Mood Disorders Can Range From Mild to Severe; the Most Severe Type of Depression Is Called

Learning Objectives

Past the end of this department, y'all volition exist able to:

• Distinguish normal states of sadness and euphoria from states of depression and mania
• Describe the symptoms of major depressive disorder and bipolar disorder
• Understand the differences betwixt major depressive disorder and persistent depressive disorder, and identify two subtypes of depression
• Define the criteria for a manic episode
• Understand genetic, biological, and psychological explanations of major depressive disorder
• Talk over the relationship between mood disorders and suicidal ideation, too equally factors associated with suicide

Blake cries all day and feeling that he is worthless and his life is hopeless, he cannot go out of bed. Crystal stays up all night, talks very quickly, and went on a shopping spree in which she spent $3,000 on furniture, although she cannot beget information technology. Maria recently had a baby, and she feels overwhelmed, teary, anxious, and panicked, and believes she is a terrible mother—practically every twenty-four hour period since the baby was born. All these individuals demonstrate symptoms of a potential mood disorder.

Mood disorders ([link]) are characterized past severe disturbances in mood and emotions—most often depression, just also mania and elation (Rothschild, 1999). All of us experience fluctuations in our moods and emotional states, and often these fluctuations are caused past events in our lives. We become elated if our favorite team wins the World Series and dejected if a romantic relationship ends or if we lose our job. At times, we feel fantastic or miserable for no articulate reason. People with mood disorders as well feel mood fluctuations, only their fluctuations are extreme, distort their outlook on life, and impair their ability to function.

Mood disorders are characterized by massive disruptions in mood. Symptoms can range from the extreme sadness and hopelessness of depression to the extreme elation and irritability of mania. (credit: Kiran Foster)

The DSM-5 lists two full general categories of mood disorders. Depressive disorders are a grouping of disorders in which depression is the main characteristic. Depression is a vague term that, in everyday language, refers to an intense and persistent sadness. Low is a heterogeneous mood country—it consists of a broad spectrum of symptoms that range in severity. Depressed people feel pitiful, discouraged, and hopeless. These individuals lose interest in activities once enjoyed, often experience a decrease in drives such as hunger and sexual activity, and frequently doubt personal worth. Depressive disorders vary by degree, just this chapter highlights the well-nigh well-known: major depressive disorder (sometimes chosen unipolar depression).

Bipolar and related disorders are a group of disorders in which mania is the defining feature. Mania is a state of extreme elation and agitation. When people experience mania, they may become extremely talkative, comport recklessly, or try to take on many tasks simultaneously. The most recognized of these disorders is bipolar disorder.

MAJOR DEPRESSIVE DISORDER

Co-ordinate to the DSM-five, the defining symptoms of major depressive disorder include "depressed mood virtually of the day, nearly every day" (feeling deplorable, empty, hopeless, or appearing tearful to others), and loss of interest and pleasure in usual activities (APA, 2013). In add-on to feeling overwhelmingly sad most of each solar day, people with depression will no longer bear witness interest or enjoyment in activities that previously were gratifying, such as hobbies, sports, sex, social events, time spent with family, so on. Friends and family unit members may notice that the person has completely abandoned previously enjoyed hobbies; for example, an avid tennis thespian who develops major depressive disorder no longer plays lawn tennis (Rothschild, 1999).

To receive a diagnosis of major depressive disorder, one must experience a full of v symptoms for at to the lowest degree a two-week period; these symptoms must crusade significant distress or impair normal performance, and they must not be caused by substances or a medical condition. At least ane of the two symptoms mentioned above must exist nowadays, plus any combination of the following symptoms (APA, 2013):

• meaning weight loss (when not dieting) or weight gain and/or significant decrease or increment in appetite;
• difficulty falling asleep or sleeping too much;
• psychomotor agitation (the person is noticeably fidgety and jittery, demonstrated by behaviors similar the disability to sit, pacing, manus-wringing, pulling or rubbing of the peel, clothing, or other objects) or psychomotor retardation (the person talks and moves slowly, for example, talking softly, very footling, or in a monotone);
• fatigue or loss of energy;
• feelings of worthlessness or guilt;
• difficulty concentrating and indecisiveness; and
• suicidal ideation: thoughts of expiry (non only fear of dying), thinking about or planning suicide, or making an bodily suicide try.

