Abnormal Psychology 1

• Experts predict that depression will become an even greater problem in coming years. Younger generations are experiencing higher rates of depression than their predecessors, and those who become depressed are doing so at an early age
• Emotion


  A state of arousal that is defined by subjective states of feeling, such as sadness, anger, and disgust. Emotions are often accompanied by physiological changes, such as changes in heart rate and respiration rate
• Affect


  The pattern of observable behaviors, such as facial expression, that are associated with these subjective feelings. People also express affect through the pitch of their voices and with their hand and body movements
• Mood


  A pervasive and sustained emotional response that, in its extreme form, can color the person's perception of the world
• Depression


  Can refer either to a mood or to a clinical syndrome, a combination of emotional, cognitive, and behavioral symptoms. The feelings associated with a depressed mood often include disappointment and despair
• Andrew Solomon: 'Depression starts out insipid, fogs the days into a dull color, weakens ordinary actions until their clear shapes are obscured by the effort they require, leaves you tired and bored and self-obsessed—but you get through all that. Not happily, perhaps, but you can get through. No one has ever been able to define the collapse point that marks major depression, but when you get there, there's not much mistaking it.'

  
• Clinical depression


  A depressed mood is accompanied by several other symptoms, such as fatigue, loss of energy, difficulty sleeping, and changes in appetite. Clinical depression also involves a variety of changes in thinking and overt behavior. The person may experience cognitive symptoms, such as extreme guilt, feelings of worthlessness, concentration problems, and thoughts of suicide. Behavioral symptoms may range from constant pacing and fidgeting to extreme inactivity.

  
• Mania


  The flip side of depression, also involves a disturbance in mood that is accompanied by additional symptoms. The central feature of mania is a persistently elevated or irritable mood that lasts for at least one week
• Euphoria


  An exaggerated feeling of physical and emotional well-being
• Mood disorders


  Defined in terms of episodes—discrete periods of time in which the person's behavior is dominated by either a depressed or manic mood
• Most people with a mood disorder experience more than one episode
• Depressed mood


  The most common and obvious symptom of depression. Most people who are depressed describe themselves as feeling utterly gloomy, dejected, or despondent. The severity of a depressed mood can reach painful and overwhelming proportions

  
• Andrew Solomon: 'I returned, not long ago, to a wood in which I had played as a child and saw an oak, a hundred years dignified, in whose shade I used to play with my brother. In twenty years, a huge vine had attached itself to this confident tree and had nearly smothered it. It was hard to say where the tree left off and the vine began. The vine had twisted itself so entirely around the scaffolding of tree branches that its leaves seemed from a distance to be the leaves of the tree; only up close could you see how few living oak branches were left. I empathized with that tree. My depression had grown on me as that vine had conquered the oak; it had been a sucking thing that had wrapped itself around me, ugly and more alive than I.'
• Anxiety


  Also common among people with mood disorders, just as depression is a common feature of some anxiety disorders. People who are depressed are sometimes apprehensive, fearing that matters will become worse than they already are or that others will discover their inadequacy. They sometimes report that they are chronically tense and unable to relax
• Cognitive Symptoms of Depression


  • Thinking is slowed down
  • Trouble concentrating
  • Easily distracted
• Depressive Triad


  Guilt and worthlessness are common preoccupations. Depressed patients blame themselves for things that have gone wrong, regardless of whether they are in fact responsible. They focus considerable attention on the most negative features of themselves, their environments, and the future

  
• Manic Thoughts


  Ideas flash through their minds faster than they can articulate their thoughts. Manic patients can also be easily distracted, responding to seemingly random stimuli in a completely uninterpretable and incoherent fashion. Grandiosity and inflated self-esteem are also characteristic features of mania.
• Self-Destructive Ideas


  Many people experience self-destructive ideas and impulses when they are depressed. Interest in suicide, usually, develops gradually and may begin with the vague sense that life is not worth living. Such feelings may follow directly from the overwhelming fatigue and loss of pleasure that, typically, accompany a seriously depressed mood. In addition, feelings of guilt and failure can lead depressed people to consider killing themselves. Over a period of time, depressed people may come to believe that they would be better off dead or that their family would function more successfully and happily without them. Preoccupation with such thoughts then leads to specific plans and may culminate in a suicide attempt.
• Somatic Symptoms of Mood Disorders


  • Fatigue
  • Aches and pains
  • Serious changes in appetite
  • Serious changes in sleep patterns
• Sleeping Problems


  Particularly trouble getting to sleep. This disturbance frequently goes hand in hand with cognitive difficulties mentioned earlier.
• Change in Appetite

