MOOD DISORDERS

Depression
• It is characterized by persistent feelings of sadness, hopelessness, and a loss of
interest in activities that were once enjoyable.
• Signs and Symptoms Cognitive

Difficulty concentrating in day to day life

Difficulty making decisions
Poor memory
Suicidal thooughts
Hopelessness or feeling empty
Self blame/guilt

• Signs and Symptoms : Behavioral

Slower in function
Irritable
Loss of libido
Crying spells
Withdrawal
Anhedonia
Suicidal attempts

• Signs and Symptoms : Physical

Sleep disturbances (insomnia or sleeping too much)

Lack of energy
Loss of appetite
Weight loss or gain
Unexplained headaches and backaches
Stomach aches, indigestion or change is bowel habits
DSM V TR (DSM-5-TR is the standard classification of mental disorders used by mental health
professionals in the United States) [ don’t have to study this definition – just for reference ]
• The individual must be experiencing five or more symptoms during the same 2-
week period
1. Depressed mood most of the day, nearly every day.
2. Markedly diminished interest or pleasure in all, or almost all, activities most of
the day, nearly every day.
3. Recurrent thoughts of death, recurrent suicidal ideation without a specific plan,
or a suicide attempt or a specific plan for committing suicide.

4. Significant weight loss when not dieting or weight gain, or decrease or

increase in appetite nearly every day.
5. A slowing down of thought and a reduction of physical movement (observable
by others, not merely subjective feelings of restlessness or being slowed
down).
6. Fatigue or loss of energy nearly every day.
CAUSES OF MOOD DISORDERS
Causes: Biological
Genetic Predisposition
1st degree relatives
Chemical
Depression has been associated with imbalances in certain neurotransmitters, such
as serotonin, norepinephrine, and dopamine.
These chemicals regulate mood, emotions, and motivation.
Causes: Environmental Factors

Adverse life events

Traumatic events, such as the loss of a loved one, physical or emotional abuse, or
significant life stressors, can increase the risk of developing depression. Research
suggests that individuals who experience early-life adversity or chronic stress are
more susceptible to depression .
Chronic illness/pain
Cancer, diabetes, cardiovascular disease etc.The burden of managing a chronic
illness, along with physical pain and limitations, can contribute to the development
of depressive symptoms .
Substance Abuse
The relationship between substance abuse and depression is complex and
bidirectional, with substance abuse increasing the risk of depression and
depression increasing the risk of substance abuse .
Causes: Psychological
Cognitive Factors
Negative thinking patterns, self-critical thoughts, and distorted
can contribute to the development and
maintenance of depression. Cognitive theories highlight the role of these cognitive
biases in the onset and persistence of depressive symptoms
Personality Traits
Neuroticism (tendency to experience negative emotions) and introversion, have
been associated with an increased risk of depression.

COMMON TYPES OF DEPRESSION

1) Major Depressive Disorder (MDD)
-Most common type
-Continues for months or years
-One episode occurring can happen, but mostly there are multiple
occurrences/episodes.
2) Persistent Depressive Disorder (PDD)
-PDD(dysthymia) is characterized by a chronic and long-lasting

depressed mood.

- similar to MDD but are less severe.

symptoms must persist for at least two years in adults

(one year in children and adolescents).

-Function fairly well on a daily basis, but their relations and self esteem suffer over

time.

3) Seasonal Affective Disorder (SAD)

-follows a seasonal pattern, typically occurring

during the fall and winter months when daylight is reduced.

-thought to be

related to changes in natural light exposure.

-Symptoms include low mood, increased sleep, craving for carbohydrates,

weight gain, and reduced energy. Symptoms tend to remit during the spring and summer

4) Post Partum Depression (PPD)

-occurs after childbirth.

-It is more severe and long-

lasting than the "baby blues," which are transient mood swings experienced by

many new mothers.

-Symptoms include feelings of sadness, guilt, worthlessness, loss of interest

in the baby, changes in appetite and sleep patterns, and sometimes thoughts of

harming oneself or the baby.