Major depressive disorder is considered episodic: its symptoms are typically present at their full magnitude for a certain period of fourth dimension and then gradually abate. Approximately fifty%–60% of people who experience an episode of major depressive disorder will take a second episode at some point in the future; those who have had 2 episodes have a 70% hazard of having a 3rd episode, and those who have had iii episodes accept a xc% chance of having a quaternary episode (Rothschild, 1999). Although the episodes can last for months, a bulk a people diagnosed with this condition (around 70%) recover within a year. All the same, a substantial number do not recover; around 12% show serious signs of impairment associated with major depressive disorder after 5 years (Boland & Keller, 2009). In the long-term, many who do recover will yet show minor symptoms that fluctuate in their severity (Judd, 2012).

Results of Major Depressive Disorder

Major depressive disorder is a serious and incapacitating condition that can have a devastating effect on the quality of i's life. The person suffering from this disorder lives a profoundly miserable beingness that frequently results in unavailability for work or educational activity, abandonment of promising careers, and lost wages; occasionally, the condition requires hospitalization. The majority of those with major depressive disorder report having faced some kind of discrimination, and many report that having received such treatment has stopped them from initiating close relationships, applying for jobs for which they are qualified, and applying for pedagogy or training (Lasalvia et al., 2013). Major depressive disorder also takes a toll on wellness. Low is a hazard cistron for the evolution of center illness in good for you patients, equally well every bit adverse cardiovascular outcomes in patients with preexisting eye disease (Whooley, 2006).

Risk Factors for Major Depressive Disorder

Major depressive disorder is often referred to every bit the mutual cold of psychiatric disorders. Effectually 6.6% of the U.South. population experiences major depressive disorder each year; 16.9% will experience the disorder during their lifetime (Kessler & Wang, 2009). Information technology is more than common among women than among men, affecting approximately 20% of women and 13% of men at some point in their life (National Comorbidity Survey, 2007). The greater risk amongst women is not accounted for by a tendency to written report symptoms or to seek assistance more readily, suggesting that gender differences in the rates of major depressive disorder may reflect biological and gender-related environmental experiences (Kessler, 2003).

Lifetime rates of major depressive disorder tend to be highest in North and S America, Europe, and Commonwealth of australia; they are considerably lower in Asian countries (Hasin, Fenton, & Weissman, 2011). The rates of major depressive disorder are higher among younger age cohorts than among older cohorts, peradventure because people in younger age cohorts are more willing to admit low (Kessler & Wang, 2009).

A number of run a risk factors are associated with major depressive disorder: unemployment (including homemakers); earning less than $20,000 per yr; living in urban areas; or being separated, divorced, or widowed (Hasin et al., 2011). Comorbid disorders include anxiety disorders and substance abuse disorders (Kessler & Wang, 2009).

SUBTYPES OF DEPRESSION

The DSM-5 lists several different subtypes of depression. These subtypes—what the DSM-5 refer to as specifiers—are not specific disorders; rather, they are labels used to indicate specific patterns of symptoms or to specify certain periods of time in which the symptoms may exist present. One subtype, seasonal pattern, applies to situations in which a person experiences the symptoms of major depressive disorder only during a particular time of year (e.g., fall or winter). In everyday language, people frequently refer to this subtype every bit the wintertime blues.

Another subtype, peripartum onset (commonly referred to as postpartum depression), applies to women who feel major depression during pregnancy or in the four weeks following the birth of their child (APA, 2013). These women oft feel very anxious and may even take panic attacks. They may feel guilty, agitated, and be weepy. They may non want to hold or care for their newborn, even in cases in which the pregnancy was desired and intended. In extreme cases, the mother may accept feelings of wanting to harm her child or herself. In a horrific illustration, a woman named Andrea Yates, who suffered from farthermost peripartum-onset depression (besides as other mental illnesses), drowned her five children in a bathtub (Roche, 2002). Most women with peripartum-onset depression do not physically harm their children, simply nigh practice have difficulty being adequate caregivers (Fields, 2010). A surprisingly high number of women experience symptoms of peripartum-onset depression. A study of 10,000 women who had recently given birth found that fourteen% screened positive for peripartum-onset depression, and that well-nigh 20% reported having thoughts of wanting to harm themselves (Wisner et al., 2013).

