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Block 3 Unit 1 Mild, Moderate and Major Depressive Disorder

1) What do you mean by mood disorder? Discuss its different types?

• A mood disorder is a group of diagnoses in the DSM-IV-TR classification system where a disturbance in a person’s mood is the main underlying feature.
• Mood disorders are emotional disturbances consisting of prolonged periods of excessive sadness, excessive joyousness, or both.
• They are categorised as depressive or bipolar.
• Depressive disorders are characterised by depression.
• Bipolar disorders are characterised by varying combinations of depression and mania.
• Specific types include:
  • Major depressive disorder
  • Dysthymia
  • Depressive disorder not otherwise specified
  • Depressive disorder due to a general physical condition
  • Substance-induced depressive disorder
  • Mild depressive disorder
  • Moderate depressive disorder (including adjustment disorder with depressed mood)

2) Discuss the symptoms of mild depressive disorder.

Symptoms of mild depression include:

• Reduced concentration or ability to think, which can hamper daily activities.
• Fatigue and sleeplessness or insomnia.
• Physical problems such as aches and pains, headaches, or backaches.
• Loss of interest in activities previously enjoyed, including social activities.
• Feelings of guilt and worthlessness.
• Possible thoughts of suicide.
• Changes in eating habits and losing interest in sex.

3) Point out the symptoms and treatment of adjustment disorder with depressed mood.

• Symptoms:
  • Behaviourally indistinguishable from dysthymia, presenting with depressed mood.
  • Occurs in response to a major life stressor or crisis.
  • Also called "reactive depression".
• Treatment: The source material does not provide specific treatment for adjustment disorder with depressed mood but it notes that a combination of antidepressant medication and psychological treatment is the most common treatment for depressive disorders.

4) Differentiate between dysthymic disorder and adjustment disorder with depressed mood.

• Dysthymic disorder is a long-term, chronic, less severe type of depression that keeps one from functioning well or feeling good.
• Adjustment disorder with depressed mood differs from dysthymia as it does not exceed six months in duration and requires the existence of an identifiable psychological stressor.

5) Discuss the symptoms and types of major depressive disorder.

• Symptoms:
  • A very low mood that pervades all aspects of life.
  • Inability to experience pleasure in activities previously enjoyed (anhedonia).
  • Feelings of worthlessness, inappropriate guilt, regret, helplessness, hopelessness, and self-hatred.
  • Possible psychotic symptoms in severe cases.
  • Insomnia (sleeplessness) or hypersomnia (oversleeping).
  • Multiple physical symptoms, such as fatigue, headaches, or digestive problems.
• Types: The source material indicates that the DSM-IV-TR recognises five subtypes of MDD:
  • Atypical Depression (AD): Characterised by mood reactivity and positivity, significant weight gain or increased appetite, excessive sleep, a sensation of heaviness in limbs, and social impairment due to hypersensitivity to interpersonal rejection.

6) Explain the etiology and treatment of major depressive disorder.

• Etiology (Causes):
  • Biological factors not specified in the sources, but generally thought to be relevant.
  • Psychological factors:
    • Negative beliefs about the self, based on experiences of failure.
    • A lack of self-efficacy – not believing they can influence events or achieve personal goals.
    • A tendency to blame themselves for negative events and not taking credit for positive outcomes.
    • Early interpersonal loss and early life experiences can also be related to depression.
    • When people are unable to reach self-actualisation they can experience depression.
  • Social factors:
    • Poverty and social isolation can increase risk.
    • Child abuse (physical, emotional, sexual, or neglect) is associated with increased risk.
    • Disturbances in family functioning such as parental stress.
    • Stressful life events, especially those connected to social rejection.

• Treatment:

  • Cognitive Behavioural Therapy (CBT): Helps people to understand and change unhelpful thought patterns and behaviours.
  • Interpersonal Psychotherapy: Focuses on increasing a client's social effectiveness and helping them feel more cared for by others.
  • A combination of antidepressant medication and psychological treatment is often more effective than either treatment alone.

7) Differentiate between mild depressive disorder and major depressive disorder.

