Psychology: Essential Thinkers, Classic Theories, and How They Inform Your World - Andrea Bonior 2016

Mood Disorders
A Brief Survey of Abnormal Psychology
Definitions

DEPRESSION

US prevalence 7 percent among adults

Major depressive disorder, or a major depressive episode, is far more complicated than just feeling sad. This is the most common psychological disorder, and people who suffer from it often experience changes in eating or sleeping patterns, feelings of hopelessness or worthlessness, difficulty concentrating and making decisions, and lack of motivation. Most classic for depressed people is the experience of anhedonia, which is a loss of pleasure or the inability to be excited by things that used to be of interest. Depressed people may isolate themselves socially and have negative thoughts about themselves. Sometimes they can also be anxious and irritable (depression can cause anxiety, and anxiety can lead to depression), or they may experience an uptick in substance abuse. Depression can be dangerous if left untreated. It carries a particularly significant suicide risk when it’s severe and accompanied by feelings of hopelessness, recurrent thoughts of death, severe guilt and shame, and a sense that one is a burden to others.

BIPOLAR DISORDER

US prevalence 0.6 percent among adults

Whereas major depression involves just one pole of the emotional spectrum (a low mood), bipolar disorder involves both poles (mania or depression), and so it’s sometimes also called manic depression. Mania is a severely elevated mood that often manifests in hyperenergetic activity, grandiose plans, and a general fast-and-loud pattern of bursting through life. It typically lasts a week or more and can come on suddenly. Its main danger comes from the increased impulsivity and risk taking that are often part of the package. People in the throes of a manic episode may feel wonderful, brimming with life and ideas, and they may also be agitated and prone to fights and aggressiveness. They may max out their credit cards with spontaneous entrepreneurial schemes or quit their jobs to travel, with no planning. Both sets of characteristics are brought on by the fact that the central nervous system is in overdrive; a manic episode is not set in motion by external factors like a relationship slight, nor is a manic episode indicated merely by hour-to-hour emotional shifts (this is why it’s grossly inaccurate to describe your boss as bipolar merely because she was happy with you yesterday but is unhappy with you today). It is rare to experience a manic episode without a subsequent crash into depression, which can also pose a danger in terms of suicide risk. There are variations of the bipolar diagnosis, with bipolar I including full mania and full depression and bipolar II indicating full depression but with manic episodes that are not as severe (less severe mania, which is not a disorder in itself, is often referred to as hypomania).

SEASONAL AFFECTIVE DISORDER

US prevalence Varies widely with latitude, increasing at higher latitudes

In seasonal affective disorder (SAD), a subtype of major depression, moods follow a seasonal pattern. In a typical case of SAD, a person feels depressed over the course of the winter, but his or her mood elevates, perhaps even to the point of resembling mania or hypomania, in the spring. While many of us might get some winter doldrums or feel stressed or lonely during the winter holidays, SAD appears to be more biologically triggered and probably has to do not with changes in temperature but rather with changes in daylight that restrict the amount of naturally available ultraviolet light. This is why people affected by SAD may be particularly helped by physiological interventions like the use of a lightbox in the winter, to gain exposure to certain frequencies of light and that can help elevate mood.

PERIPARTUM DEPRESSION

US prevalence 3 to 6 percent of women who have recently given birth

Like the term seasonal affective disorder, the term peripartum depression technically specifies a major depressive episode, and it’s important to note that this diagnosis includes not just women who have recently given birth (and who are therefore suffering from postpartum depression) but also women who are pregnant. There may very well be a biological predisposition to peripartum depression, especially among women who had a history of depression before becoming pregnant. Psychotic symptoms—involving hallucinations and delusions, often related to the baby—can be present in particularly severe cases. Interestingly enough, nonbiological parents and biological fathers may also be prone to similar mood shifts around the experience of having a new child, since the child’s arrival may be accompanied by emotional upheavals and lifestyle disruptions as well as by mood disturbances and by hormonal changes occurring in response to time spent with the child (new fathers show a drop in testosterone early in the baby’s life).