People with persistent depressive disorder (previously known as dysthymia) experience depressed moods most of the mean solar day near every day for at to the lowest degree two years, as well as at least two of the other symptoms of major depressive disorder. People with persistent depressive disorder are chronically sad and melancholy, but do not see all the criteria for major depression. However, episodes of full-diddled major depressive disorder can occur during persistent depressive disorder (APA, 2013).

BIPOLAR DISORDER

A person with bipolar disorder (usually known as manic depression) oftentimes experiences mood states that vacillate between low and mania; that is, the person's mood is said to alternate from one emotional extreme to the other (in contrast to unipolar, which indicates a persistently sad mood).

To be diagnosed with bipolar disorder, a person must have experienced a manic episode at least once in his life; although major depressive episodes are common in bipolar disorder, they are non required for a diagnosis (APA, 2013). According to the DSM-5, a manic episode is characterized as a "distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or free energy lasting at least one calendar week," that lasts most of the time each day (APA, 2013, p. 124). During a manic episode, some experience a mood that is almost euphoric and get excessively talkative, sometimes spontaneously starting conversations with strangers; others become excessively irritable and complain or brand hostile comments. The person may talk loudly and quickly, exhibiting flight of ideas, abruptly switching from ane topic to another. These individuals are easily distracted, which can make a chat very hard. They may exhibit grandiosity, in which they experience inflated merely unjustified self-esteem and self-confidence. For example, they might quit a job in guild to "strike it rich" in the stock market, despite lacking the knowledge, experience, and uppercase for such an endeavor. They may take on several tasks at the same time (e.g., several time-consuming projects at work) and even so show little, if any, need for sleep; some may go for days without sleep. Patients may also recklessly appoint in pleasurable activities that could have harmful consequences, including spending sprees, reckless driving, making foolish investments, excessive gambling, or engaging in sexual encounters with strangers (APA, 2013).

During a manic episode, individuals usually feel as though they are not ill and do not need treatment. However, the reckless behaviors that often accompany these episodes—which can be hating, illegal, or physically threatening to others—may require involuntary hospitalization (APA, 2013). Some patients with bipolar disorder will experience a rapid-cycling subtype, which is characterized by at least four manic episodes (or some combination of at least four manic and major depressive episodes) within one year.

Link to Learning

In the 1997 independent film Sweetheart, actress Janeane Garofalo plays the part of Jasmine, a young woman with bipolar disorder. Watch this video to see a portion of this film in which Jasmine experiences a manic episode.

Adventure Factors for Bipolar Disorder

Bipolar disorder is considerably less frequent than major depressive disorder. In the United states, 1 out of every 167 people meets the criteria for bipolar disorder each year, and ane out of 100 meet the criteria within their lifetime (Merikangas et al., 2011). The rates are higher in men than in women, and about half of those with this disorder study onset before the age of 25 (Merikangas et al., 2011). Effectually 90% of those with bipolar disorder have a comorbid disorder, most often an anxiety disorder or a substance abuse problem. Unfortunately, close to half of the people suffering from bipolar disorder do not receive treatment (Merikangas & Tohen, 2011). Suicide rates are extremely high amidst those with bipolar disorder: around 36% of individuals with this disorder endeavour suicide at least once in their lifetime (Novick, Swartz, & Frank, 2010), and between 15%–19% complete suicide (Newman, 2004).

THE BIOLOGICAL Footing OF MOOD DISORDERS

Mood disorders take been shown to take a strong genetic and biological basis. Relatives of those with major depressive disorder have double the risk of developing major depressive disorder, whereas relatives of patients with bipolar disorder take over nine times the run a risk (Merikangas et al., 2011). The charge per unit of concordance for major depressive disorder is higher among identical twins than congenial twins (50% vs. 38%, respectively), as is that of bipolar disorder (67% vs. 16%, respectively), suggesting that genetic factors play a stronger role in bipolar disorder than in major depressive disorder (Merikangas et al. 2011).

People with mood disorders often accept imbalances in certain neurotransmitters, specially norepinephrine and serotonin (Thase, 2009). These neurotransmitters are important regulators of the actual functions that are disrupted in mood disorders, including appetite, sex bulldoze, slumber, arousal, and mood. Medications that are used to treat major depressive disorder typically boost serotonin and norepinephrine action, whereas lithium—used in the treatment of bipolar disorder—blocks norepinephrine action at the synapses ([link]).