• Mild Depressive Disorder:
  • The feeling of sorrow remains for a long time.
  • Not as serious as other versions of depression, but can still affect daily life.
  • May have reduced concentration, fatigue, physical problems, loss of interest, feelings of guilt and worthlessness.
  • If untreated, it can lead to severe depression.
• Major Depressive Disorder:
  • More severe and long-lasting feelings of sadness or related symptoms that interfere with a person’s functioning.
  • Characterised by a very low mood, inability to experience pleasure, and feelings of worthlessness, guilt, helplessness, and hopelessness.
  • Can include psychotic symptoms, insomnia, or hypersomnia, and multiple physical symptoms.

8) How does mood disorder differ from other types of mental disorders?

Mood disorders are primarily characterised by a disturbance in a person’s mood or emotional state, involving prolonged periods of excessive sadness, joy, or both. Other mental disorders may have different primary features, such as thought disturbances (as in schizophrenia), anxiety, or personality traits.

9) Describe different types of mood disorders.

Mood disorders are broadly categorised into depressive disorders and bipolar disorders.

• Depressive Disorders:
  • Major depressive disorder (MDD): severe and long-lasting feelings of sadness or related symptoms that interfere with functioning.
  • Dysthymia: less severe, chronic symptoms that do not disable but keep one from feeling good.
  • Depressive disorder not otherwise specified: when depressive symptoms don't fit the criteria for other depressive disorders.
  • Depressive disorder due to a general medical condition.
  • Substance-induced depressive disorder.
  • Mild depressive disorder: sadness impacting daily activities.
  • Moderate depressive disorder: Including adjustment disorder with depressed mood, reactive to a life stressor.

• Bipolar Disorders: Characterized by episodes of both mania (or hypomania) and depression.

10) What do you mean by mild depressive disorder? What are its main symptoms?

• Mild depressive disorder is a condition where a person experiences a low mood that affects their daily life but is not as severe as other forms of depression.
• Main symptoms include:
  • Reduced concentration.
  • Fatigue and sleeplessness.
  • Physical problems such as aches and pains.
  • Loss of interest in activities.
  • Feelings of guilt and worthlessness.

11) What do you mean by moderate depressive disorder? How is it caused and treated?

• Moderate depressive disorder includes dysthymia and adjustment disorder with depressed mood.
• Causes:
  • Dysthymia has long-term, chronic symptoms.
  • Adjustment disorder with depressed mood occurs in response to a major life stressor or crisis.
• Treatment:
  • The source material does not specify treatments for moderate depressive disorder specifically, but as depressive disorders, it notes that they are most often treated with a combination of psychological treatment and medications.

12) Explain adjustment disorder with depressed mood.

• Adjustment disorder with depressed mood is a reactive depression that occurs in response to a major life stressor or crisis.
• It is behaviourally similar to dysthymia, but differs as it does not exceed six months in duration, and requires an identifiable psychological stressor.

13) Differentiate between dysthymic disorder and adjustment disorder with depressed mood.

• Dysthymic disorder is a long-term, chronic type of depression.
• Adjustment disorder with depressed mood is a reaction to a specific stressor, lasting less than six months.

14) Describe the diagnosis and types of major depressive disorder.

• Diagnosis: based on self-reported experiences, behaviour reported by others, and mental status exam.
• Types The source material indicates that the DSM-IV-TR recognises five subtypes of MDD:
  • Atypical Depression (AD) characterized by mood reactivity, significant weight gain or increased appetite, excessive sleep, limb heaviness, and social impairment due to hypersensitivity to interpersonal rejection.

15) Explain the causes and treatment of major depressive disorder.

• Causes:
• Biological Factors: not specified by the sources.
• Psychological Factors: negative beliefs, lack of self-efficacy, self-blame, early interpersonal loss and life experiences, failure to self-actualize.
• Social Factors: poverty, social isolation, child abuse, family disturbances, stressful life events including social rejection.
• Treatment:
  • Cognitive Behavioural Therapy (CBT).
  • Interpersonal psychotherapy.
  • A combination of antidepressant medication and psychological treatment.