BIPOLAR DISORDER

-alternating periods of depressive episodes and manic or

hypomanic episodes.

-During depressive episodes, symptoms are similar to those in

MDD.
-Manic or hypomanic episodes involve elevated mood, increased energy, racing

thoughts, decreased need for sleep, excessive talking, and engaging in risky

behaviors.

Types of Bipolar Disorders

1) Bipolar 1 disorder

-will include at least one manic episode , a distinct period of abnormally elevated, expansive,
or irritable mood, lasting for at

least one week

-may also experience depressive episodes, which can be

severe and have a significant impact on their daily functioning

-could get a depressive episode without history of manic episode .BUT DIAGNOSIS REQUIRES A
MANIC EPISODE .

2) Bipolar II Disorder

-recurrent depressive episodes and at least one hypomanic

episode. Hypomania is similar to mania but has a milder intensity and shorter

duration.

-Hypomanic episodes are characterized by an elevated or

irritable mood, increased energy or activity, and other symptoms consistent with

mania. symptoms are less severe than those seen in bipolar I

disorder.

-individuals with bipolar II disorder do not experience full-

blown manic episodes.

Psychotic Depression

-Depression accompanied by psychotic symptoms,

such as hallucinations (seeing or hearing things that are not there) or delusions

(fixed, false beliefs).

-severe condition that requires prompt and

comprehensive treatment.

INTERVENTIONS FOR MOOD DISORDERS

Talk Therapy

Cognitive Behavioral Therapy (CBT): evidence-based form of psychotherapy for depression. It

focuses on identifying and modifying negative thinking patterns and behaviors associated with
depression.

Interpersonal Therapy (IPT): IPT aims to improve interpersonal relationships and

resolve conflicts that may contribute to or exacerbate depression. It focuses on

improving communication, addressing grief or loss, and managing life transitions.

Mindfulness-Based Interventions: Techniques like mindfulness-based stress

reduction (MBSR) and mindfulness-based cognitive therapy (MBCT) have shown

effectiveness in reducing depressive symptoms and preventing relapse.

Medication

● Antidepressant Medications: Selective Serotonin Reuptake Inhibitors (SSRIs)

and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) .

● Regulates neurotransmitters in the brain associated with mood.

● Other antidepressants, such as tricyclic antidepressants (TCAs) and

monoamine oxidase inhibitors (MAOIs) can also be used .

ANXIETY DISORDERS
-Anxiety disorders refer to a group of mental health conditions characterized by excessive and
persistent feelings of fear, worry, or anxiety.

Types of Anxiety Disorders

1) Generalized Anxiety Disorder
-Excessive worry and anxiety about various aspects of life, such as work, health, family, or
everyday issues.
-Restlessness, feeling on edge, or being easily fatigued.
-Difficulty concentrating, irritability, muscle tension, and sleep disturbances.

DSM 5 Criteria

Causal Factors
Biological Factors

• Moderate heritability
• Imbalances in neurotransmitters, particularly serotonin, norepinephrine, and gamma-
aminobutyric acid (GABA), have been implicated in GAD.
• Abnormalities in brain regions involved in emotion regulation and threat processing,
such as the amygdala, prefrontal cortex, and insula, leading to heightened anxiety
response.

Cognitive Factors

• Cognitive biases- catastrophizing, maximizing negatives etc

Environmental Factors

• Early Life Experiences: Adverse childhood experiences, such as trauma, neglect, or

insecure attachment, have been associated with an increased risk of developing GAD.
• Chronic Stress: Chronic stressors, such as work-related stress, relationship
difficulties, or financial problems, can contribute to the development or exacerbation of
GAD.
• Parental Modeling: Observing anxious behaviors or receiving inconsistent or
overprotective parenting styles

PANIC DISORDER

-recurrent and unexpected panic attacks

-is a severe mental health condition.
-developing in late adolescence or early adulthood.
-These episodes can have a chronic course if untreated, leading to concerns about
future panic attacks and behavioral changes.