Many medications designed to treat mood disorders work by altering neurotransmitter activity in the neural synapse.

Depression is linked to abnormal activity in several regions of the brain (Fitzgerald, Laird, Maller, & Daskalakis, 2008) including those important in assessing the emotional significance of stimuli and experiencing emotions (amygdala), and in regulating and decision-making emotions (like the prefrontal cortex, or PFC) (LeMoult, Castonguay, Joormann, & McAleavey, 2013). Depressed individuals show elevated amygdala activity (Drevets, Bogers, & Raichle, 2002), especially when presented with negative emotional stimuli, such as photos of deplorable faces ([link]) (Surguladze et al., 2005). Interestingly, heightened amygdala activation to negative emotional stimuli amid depressed persons occurs even when stimuli are presented outside of conscious awareness (Victor, Furey, Fromm, Öhman, & Drevets, 2010), and it persists even later the negative emotional stimuli are no longer nowadays (Siegle, Thompson, Carter, Steinhauer, & Thase, 2007). Additionally, depressed individuals exhibit less activation in the prefrontal, specially on the left side (Davidson, Pizzagalli, & Nitschke, 2009). Because the PFC can dampen amygdala activation, thereby enabling one to suppress negative emotions (Phan et al., 2005), decreased activation in certain regions of the PFC may inhibit its ability to override negative emotions that might then lead to more negative mood states (Davidson et al., 2009). These findings suggest that depressed persons are more than prone to react to emotionally negative stimuli, yet accept greater difficulty decision-making these reactions.

Depressed individuals react to negative emotional stimuli, such as sad faces, with greater amygdala activation than do non-depressed individuals. (credit: Ian Munroe)

Since the 1950s, researchers have noted that depressed individuals accept abnormal levels of cortisol, a stress hormone released into the blood by the neuroendocrine system during times of stress (Mackin & Young, 2004). When cortisol is released, the body initiates a fight-or-flight response in reaction to a threat or danger. Many people with depression bear witness elevated cortisol levels (Holsboer & Ising, 2010), especially those reporting a history of early on life trauma such as the loss of a parent or abuse during babyhood (Baes, Tofoli, Martins, & Juruena, 2012). Such findings enhance the question of whether high cortisol levels are a crusade or a consequence of low. Loftier levels of cortisol are a run a risk factor for time to come depression (Halligan, Herbert, Goodyer, & Murray, 2007), and cortisol activates action in the amygdala while deactivating activity in the PFC (McEwen, 2005)—both brain disturbances are connected to depression. Thus, high cortisol levels may have a causal result on depression, equally well as on its encephalon part abnormalities (van Praag, 2005). Also, because stress results in increased cortisol release (Michaud, Matheson, Kelly, Anisman, 2008), it is equally reasonable to presume that stress may precipitate depression.

A Diathesis-Stress Model and Major Depressive Disorders

Indeed, it has long been believed that stressful life events tin trigger low, and research has consistently supported this conclusion (Mazure, 1998). Stressful life events include pregnant losses, such as decease of a loved one, divorce or separation, and serious wellness and money problems; life events such as these ofttimes precede the onset of depressive episodes (Brown & Harris, 1989). In particular, exit events—instances in which an important person departs (e.g., a death, divorce or separation, or a family member leaving home)—often occur prior to an episode (Paykel, 2003). Exit events are especially likely to trigger depression if these happenings occur in a way that humiliates or devalues the individual. For instance, people who experience the breakup of a relationship initiated past the other person develop major depressive disorder at a rate more 2 times that of people who experience the death of a loved one (Kendler, Hettema, Butera, Gardner, & Prescott, 2003).

Likewise, individuals who are exposed to traumatic stress during childhood—such as separation from a parent, family turmoil, and maltreatment (physical or sexual corruption)—are at a heightened gamble of developing low at any point in their lives (Kessler, 1997). A recent review of 16 studies involving over 23,000 subjects concluded that those who experience childhood maltreatment are more two times as probable to develop recurring and persistent low (Nanni, Uher, & Danese, 2012).

