Major depression- example of unipolar
Major depressive episode for months, than feel a little better than have another episode
Deviation from mood is low, in graphic either depression or mania
In theory you can be manic the other side of mood low vs. high
If someone has manic episode its assumed they will alternate between low and high states
Functioning along continuum of mood- band of functioning that is not to high and not to low, when someone suffers from a gross deviation in mood high or low it is important to try and assess when this is a real clinical disorder that should be addressed primarly because everyone gets depressed and happy occasionally, just cause someones sad doesn’t mean they need treatment
Distinguishing more biological or dogninous depression from normal sadness
1. intensity- clinical depression much more intense, major depression black ho0le that nothing matters, pit in the stomach kind of pain, the intensity over an extended period of time(2 weeks) marker that something is wrong related to it..
2. absence of precipitant- nothing is causing the depression, someone is feeling very sad after their parent died, someone breaks up, precipitant that can explain depressed state, its still fuzzy because how long is a normal period of time to grieve a death in DSM- 2 to 3 months, if they persist feeling really depressed to a year or more than theres evidence something else is going on, people who have clinical depression will be sad- theres not a reason why it happens, life is stressful and things will happen to you its hard to assess if things just come out of the blue
3. History- very important, most useful statements best predictor of future behavior is past behavior- one way to tell if a person has clinical depression is if they have a bowt of clinical depression much more likely they’ll expierence it again, accurate history is very important
4. Biological changes that occur( associated features/vegetative symptoms) with clinical depression you have biological changes- changes in sleep habits, person usually cant sleep or cant wake up cant stop eating, more irritable, sleep lab sometimes structure of sleep has changed go into REM sleep, stress test- cortisol someone who is depressed for a day or two is irritable how intensive hoe pervasive
Mood disorders best ways to understand them is each of the different disorders are built on two building blocks, each disorder uses them in slightly different ways
MDE- major depressive episode- period of 2 weeks where a person expierences 5 or more of the following 9 symptoms, chinese menu example people diangnos with same things
Person with MDE-
1. Must have significantly depressed mood
2. A loss of interest or pleasure in what they used to do anidonia
3.irritability
4.Insomnia-more common or hypersomnia- to sleep too much
5. psychomotor agitation- figidy have difficulty sitting still, rubbing hands together, washing hands, psychomotor retardation- slow down
6.fatigue- seen in everyone goes with sleep, people feel tired all the time they don’t have energy to do things, related to loss of interest, just don’t feel like it
7.cognitive changes feeling of worthlessness- person may feel that there wasting other peoples time, may feel guilty for feeling sad or feeling depressed, people who are overly apologetic- inside into a sense that there apologizing for themselves and their self esteem, when they come out of depression they are not confident
8.diminished ability to concentrate or think- difficulty in reading, following a movie, vegging, staring at the wall- assess on a psychological test- concentration has gone down
9.recurrent thought of death- related to worthlessness, whats it all about I just should end it, reoccurance idoliziation-