Signs and Symptoms

1)Panic Attacks

2) Fear of Future Attacks

3) Anticipatory Anxiety: worry about the possibility of experiencing a panic attack, leading to
heightened vigilance and hypervigilance.
4) Agoraphobia (in some cases): Some individuals may develop Agoraphobia, which involves
avoiding certain places or situations due to concerns about having a panic attack or being
unable to escape or receive help if needed.

5) Impairment and Distress: can significantly impair an individual's daily functioning, social
interactions.
Causal factors of panic attacks :
BIOLOGICAL
Genetic predisposition
Neurochemical imbalances
Brain circuitry
PSYCHOLOGICAL
Cognitive factors
Conditioning and learning

Social Anxiety Disorder

Signs and symptoms
-Fear of social situations
-Fear of negative evaluation
-Avoiding Behaviors

Physical Symptoms: rapid heartbeat, sweating, trembling, blushing, shortness of

breath, or nausea.

Cognitive Symptoms: Anticipatory anxiety, negative self-beliefs, excessive self-

criticism, overanalyzing social interactions, and a distorted perception of how one is
perceived by others.

Impact on Daily Life: can significantly impair an individual's ability to participate in

social activities, make friends, pursue educational or career goals, and maintain
relationships.
CAUSAL FACTORS
Learned behavior

• originates from classical conditioning e.g. experiencing or witnessing a social defeat or

humiliation or witnessing the target of anger or criticism

Genetic and temperamental Factors

• Behaviorally inhibited infants who are shy & avoidant are more likely to become fearful
during childhood, & by adolescence, show increased risk of developing social phobia
• have a diminished sense of personal control over events in their lives.
• function of having been raised in families with overprotective (sometimes rejecting)parents

Cognitive

Negative schemas : People with social phobia tend to expect that other people will reject or
negatively evaluate them

Specific Phobias

• An anxiety disorder characterized by intense, irrational fear of a specific object, situation, or

activity.
• Intense fear: Overwhelming and persistent anxiety when exposed to the feared stimulus.
• Avoidance: Individuals may go to great lengths to avoid situations or places where they might
encounter the feared stimulus.
• Physical Symptoms: Exposure to the phobic stimulus can lead to immediate physical
symptoms like rapid heartbeat, sweating, trembling, shortness of breath, or panic attacks.

CASUAL FACTORS
Psychosocial Factors
Psychodynamics
• Psychodynamics: Fears as defense against anxiety stemming from repressed id
impulses.
• External objects or situations symbolize the anxiety's real object.
Behavioral

-Classical conditioning with a traumatic event

-Vicarious or Observational Learning
Biological Factors

Moderate Genetic link

Evolutionary explanation

-Fear was conditioned more effectively to fear relevant stimuli

-Evolutionary factors may be responsible for this association

Obsessive Compulsive Disorder
A Chronic Mental Health Condition
• Characterized by recurrent thoughts and compulsions.
• Aims to reduce distress or prevent perceived harm.

SIGNS AND SYMPTOMS

• Obsessions: Persistent, intrusive thoughts, images, or urges causing distress or

anxiety. Common obsessions include contamination, doubt, symmetry, aggressive
thoughts, and sexual/religious obsessions.
• Compulsions: Repetitive behaviors or mental acts to alleviate anxiety or prevent
feared outcomes. Common compulsions include excessive hand washing, counting,
arranging objects, or mental rituals.
• Emotional distress: High levels of anxiety, fear, guilt, or shame due to obsessions and
compulsions.
• Impact on daily life: Interference with work, school, relationships, and social
activities.

COMMON TYPES OF OCD

• Contamination OCD: Excessive fear of germs, dirt, or contaminants leading to

compulsive cleaning and handwashing.
• Checking OCD: Persistent doubts about harm or danger, resulting in compulsive
checking behaviors.
• Symmetry and Ordering OCD: Obsession with symmetry, exactness, or specific order,
causing compulsive object arrangement.
• Intrusive Thoughts OCD: Disturbing, unwanted thoughts causing distress, leading to
compulsive behaviors.
• Hoarding OCD: Difficulty in discarding possessions, causing excessive clutter and
distress.