Of course, not everyone who experiences stressful life events or babyhood adversities succumbs to depression—indeed, nigh do non. Clearly, a diathesis-stress interpretation of major depressive disorder, in which sure predispositions or vulnerability factors influence one'southward reaction to stress, would seem logical. If and then, what might such predispositions be? A report by Caspi and others (2003) suggests that an alteration in a specific gene that regulates serotonin (the 5-HTTLPR gene) might exist one culprit. These investigators found that people who experienced several stressful life events were significantly more than probable to experience episodes of major depression if they carried one or two curt versions of this gene than if they carried two long versions. Those who carried one or two brusque versions of the five-HTTLPR factor were unlikely to experience an episode, still, if they had experienced few or no stressful life events. Numerous studies have replicated these findings, including studies of people who experienced maltreatment during childhood (Goodman & Brand, 2009). In a recent investigation conducted in the United Kingdom (Brown & Harris, 2013), researchers found that babyhood maltreatment before age 9 elevated the risk of chronic adult depression (a depression episode lasting for at least 12 months) among those individuals having 1 (LS) or 2 (SS) short versions of the 5-HTTLPR gene ([link]). Childhood maltreatment did not increase the risk for chronic depression for those accept two long (LL) versions of this factor. Thus, genetic vulnerability may exist ane mechanism through which stress potentially leads to depression.

A study on gene-environment interaction in people experiencing chronic low in adulthood suggests a much higher incidence in individuals with a short version of the gene in combination with childhood maltreatment (Brown & Harris, 2013).

Cognitive Theories of Low

Cerebral theories of depression take the view that depression is triggered by negative thoughts, interpretations, self-evaluations, and expectations (Joormann, 2009). These diathesis-stress models propose that depression is triggered past a "cognitive vulnerability" (negative and maladaptive thinking) and by precipitating stressful life events (Gotlib & Joormann, 2010). Perchance the nearly well-known cognitive theory of depression was adult in the 1960s past psychiatrist Aaron Beck, based on clinical observations and supported past research (Beck, 2008). Brook theorized that depression-prone people possess depressive schemas, or mental predispositions to think about most things in a negative way (Beck, 1976). Depressive schemas comprise themes of loss, failure, rejection, worthlessness, and inadequacy, and may develop early in babyhood in response to adverse experiences, then remain dormant until they are activated by stressful or negative life events. Depressive schemas prompt dysfunctional and pessimistic thoughts about the self, the world, and the future. Beck believed that this dysfunctional style of thinking is maintained by cognitive biases, or errors in how we process data about ourselves, which lead us to focus on negative aspects of experiences, translate things negatively, and block positive memories (Beck, 2008). A person whose depressive schema consists of a theme of rejection might be overly attentive to social cues of rejection (more than likely to detect some other's frown), and he might interpret this cue equally a sign of rejection and automatically call back past incidents of rejection. Longitudinal studies have supported Beck'due south theory, in showing that a preexisting tendency to engage in this negative, self-defeating style of thinking—when combined with life stress—over fourth dimension predicts the onset of depression (Dozois & Beck, 2008). Cognitive therapies for low, aimed at changing a depressed person's negative thinking, were developed as an expansion of this theory (Beck, 1976).

Another cognitive theory of low, hopelessness theory, postulates that a item style of negative thinking leads to a sense of hopelessness, which then leads to depression (Abramson, Metalsky, & Alloy, 1989). According to this theory, hopelessness is an expectation that unpleasant outcomes volition occur or that desired outcomes will not occur, and at that place is zero ane can practise to prevent such outcomes. A key supposition of this theory is that hopelessness stems from a tendency to perceive negative life events equally having stable ("Information technology'south never going to modify") and global ("It'southward going to touch my whole life") causes, in contrast to unstable ("It's fixable") and specific ("It applies merely to this particular situation") causes, especially if these negative life events occur in of import life realms, such as relationships, academic achievement, and the similar. Suppose a student who wishes to become to law school does poorly on an admissions test. If the student infers negative life events as having stable and global causes, she may believe that her poor functioning has a stable and global cause ("I lack intelligence, and it's going to prevent me from ever finding a meaningful career"), as opposed to an unstable and specific cause ("I was sick the day of the exam, and so my low score was a fluke"). Hopelessness theory predicts that people who exhibit this cognitive style in response to undesirable life events will view such events equally having negative implications for their time to come and cocky-worth, thereby increasing the likelihood of hopelessness—the main cause of depression (Abramson et al., 1989). One report testing hopelessness theory measured the trend to make negative inferences for bad life effects in participants who were experiencing uncontrollable stressors. Over the ensuing six months, those with scores reflecting loftier cognitive vulnerability were 7 times more likely to develop low compared to those with lower scores (Kleim, Gonzalo, & Ehlers, 2011).

