Major Depressive Episode
Mood Disorders are among the most common Psychological Disorders, and the risk of developing them is increasing worldwide, particularly in younger people. Mood disorders involve disabling disturbances in emotion-from the sadness of depression to the unrealistic elation and irritability of mania. Mood disorders in children are fundamentally similar to mood disorders in adults.
About Major Depressive Episode:
The most commonly diagnosed and most Severe depression is called a Major Depressive Episode. The DSM-5 criteria describe it as an extremely depressed mood state that lasts at least 2 weeks and includes Cognitive Symptoms and disturbed Physical functions to the point that even the slightest activity or movement requires an overwhelming effort. Although all Symptoms are important, evidence suggests that the most central indicators of a full major depressive episode are the physical changes.
1. Depressed mood, nearly every day.
2. Feel sad or empty, appears tearful.
3. In children and adolescents can be irritable mood.
4. Diminished interest or pleasure in all activities, nearly every day.
5. When not on diet, Significant weight loss gain.
6. Decrease or increase in appetite nearly every day.
7. Insomnia or Hyper Somnia nearly every day.
8. Feelings of restlessness or being slowed down nearly every day
9. Fatigue or loss of Energy, nearly every day
10. Feelings of worthlessness or excessive or inappropriate guilt, nearly every day.
11. Diminished ability to think or concentrate or indecisiveness, nearly every day.
12. Recurrent Suicidal ideation without a specific Plan or suicide attempt with a Specific plan.
The causes of mood disorder & lie in a complex interaction of biological, Psychological and Social factors from a biological perspective, researchers are particularly interested in the Stress Hypothesis and the role of Neuro Hormones Psychological theories of depression focus on learned helplessness and the depressive cognitive schemas, as well as interpersonal disruptions.
Cause includes Biological influences, Behavioral influences, Social influences and Emotional & Cognitive influences.
- Inherited vulnerability
- Altered neurotransmitters and neuro hormonal systems.
- Sleep deprivation.
- Circadian rhythm disturbances.
- General slowing down.
- Neglect or responsibilities and appearance.
- Irritability; complaints about matters that used to be taken in stride.
- Emotional flatness or emptiness.
- Inability to feel pleasure.
- Poor memory.
- Inability to concentrate.
- Hopelessness and/or learned helplessness.
- Loss of sexual desire.
- Loss of warm feelings for family and friends.
- Exaggerated self-blame or guilt
- Loss of self-esteem
- Suicidal thoughts or actions.
- Women and minorities—social inequality and oppression and a diminished sense of control.
- Social support can reduce symptoms.
- Lack of social support can aggravate symptoms.
We have seen that major disruptions our interpersonal relationships are an important category of stresses that can trigger mood disorders. In addition people with few, if any, important social relationships seem at risk for developing and sustaining mood disorders. Interpersonal Psychotherapy A variety of treatments, both Biological and Psychological, have proved effective for the mood disorders, at least in the short term. For those individuals who do not respond to antidepressant drugs or psychosocial treatments a more dramatic physical treatment, Electroconclusive Therapy, is sometimes used. Two Psychological treatments - Cognitive therapy and Interpersonal Psychotherapy seem effective in treating Depressive Disorders.
A number of medications are effective treatments for depression. Four basic types of antidepressant medications are used to treat depressive disorders: Selective-serotonin reuptake inhibitors (SSRIs) - Citalopram (celexa), Escitalopram. (Lexapro), Fluoxetine (Prozac), Fluvoxamine (Luvox),Paroxetine (Paxil), Sertraline (zoloft); Mixed reuptake inhibitors - Bupropion (Wellbutrin), Venlafaxine (Effexor), Duloxetine (Celexa);Tricyclic Antidexpressants - Imipramine (Tofranil), Amitriptyline (Elavil) ; Monoamine Oxidase( MAO). Another type of antidepressant drug, lithium Carbonate, is most often referred to as a mood-stabilizing drug.
AIL Antidepressants have side effects. It is advised to use only with the Medical Professional suggestions.
When someone does not respond to the medication (or in an extreme severe case), it is advised to go for Electroconvulsive Therapy (ECT), the most controversial treatment for Psychological disorders after Psychosurgery. Beck's Cognitive Therapy grew directly out of his observations of the role of deep-seated negative thinking in generating depression. Clients are taught to examine carefully their thought processes while they are depressed and to recognize “depressive” errors in thinking. Treatment involves cognitive errors and substituting less depressing and (perhaps) more realistic thoughts and appraisals.
(IPT) focuses on resolving problems in existing relationships and learning to form important Interpersonal Relationships.
David H. Barlow, BOSTON UNIVERSITY
V. Mark Durand, UNIVERSITY OF SOUTH FLORIDA- ST. PETERSBERG
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