Mood Disorders Lecture Notes

Introduction

• Mood disorders: extended periods of abnormal mood (depressed, euphoric, irritable)
• Cause distress and interfere with daily life
• Include major depressive disorder (MDD) and bipolar disorder (BD)
• Factors: biological, environmental (heredity, stressful events)
• Treatments: effective options available, new ones emerging

Learning Objectives

• Diagnostic criteria for mood disorders
• Age, gender, ethnic differences in prevalence
• Common risk factors
• Effective treatments

Types of Mood Episodes

Major Depressive Episode (MDE)

• Symptoms: must occur for at least two weeks
• Causes significant distress/impairment
• Core symptoms:
  • Depressed mood
  • Anhedonia (loss of interest/pleasure)
• DSM-5 Criteria (5 or more symptoms):
  • Depressed mood
  • Anhedonia
  • Weight changes
  • Sleep disturbances
  • Psychomotor changes
  • Fatigue
  • Feelings of worthlessness/guilt
  • Concentration issues
  • Suicidal ideation

Manic or Hypomanic Episode

• Abnormally euphoric/irritable mood
• Increased energy or activity
• Mania: at least one week, Hypomania: at least four days
• Symptoms include:
  • Grandiosity
  • Reduced need for sleep
  • Racing thoughts
  • Distractibility
  • Talkativeness
  • Risky behaviors

Mood Disorders

Unipolar Mood Disorders

• Major Depressive Disorder (MDD): one or more MDEs, no manic/hypomanic episodes
• Persistent Depressive Disorder (PDD): chronic depression, at least two years
  • Symptoms: poor appetite, sleep disturbances, low energy, low self-esteem, concentration issues, hopelessness

Bipolar Mood Disorders

• Bipolar I Disorder (BD I): manic episodes, may include depressive episodes
• Bipolar II Disorder: hypomanic and depressive episodes
• Cyclothymia: alternating hypomania and depression, does not meet full criteria for MDE

Prevalence and Demographics

Depressive Disorders

• Lifetime prevalence of MDD: 16.6%
• Average MDD onset: mid-20s
• Higher in women, lower socioeconomic status (SES)
• Ethnic disparities: European > African/Hispanic Americans

Bipolar Disorders

• Lifetime prevalence: 4.4%, BD I: ~1%
• High comorbidity with anxiety, substance use disorders
• Adolescence significant risk period

Risk Factors

Depressive Disorders

• Genetic factors: strong familial influence
• Environmental: severe life events (e.g., divorce, unemployment)
• Neural circuitry differences observed in brain imaging
• Early adversity, chronic stress, and interpersonal factors

Bipolar Disorders

• Highly heritable
• Environmental stressors influence onset/relapse
• Circadian vulnerabilities (e.g., sleep disruptions)

Treatments

Depressive Disorders

• Medications: MAOIs, Tricyclics, SSRIs, SNRIs
• Biological: ECT, TMS, deep brain stimulation
• Psychosocial: Behavior therapy, cognitive therapy, interpersonal therapy

Bipolar Disorders

• Pharmacotherapy: lithium, anticonvulsants
• Adjunctive: interpersonal and social rhythm therapy

Conclusion

• Mood disorders affect daily life significantly
• Important to seek help; treatments effective and improving
• Opportunities in research and clinical work

Resources

• Association for Behavioral and Cognitive Therapies: http://www.abct.org
• Depression and Bipolar Support Alliance: http://www.dbsalliance.org/