A third cerebral theory of depression focuses on how people'southward thoughts about their distressed moods—depressed symptoms in particular—can increase the risk and duration of depression. This theory, which focuses on rumination in the development of low, was kickoff described in the late 1980s to explain the higher rates of low in women than in men (Nolen-Hoeksema, 1987). Rumination is the repetitive and passive focus on the fact that one is depressed and dwelling on depressed symptoms, rather that distracting i'southward cocky from the symptoms or attempting to address them in an active, problem-solving manner (Nolen-Hoeksema, 1991). When people ruminate, they have thoughts such every bit "Why am I and so unmotivated? I only can't go going. I'chiliad never going to get my work washed feeling this fashion" (Nolen-Hoeksema & Hilt, 2009, p. 393). Women are more likely than men to ruminate when they are sad or depressed (Butler & Nolen-Hoeksema, 1994), and the tendency to ruminate is associated with increases in low symptoms (Nolen-Hoeksema, Larson, & Grayson, 1999), heightened risk of major depressive episodes (Abela & Hankin, 2011), and chronicity of such episodes (Robinson & Alloy, 2003)

SUICIDE

For some people with mood disorders, the extreme emotional pain they experience becomes unendurable. Overwhelmed by hopelessness, devastated by incapacitating feelings of worthlessness, and burdened with the disability to fairly cope with such feelings, they may consider suicide to be a reasonable way out. Suicide, defined by the CDC as "death caused past cocky-directed injurious behavior with any intent to dice equally the result of the beliefs" (CDC, 2013a), in a sense represents an upshot of several things going wrong all at the aforementioned time Crosby, Ortega, & Melanson, 2011). Not only must the person be biologically or psychologically vulnerable, but he must also have the ways to perform the suicidal deed, and he must lack the necessary protective factors (e.1000., social support from friends and family, religion, coping skills, and problem-solving skills) that provide comfort and enable one to cope during times of crunch or great psychological pain (Berman, 2009).

Suicide is non listed as a disorder in the DSM-5; however, suffering from a mental disorder—especially a mood disorder—poses the greatest chance for suicide. Around 90% of those who complete suicides take a diagnosis of at least one mental disorder, with mood disorders being the nigh frequent (Fleischman, Bertolote, Belfer, & Beautrais, 2005). In fact, the association between major depressive disorder and suicide is so potent that one of the criteria for the disorder is thoughts of suicide, as discussed higher up (APA, 2013).

Suicide rates can exist difficult to interpret because some deaths that appear to be accidental may in fact be acts of suicide (e.g., machine crash). Nevertheless, investigations into U.S. suicide rates have uncovered these facts:

• Suicide was the 10th leading crusade of death for all ages in 2010 (Centers for Disease Control and Prevention [CDC], 2012).
• There were 38,364 suicides in 2010 in the United States—an boilerplate of 105 each twenty-four hour period (CDC, 2012).
• Suicide among males is 4 times higher than among females and accounts for 79% of all suicides; firearms are the near commonly used method of suicide for males, whereas poisoning is the most commonly used method for females (CDC, 2012).
• From 1991 to 2003, suicide rates were consistently college among those 65 years and older. Since 2001, however, suicide rates among those ages 25–64 take risen consistently, and, since 2006, suicide rates take been greater for those ages 65 and older (CDC, 2013b). This increase in suicide rates among middle-aged Americans has prompted business in some quarters that baby boomers (individuals born between 1946–1964) who face economical worry and like shooting fish in a barrel admission to prescription medication may be peculiarly vulnerable to suicide (Parker-Pope, 2013).
• The highest rates of suicide within the United states of america are amongst American Indians/Alaskan natives and Non-Hispanic Whites (CDC, 2013b).
• Suicide rates vary beyond the United states, with the highest rates consistently found in the mountain states of the westward (Alaska, Montana, Nevada, Wyoming, Colorado, and Idaho) (Berman, 2009).

Contrary to popular belief, suicide rates elevation during the springtime (April and May), not during the holiday flavour or winter. In fact, suicide rates are generally everyman during the winter months (Postolache et al., 2010).