16) Differentiate between mild depressive disorder and major depressive disorder.

• Mild depressive disorder has less severe symptoms and does not interfere with functioning to the same extent as major depression. It still affects daily life though.
• Major depressive disorder is characterised by more severe and long-lasting symptoms, including a low mood, inability to experience pleasure, feelings of worthlessness, guilt, and hopelessness that interfere with a person’s functioning.

17) Treatment of mild mood disorder

Mild Mood Disorder

• Symptoms of mild mood disorder While "mild mood disorder" is not a formal diagnosis, the symptoms described in the source material related to mild depression include:

  • Reduced concentration
  • Fatigue and sleeplessness
  • Physical problems such as aches and pains
  • Changes in eating habits or losing interest in sex

• Treatment of mild mood disorder As with dysthymia, psychotherapy, and medication may be used for mild mood disorders. The material also mentions that cognitive therapy, behavioural therapy, interpersonal therapy, and problem solving therapy are possible treatment options.

18) Explain the symptoms, diagnosis and treatment of dysthymic disorder.

Dysthymic Disorder

• Symptoms: Dysthymia is a form of mild depression characterised by chronic, long-term symptoms that, while not disabling, prevent one from feeling well or functioning optimally. It is also referred to as a low-level depression.
  • A depressed mood is present for most of the day, for more days than not, for at least two years (one year in children and adolescents).
  • The symptoms must cause significant distress or impairment in social, occupational, educational, or other important areas of functioning.
  • The symptoms tend to be less severe than major depression but do fluctuate in intensity.
  • To be diagnosed, an adult must experience two or more of the following symptoms for at least two years:
    • Poor appetite or overeating
    • Insomnia or hypersomnia (oversleeping)
    • Low energy or fatigue
    • Low self-esteem
    • Poor concentration or difficulty making decisions
    • Feelings of hopelessness
    • Low sex drive
    • Irritability
  • Symptoms exclude "manic, hypomanic or mixed episodes commonly associated with bipolar disorders".
  • Individuals with dysthymia may be lethargic, introverted, hypercritical, and complaining.
  • People may believe depression is part of their character and not discuss it with doctors, family, or friends.
• Diagnosis: Diagnosis is made when a person experiences a depressed mood for most of the day, for more days than not, for at least two years, plus two or more of the above symptoms.
• Treatment:
  • Psychotherapy is the primary treatment.
  • Antidepressant medication may also be recommended due to the chronic nature of the disorder.
  • Cognitive therapy can help the depressed person recognise critical and minor life problems, learn to accept the unchangeable, and address unrealistic expectations and self-evaluations.
  • Behavioural therapy can help develop better coping skills.
  • Interpersonal therapy can assist in resolving relationship conflicts.
  • Problem-solving therapy helps to change areas of life causing significant stress.

19) Discuss the symptoms and treatment of adjustment disorder with depressed mood.

Adjustment Disorder with Depressed Mood

• Symptoms:
  • This disorder is also known as "reactive depression" because it occurs in response to a major life stressor or crisis.
  • Its symptoms are similar to those of dysthymia, with a depressed mood.
  • The depressive symptoms are developed in response to a specific and identifiable psychosocial stressor.
  • It differs from dysthymia in that it does not exceed six months in duration.
• Diagnosis: Diagnosis is made when depressive symptoms occur in response to an identifiable psychological stressor. A diagnosis of adjustment disorder is not used if the individual meets the criteria for another disorder. The symptoms of adjustment disorder should resolve within six months of the stressor being removed. However, if the stressor continues over a long period, the diagnosis may still be used even if the symptoms continue for more than six months.
• Treatment:
  • While the source material does not provide specific treatments for adjustment disorder, it indicates that treatment is similar to other depressive disorders.
• Cognitive-behavioural therapy and/or interpersonal therapy are the recommended treatments.
• Emphasis is placed on resolving the stressor, which may involve making changes in the person's life and decision-making.
• Helping the person develop a solution to their problems is also a key part of treatment.