What Is A Mood Disorder?~The Symptoms of Depression and Mania

I've decided definitely to start incorporating the posts from my other blog, Humanus Vegetalis, to this blog and just to use this blog for all of my ideas and what not instead of spreading them out. Some people may say that my blog needs one definite subject matter, but I don't see why. I don't remember who said it, but it goes something like this, "Whatever you do, pick one thing and do it well." That's what I intend to do. All of my posts from my other blog will be labeled "Humanis Vegetalis" and all future posts on the subject of Psychology will be labeled as such because I don't want to create, like, a billion different labels for them. With that in mind, here is the first post I made on Humanus Vegetalis:


Mood Disorders~The Symptoms of Depression and Mania-Depression

ONE:What Is A Mood Disorder?

Mood disorders are disturbances in emotions that cause subjective discomfort, hinder a person's ability to function, or both; depression and mania are central to these disorders.

A. What are the symptoms of mood disorders?

Depression is characterized by intense sadness, feelings of futility and worthlessness, and withdrawal from others.

Surveys

1. The prevalence of depression has been found to be more than ten times higher than that of mania (Robins et al.., 1991). It is quite prevalent in the general population, and it is the most common complaint of individuals seeking mental health care (Gotlib,1992; Strickland,1992).

Some 10 million Americans, and more than 100 million people world-wide, will experience clinical depression this year. Lifetime prevalence (the proportion of people who develop severe depression at some point in their lives) ranges from 10 to 25 percent for women and from 5-12 percent for men (American Psychiatric Association, 2000). A large-scale study has found even higher overall lifetime prevalence for all mood disorders-reaching almost 15 percent for adult males and almost 24 percent for adult females (Kesler et al., 1994)

There are indications that it may be a continuous phenomenon that waxes and wanes. After one episode of depression, the likelihood of another is 50 percent; after two episodes, 70 percent; and after three episodes, 90 percent (Munoz et al., 1995). Moreover, depression has been found to be associated with the risk of having a heart attack. In one large-scale study, individuals with depression were more than four times as likely to suffer a heart attack over a twelve-to thirteen-year follow-up period as were people with no history of the disorder (Spearing & Hendrix, 1998). Among college students, one survey found that over half indicated that they had experienced depression, 9 percent thought of suicide, and 1 percent had attempted suicide since the beginning of college (Furr, Westefeld, McConnell & Jenkins, 2001_

The Symptoms of Depression
Certain core characteristics are often seen among people with depression. These characteristics may be organized within the four psychological domains used to describe anxiety: the affective domain, the cognitive domain, the behavioral domain, and the physiological domain.

Affective Symptoms
The most striking symptom of depression is depressed mood, with feelings of sadness, dejection and an excessive and prolonged mourning. Feelings of worthlessness and having lost the joy of living are common. Wild weeping may occur as a general reaction to frustration or anger. Such crying spells do not seem to be directly correlated with a specific situation. Anxiety frequently accompanies depression, with a high correlation.

Also, note that severe depressive symptoms often occur as a normal reaction to the death of a loved one. This intensive mourning seems to have a positive psychological function in helping one to adjust. An excessively long period of bereavement, accompanied by a preoccupation with feelings of worthlessness, marked functional impairment, and serious psycohmotor retardation, however, can indicate a major mood disorder. Cultures vary in the normal duration of bereavement, but severe incapacitating depression rarely continues beyond the first three months.

Cognitive Symptoms
Besides general feelings of futility, emptiness, and hopelessness, certain thoughts and ideas are clearly related to depressive reactions. For example, the person has profoundly pessimistic beliefs about the future. Disinterest, decreased energy, and loss of motivation make it difficult for the depressed person to cope with everyday situations. Work responsibilities become monumental tasks, and the person avoids them. Self-accusations of incompetence and general self-denigration are common, as are thoughts of suicide. Other symptoms include difficulty in concentrating and in making decisions.

Depression may be reflected in a cognitve triad, which consists of negative views of the self, of the outside world, and of the future (Beck, 1974). The person has pessimistic beliefs about what he/she can do, about what others can do to help, and about his or her prospects for the future. Some of this triad can be seen in the following self-description of the thoughts and feelings of someone with severe depression:

The gradual progression to this state of semicognizance and quiescence was steady; it is hard to trace. People and things counted less. I ceased to wonder. I asked a member of my family where I was and, having received an answer, accepted it. And usually I remembered it, when I was in a state to remember anything objective. The days dragged; there was no "motive," no drive of any kind. A dull acceptance settled upon me. Nothing interested me. I was very tired and heavy. I refused to do most of the things that were asked of me, and to avoid further disturbance I was put to bed again. (Hillyer, 1964, pp. 158-159)

Ezra Pound, one of the most brilliant poets of the twentieth century, suffered a severe depression when he was in his seventies. He told and interviewer bitterly, "I have lived all my life believing that I knew something. And then a strange day came and I realized that I knew nothing, nothing at all. And so words have become empty of meaning. Everything that I touch, I spoil. I have blundered always" (Darrach, 1976, p. 81) Pound stopped writing for years; for days on end, he ceased to speak. For both Hillyer and Pound, motivation, activity, vitality, and optimism had declined drastically.