  Depressed people frequently experience a change in appetite. Although some patients report that they eat more than usual, most reduce the amount that they eat; some may eat next to nothing. Food just doesn't taste good any more. Depressed people can also lose a great deal of weight, even without trying to diet.
• Loss of Interest in Various Activities


  People who are severely depressed commonly lose their interest in various types of activities that are otherwise sources of pleasure and fulfillment. One common example is a loss of sexual desire. Depressed people are less likely to initiate sexual activity, and they are less likely to enjoy sex if their partners can persuade them to participate.
• Ill-Defined Somatic Complaints


  Various ill-defined somatic complaints can also accompany mood disorders. Some patients complain of frequent headaches and muscular aches and pains. These concerns may develop into a preoccupation with bodily functions and fear of disease.
• Psychomotor Retardation


  The symptoms of mood disorders also include changes in the things that people do and the rate at which they do them.
• Types of Depressive Disorders


  • Major Depressive Disorder
  • Persistent Depressive Disorder (Dysthymia)
  • Premenstrual Dysphoric Disorder

  
• Persistent Depressive Disorder (Dysthymia)


  A chronic mild depressive condition that has been present for many years. In order to fulfill DSM-5 criteria for this disorder, the person must, over a period of at least two years, exhibit a depressed mood for most of the day on more days than not. Two or more of the following symptoms must also be present: poor appetite or overeating, insomnia or hypersomnia, low energy or fatigue, low self-esteem, poor concentration or difficulty making decisions, feelings of hopelessness.

  
• Premenstrual Dysphoric Disorder (PMDD)


  Women commonly experience premenstrual symptoms that center on emotional and physical complaints, but they are typically mild. A few experience these symptoms in greater numbers and with increased severity, to the extent that they are associated with obvious social and occupational impairment. PMDD is defined in terms of various mood-related symptoms that occur repeatedly during the premenstrual phase of the cycle and are then diminished at the onset or shortly after menses. Symptoms include mood lability, irritability, dysphoria, and anxiety as well as cognitive (difficulty concentrating, feeling of being overwhelmed or out of control), and somatic symptoms (e.g., lethargy, changes in appetite, sleep problems, joint or muscle pain, a sensation of bloating, etc.)

  
• Types of Bipolar Disorder


  • Bipolar I Disorder
  • Bipolar II Disorder
  • Cyclothymia
• Bipolar I Disorder


  The mood disturbance must be severe enough to interfere with occupational or social functioning. A person who has experienced at least one manic episode would be assigned a diagnosis of bipolar I disorder. The vast majority of patients with this disorder have episodes of major depression in addition to manic episodes.

  
• Bipolar II Disorder


  Some patients experience episodes of increased energy that are not sufficiently severe to qualify as full-blown mania. These episodes are called hypomania. A person who has experienced at least one major depressive episode, at least one hypomanic episode, and no full-blown manic episodes would be assigned a diagnosis of bipolar II disorder.

  
• Cyclothymia


  A chronic but less severe form of bipolar disorder. In order to meet criteria for cyclothymia, the person must experience several periods of time with hypomanic symptoms and frequent periods of depression (or loss of interest or pleasure) during a period of two years. There must be no history of major depressive episodes and no clear evidence of a manic episode during the first two years of the disturbance.

  
• Episode Specifiers for Mood Disorders


  • Melancholic Features
  • Psychotic Features
• Melancholia


  A term that is used to describe a particularly severe type of depression. Some experts believe that melancholia represents a subtype of depression that is caused by different factors than those that are responsible for other forms of depression
• Psychotic Features


  Hallucinations or delusions that can be either consistent or inconsistent with the patient's mood. For example, if a depressed man reports hearing voices that tell him he is a worthless human being who deserves to suffer for his sins, the psychotic features would be consistent with his depressed mood.

  
• Episode specifiers


  1. Descriptions of the most recent episode of depression 2. More extensive descriptions of the pattern that the disorder follows over time

  
• Melancholia


  A term used to describe a particularly severe type of depression. Some experts believe it represents a subtype of depression caused by different factors than other forms of depression.
• Psychotic features


  Hallucinations or delusions during the most recent episode of depression or mania. Can be mood congruent or mood incongruent.
• Postpartum onset


  Applies to women who become depressed or manic following pregnancy, beginning within four weeks after childbirth.
• Seasonal affective disorder


  A mood disorder that follows a seasonal pattern, with episodes typically occurring in the fall or winter and recovery in spring or summer.
• Women are two or three times more vulnerable to depression than men are.