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Mood Disorders

Depression

When people talk about having depression they are typically referring to what is known as Major Depression. This type of depression is when a person experiences the characteristics of depression with a certain degree of intensity either in a single episode or that keep recurring over time.

Another common type of depression is called Dysthymia, which is characterized by chronic, low-grade symptoms. People with Dysthymia go through life almost always feeling mildly depressed, which can greatly impair their ability to enjoy the positives in life.

A person who suffers from a Major Depressive Disorder must either have a depressed mood or a loss of interest or pleasure in daily activities consistently for at least a 2 week period. This mood must represent a change from the person's normal mood; social, occupational, educational or other important functioning must also be negatively impaired by the change in mood. A depressed mood caused by substances (such as drugs, alcohol, medications) is not considered a major depressive disorder, nor is one which is caused by a general medical condition.

Less common forms of depression, but still just as disruptive to a person's overall functioning, are the depressions related to Bipolar Disorder and Seasonal Affective Disorder. Bipolar Disorder, or what was commonly known as manic-depression, involves cyclical periods of severe depression with periods of extremely elevated or irritable mood known as mania.

Major depressive disorder cannot be diagnosed if a person has a history of manic, hypomanic, or mixed episodes (e.g., a bipolar disorder) or if the depressed mood is better accounted for by schizoaffective disorder and is not superimposed on schizophrenia, a delusion or psychotic disorder.

Bipolar Disorder

Bipolar Disorders (also known as manic depression), are characterized by alternating episodes of mania or hypomania, and depression. A manic episode is defined by a period of an elevated, expansive or notably irritable mood, lasting for at least one week. This disorder must be sufficiently severe to cause difficulty or impairment in occupational, social, educational or other important functioning and can not be better explained by a mixed episode. Symptoms also can not be the result of substance use or abuse (alcohol, drugs, medications) or caused by a general medical condition.

Dysthymia

This disorder is characterized by a mild-to-moderate, but chronic state of depression, characterized by a depressed mood for most days for at least a two year period. (In children and adolescents, mood can be irritable and duration must be at least 1 year.) The person who suffers from this disorder must have experienced two or more of the following symptoms for most of the two year period with no more than a month of symptomatic absence: poor appetite or overeating insomnia or hypersomnia low energy or fatigue low self-esteem poor concentration or difficulty making decisions feelings of hopelessness No Major Depressive Episode has been present during the first two years (or one year in children and adolescents) and there has never been a Manic Episode, a Mixed Episode, or a Hypomanic Episode, and criteria have never been met for Cyclothymic Disorder. The symptoms are not due to the direct physiological effects of the use or abuse of a substance (alcohol, drugs, medications) or a general medical condition. The symptoms must also cause significant distress or impairment in social, occupational, educational or other important areas of functioning.

Seasonal Affective Disorder

The term 'Seasonal Affective Disorder' is not a recognized diagnosis in the DSM-IV. SAD is, instead, diagnosed as a variant of Major Depression, with a seasonal affect specifier noted in the diagnosis.

Symptoms can include all of the characteristics of a major depressive episode. However, certain symptoms seem to be more pronounced such as fatigue, sleeping longer, decreased energy and motivation, increase in appetite especially for carbohydrates, weight gain, and increased irritability. The symptoms begin during the fall and winter months when the days are shorter and there is less exposure to sunlight. The depressive symptoms disappear when the spring and summer months begin and there is more exposure to sunlight.

Researchers have found that SAD seems to occur in some people because without a certain amount of exposure to sunlight they begin to produce higher amounts of a neurochemical in the brain called Melatonin. Melatonin tends to play an important role in affecting a person's sleeping and eating habits. When there is too much Melatonin being produced it will cause a person to want to sleep and eat more, therefore causing the symptoms of SAD.

Depression Symptoms

Major Depression is characterized by the presence of the majority of these symptoms:

• 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). (In children and adolescents, this may be characterized as an irritable mood.)
• markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day
• 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.
• insomnia or hypersomnia nearly every day
• psychomotor agitation or retardation nearly every day
• ffatigue or loss of energy nearly every day
• feelings of worthlessness or excessive or inappropriate guilt nearly every day
• diminished ability to think or concentrate, or indecisiveness, nearly every day
• 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

Bipolar Symptoms

A majority of the following symptoms are also present:

• 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
• attention is easily drawn to unimportant or irrelevant items
• 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

Resources

• Depression fact sheet (pdf 39k)