CAUSAL FACTORS
Genetic Factors :
• OCD has a strong genetic component, with relatives of individuals with the disorder at
higher risk.
• Various genes, including those regulating serotonin and the glutamate system, are
implicated in OCD development.

Neurobiological Factors :
• Serotonin Dysfunction: Involves abnormalities in serotonin system.
• Cortico-Striato-Thalamo-Cortical (CSTC) Circuitry Dysregulation: Involves prefrontal
cortex, basal ganglia, thalamus.

Environmental Factors :
• Adverse early life experiences like trauma, neglect, or abuse increase OCD risk.
• Childhood-onset OCD linked to stressful life events.
• Infections and autoimmune conditions may trigger or exacerbate OCD symptoms,
especially in pediatric cases.

Post Traumatic Stress Disorder

• Mental health condition resulting from exposure to traumatic events.
• Traumatic events include combat, sexual assault, natural disasters, accidents, or life-
threatening events.

SIGNS AND SYMPTOMS

• Intrusive Symptoms: Recurrent distressing memories, flashbacks, or nightmares.
• Avoidance: Efforts to avoid thoughts, feelings, or reminders associated with the
trauma.
• Negative Alterations in Cognition and Mood: Persistent negative emotions, loss of
interest, feelings of detachment, and distorted beliefs.
• Hyperarousal: Hypervigilance, exaggerated startle response, irritability, difficulty
concentrating, and sleep disturbances.
• Duration and Impairment: Symptoms must persist for at least one month, causing
significant distress or impairment.

CAUSAL FACTORS

Biological factors
Genetic link-higher rates of PTSD among first-degree relatives of individuals with the disorder,
indicating a genetic predisposition

Environmental Factors

• Increased likelihood from combat, assault, natural disasters, and accidents.

• Adverse childhood experiences linked to PTSD development.

Psychological Factors

• Negative responses to trauma and inaccurate self-perceptions contribute to PTSD.

• Ineffective coping techniques can impede healing and prolong discomfort.
• Avoidance coping techniques linked to higher PTSD symptoms.
Agoraphobia
• Intense fear or anxiety about difficult escape situations.
• Individuals avoid crowded places, public transportation, home alone, open spaces.
• May lead to panic attacks or incapacitating symptoms.

DSM 5 Criteria
• Individuals fear or avoid these situations due to fear of escape or lack of help.
• Agoraphobia situations often provoke fear or anxiety.
• Persistent fear or anxiety, lasting six months or more, is common.
• Fear or anxiety causes significant distress or impairment in social, occupational, or
other areas.
• Fear or anxiety is not better explained by substances, medications, or other medical
conditions.

Separation anxiety Disorder

• Excessive anxiety and fear from separation from attachment figures.

• Often diagnosed in children, often considered normal early childhood development.

Treatment and interventions of Anxiety Disorders

Psychotherapy

• CBT: Identifies and modifies unhelpful thoughts, beliefs, and behaviors contributing to
anxiety.
• Techniques include cognitive restructuring, exposure therapy, and relaxation
exercises.
• Exposure Therapy: Gradually exposes individuals to feared situations or objects to
manage anxiety.
• Can be conducted in vivo or through imaginal exposure.
Acceptance and Commitment :
Develops acceptance and mindfulness skills.
Promotes psychological flexibility and resilience.
• Practices like mindfulness meditation and stress reduction.
• Reduces reactivity and promotes well-being.

MEDICATION
• SSRIs are antidepressants that regulate mood and reduce anxiety symptoms.
• Benzodiazepines provide short-term relief for severe anxiety, but are cautiously
prescribed due to dependence risk and side effects.
• Other medications like SNRIs, TCAs, and beta-blockers may be prescribed as
adjunctive treatments.