Skodol, A., Markon, K., Grant, B. (2012) An Invariant Dimensional Liability Model of Gender Differences in Mental Disorder Prevalance: Evidence from a National Sample. Journal of Abnormal Psychology, 121(1), 282-288.

11. BIPOLAR DISORDER Bipolar Disorder is a serious mental illness in which common emotions become intensely and often unpredictably magnified. According to the APA DSM, it defines the Bipolar Disorder in to four different types: • Bipolar I • Bipolar II • Cyclothymic Disorder • Bipolar “Not otherwise specified” • Bipolar Spectrum Disorder can often be associated with life altering changes including divorce, substance abuse, suicide, work and/or academic disruptions. • Milder forms of BD have the possibility to progress to a more severe form • Children as young as 15-19 can suffer from the adult form of BD • BD frequently emerges in adolescence, this time is a critical development “age of risk” • Genetic Inheritance

12. Behavioral Approach System(BAS) Model TEAM – Teen Emotion And Motivation Project Theory & Evidence - Goal directed behavior or reward seeking internal stimuli (expectancies of goal attainment) or external stimuli (presence of a desired goal) deactivation or shut down of behavior and engagement happens when there is failure, loss, or not having the ability to obtain goals – may lead to hypomania symptoms BAS Activation - Excessive goal seeking behavior, increased energy, decreased need for sleep, great optimism, loss of interest, loss of ability to experience pleasure from daily activities, verbal exaggeration or grandiosity, euphoria BAS Deactivation - May lead to depression, decreased goal orientation and drive, decreased energy, loss of interest in life and enjoyment, hopelessness, and sadness

13. Psychotherapy for Bipolar II Disorder Bipolar Disorder II is a chronic illness characterized by recurrent episodes of depression and hypomania, is associated with high levels of psychosocial impairment. Expansive abnormal moods and irritability lasting up to four days. • Common and disabling illness • Never experience psychosis or a full syndrome mania • More likely to be female • More episodes of rapid cycling and more chronic courses of illness • Appears to be more stable then BD I over time • Was thought to more benign then BD I • High rates of suicidal ideas and behaviors, poor health related quality of life, psychiatric comorbidity • Mixed mood states – dysphoric (feeling distressed), uncomfortable, and an energized but tired state known as the ‘tired-wired state’

14. Treating Bipolar Disorder II: The Role of Psychotherapyand Interpersonal And Social Rhythm Therapy Interpersonal and Social Rhythm Therapy (IPSRT) – evidence based treatment Cognitive therapy, cognitive-behavioral therapy, psycho-education, family focused therapy, case management and IPRST treatment IPSRT Therapeutic strategies • Psycho-education - focuses on the illness and its consequences, how drugs can treat the illness and potential side effects, early episode warning signs • Social rhythm therapy - focuses on developing strategies to promote regular, rhythm entraining social cues and to reduce the impact of events that disrupt rhythms • Interpersonal Psychotherapy - used to help patients recognize the reciprocal relationship between interpersonal problems and mood dysregulation

15. Additional attention is given to: • Identification of mixed mood states • Justification for regulating social rhythms • Emotion regulation • Management of grandiosity • Regulation of levels of stimulation • Evaluation of comorbid substance abuse • This treatment offers patients strategies for recognizing and reducing cycling mood states, entrain biologic rhythms, manage psychosocial consequences of the illness 

16. Posttraumatic stress disorder An anxiety disorder or psychological reaction to stress that develops after any event of traumatic consequence. Common Causes of PTSD Definition • “Combat fatigue”, “War neurosis”, “Shell-shock” and other war-related events. • Sexual or physical assault • An automobile accident • A life-threatening illness • Any other type of disaster that affects your well-being.

17. Reoccuring unwanted thoughts or images of the trauma symptoms • Chronic physiological arousal • Avoidance of things that call the traumatic event to mind Flashbacks of the event are common, as well as exaggerated anxiety and startle reactions to anything related to the trauma. Even 20 years after the Vietnam War, the Centers for Disease Control found 15% of veterans who had seen combat continued to report lingering symptoms. 8% of Americans are estimated to suffer from PTSD at some point over the course of their lives.

18. Causes Schizophrenia can be classified by two or more symptoms of delusion, hallucination, disorganized speech, grossly disorganized behavior or catatonic behavior, and negative symptoms like emotional and social withdrawal. Two or more of these symptoms emerging at a period of at least 1 month and persisting for at least six months are considered to be schizophrenic. People with PTSD are more prone to develop other mental health disorders and physical disorders. Physical Health Disorders • Anxiety Disorders • Eating Disorders • Depression • Suicidal Thoughts • Substance Abuse • Schizophrenia • Arthritis • Diabetes • Obesity • Respiratory Problems • Heart Problems • Sexual Dysfunction • Self-inflicted Harm Mental Health Disorders Studies suggest that it is possible people with a smaller hippocampus are more susceptible to developing PTSD when exposed to a trauma.

19. TREATMENT • 1/3 of people with diagnosed PTSD are in a form of treatment. • Because of difficulties concentrating, PTSD are more than twice as likely to forget to take prescriptions or skip them altogether. • This can also be because of a delusion of a foreshortened future. • Forgetting to take medications and the thought of a foreshortened future can be greatly reduced with memory improvement and concentration exercises. Seeking Safety is a program that teaches people with PTSD and alcohol/drug problems to cope and recognize their own symptoms to help them get better. By teaching people with PTSD to ask others for help, the Seeking Safety program has been found to reduce PTSD symptoms, risk for suicide and depression, to improve social skills and increase problem-solving abilities. By treating Posttraumatic Stress Disorder, it improves the person’s safety and helps keep another traumatic event from happening.

20. Seasonal Affective Disorder (SAD) • Symptoms • Low Energy • Depression • Sleep, Eating & Weight Fluctuations • Treatments • Light Therapy • Diet & Exercise • Medications • Psychotherapy • Self Care • SAD- A clinical condition occurring annually at the same time each year

21. Seasonal Affective Disorder

22. Postpartum Depression (PPD) • 500,000 Women in USA • 10% of New Fathers • Symptoms • Feelings- hopeless, sad, irritable, worthless, guilty, overwhelmed • Headaches • Withdrawal • Eating and Sleeping Changes • Crying Often • Treatments • Medications • Psychotherapy • Self Care • Causes • Glutamate Levels • Hormonal Imbalance or Changes

23. Postpartum Depression (PPD) • 50% Undiagnosed • Outcomes • Andrea Yeates • Brooke Shields Brooke Shields Postpartum Depression Andrea Yeates Postpartum Psychosis

24. CONCLUSION Mood Disorders are more and more prevalent nowadays. Many of the symptoms are similar, however research has come a long way in narrowing down the actual causes. Genetics, environment, and individual personality all can play a role in mood disorders. Every situation is unique and diagnosis can sometimes be difficult. But one thing is clear, no one needs to suffer the devastating outcomes that can accompany mood disorders. PTSD, SAD, Postpartum depression/psychosis, depression and all other personality disorders are treatable. There is a wide range of psychotherapy, self-help groups, medication and personal life changes that can empower anyone who is suffering from any form of mood disorder. Taking responsibility is the first and most important step on the road to recovery!