Ezra Pound-His Life, Works and Manuscripts


Behavioral Symptoms
A person with depression often shows social withdrawal and lowered work productivity. This low energy level is one of the dominant behavioral symptoms of depression, and it has been found to distinguish depressed individuals from non-depressed individuals (Christensen & Duncan, 1995). Other symptoms include sloppy or dirty clothing, unkempt hair, and lack of concern for personal cleanliness. A dull, masklike facial expression may become characteristic, and the person tends to move slowly and does not initiate new activities. Speech is similarly reduced and slow, and responses may be limited to short phrases. This slowing down of all bodily movements, expressive gestures, and spontaneous responses is called psychomotor retardation. Although psychomotor retardation is typical, some people suffering from depression manifest an agitated state and symptoms of restlessness.

Physiological Symptoms
The following somatic and related symptoms frequently accompany depression:
1. Loss of appetite and weight~ Some people, however, have increased appetite and gain weight. The loss of appetite often stems from the person's disinterest in eating; food seems tasteless. In severe depression, weight loss can become life threatening.

2. Constipation~ The person may not have bowl movements for days at a time.

3. Sleep disturbance~ Difficulty in falling asleep, waking up early, waking up erratically during the night, insomnia, and nightmares leave the person exhausted and tired during the day. Many dread the arrival of night because it represents a major fatigue-producing battle to fall asleep. Some depressed people, however, show hypersomnia, or excessive sleep.

4. Disruption of the normal menstrual cycle in women~ The disruption is usually a lengthening of the cycle, and the woman may skip one or several periods. The volume of menstrual flow may decrease.

5. Aversion to sexual activity~ Many people report that their sexual arousal dramatically declines.

Culture defines the experience and expression of symptoms of depression. In some cultures, depression may be experienced largely in somatic or bodily complaints, rather than in sadness or guilt. Complaints of "nerves" and headaches (in Latino and Mediterranean cultures), of weakness, tiredness, or "imbalance" (in Chinese and Asian cultures), of problems of the "heart" (in Middle Eastern cultures), or of being "heartbroken" (among Hopi) may reveal the depressive experience (American Psychiatric Association, 2000).

The core symptoms of a major depressive episode are the same for children and adolescents, although the prominence of characteristic symptoms may change with age. Certain symptoms such as somatic complaints, irritability, and social withdrawal are particularly common in children, whereas psychomotor retardation, hypersomnia, and delusions are more common in adolescence and adulthood (American Psychiatric Association, 2000).

More Personal Stories of Depression

1. "Amanda was a thirty-nine-year-old homemaker with three children, ages nine, eleven ,and fourteen. Her husband, Jim, was the sales manager for an auto agency, and the family did well financially and lived comfortably. For years, family life was stable and no serious problems existed between family members. The family could be described as cohesive and loving. However, Jim began to notice that his wife was becoming more and more unhappy and depressed. She constantly said that her life lacked purpose. Jim would reassure her, pointing out that they had a nice home and that she had no reason to be unhappy. He suggested that she find some hobbies or socialize more with their neighbors and friends. But Amanda became progressively more absorbed in her belief that her life was meaningless.

After a while, Amanda no longer bothered to keep the house clean, to cook, or to take care of the children. At first Jim thought she was merely in a "bad mood" and that it would pass, but as her lethargy deepened, he became increasingly worried. He thought his wife was either sick or no longer loved him and the children. Amanda told him that she was tired, and that simple household chores took too much energy. She said that she still loved Jim and the children but no longer had strong feelings for anything. Amanda did show some guilt about her inability to take care of the children and to be a wife, but everything was simply to depressing. Life was no longer important, and she just wanted to be left alone. At that point she began to cry uncontrollably. Nothing Jim said could bring her out of the depression or stop her from crying. He decided that she had to see a physician, and he made an appointment for her. Amanda is currently receiving medication and psychotherapy to treat her depression."



2. "It's hard to describe the state I was in several months ago. The depression was total-it was as if everything that happened to me passed through this filter which colored all experiences. Nothing was exciting to me. I felt I was no good, completely worthless, and deserving of nothing. The people who tried to cheer me up were just living in a different world."

This text is taken from the book 'Understanding Abnormal Behavior' written by David Sue, Derald Wing Sue and Stanley Sue (seventh edition-pp. 348-351), copyright 2003-Houghton Mifflin Company. Used with permission.