RISK FACTORS FOR SUICIDE

Suicidal gamble is especially high amidst people with substance abuse problems. Individuals with booze dependence are at 10 times greater risk for suicide than the general population (Wilcox, Conner, & Caine, 2004). The take chances of suicidal behavior is especially high among those who have made a prior suicide attempt. Among those who attempt suicide, 16% make another attempt within a year and over 21% make another try inside 4 years (Owens, Horrocks, & House, 2002). Suicidal individuals may exist at high risk for terminating their life if they take a lethal means in which to act, such as a firearm in the home (Brent & Bridge, 2003). Withdrawal from social relationships, feeling as though one is a burden to others, and engaging in reckless and risk-taking behaviors may be precursors to suicidal behavior (Berman, 2009). A sense of entrapment or feeling unable to escape i'southward miserable feelings or external circumstances (e.g., an abusive relationship with no perceived manner out) predicts suicidal beliefs (O'Connor, Smyth, Ferguson, Ryan, & Williams, 2013). Tragically, reports of suicides among adolescents post-obit instances of cyberbullying have emerged in recent years. In 1 widely-publicized case a few years ago, Phoebe Prince, a 15-year-old Massachusetts high school educatee, committed suicide following incessant harassment and taunting from her classmates via texting and Facebook (McCabe, 2010).

Suicides can have a contagious effect on people. For example, another's suicide, especially that of a family member, heightens one's adventure of suicide (Agerbo, Nordentoft, & Mortensen, 2002). Additionally, widely-publicized suicides tend to trigger copycat suicides in some individuals. One study examining suicide statistics in the United States from 1947–1967 plant that the rates of suicide skyrocketed for the first month later a suicide story was printed on the front page of the New York Times (Phillips, 1974). Austrian researchers found a significant increase in the number of suicides by firearms in the 3 weeks following extensive reports in Austria'south largest paper of a celebrity suicide by gun (Etzersdorfer, Voracek, & Sonneck, 2004). A review of 42 studies concluded that media coverage of celebrity suicides is more than 14 times more likely to trigger copycat suicides than is coverage of non-celebrity suicides (Stack, 2000). This review also demonstrated that the medium of coverage is important: televised stories are considerably less probable to prompt a surge in suicides than are newspaper stories. Research suggests that a trend appears to be emerging whereby people employ online social media to leave suicide notes, although it is not clear to what extent suicide notes on such media might induce copycat suicides (Ruder, Hatch, Ampanozi, Thali, & Fischer, 2011). Nevertheless, it is reasonable to conjecture that suicide notes left by individuals on social media may influence the decisions of other vulnerable people who run across them (Luxton, June, & Fairall, 2012).

One possible contributing cistron in suicide is brain chemistry. Contemporary neurological research shows that disturbances in the operation of serotonin are linked to suicidal behavior (Pompili et al., 2010). Depression levels of serotonin predict hereafter suicide attempts and suicide completions, and low levels accept been observed post-mortem among suicide victims (Isle of man, 2003). Serotonin dysfunction, as noted before, is also known to play an of import function in depression; depression levels of serotonin have also been linked to aggression and impulsivity (Stanley et al., 2000). The combination of these 3 characteristics constitutes a potential formula for suicide—especially violent suicide. A classic study conducted during the 1970s constitute that patients with major depressive disorder who had very low levels of serotonin attempted suicide more frequently and more violently than did patients with higher levels (Asberg, Thorén, Träskman, Bertilsson, & Ringberger, 1976; Mann, 2003).

Suicidal thoughts, plans, and fifty-fifty off-hand remarks ("I might kill myself this afternoon") should always be taken extremely seriously. People who contemplate terminating their life need immediate aid. Below are links to ii excellent websites that contain resources (including hotlines) for people who are struggling with suicidal ideation, have loved ones who may be suicidal, or who have lost loved ones to suicide: http://world wide web.afsp.org and http://suicidology.org.

Summary

Mood disorders are those in which the person experiences severe disturbances in mood and emotion. They include depressive disorders and bipolar and related disorders. Depressive disorders include major depressive disorder, which is characterized by episodes of profound sadness and loss of involvement or pleasure in usual activities and other associated features, and persistent depressive disorder, which marked past a chronic state of sadness. Bipolar disorder is characterized by mood states that vacillate between sadness and euphoria; a diagnosis of bipolar disorder requires experiencing at least i manic episode, which is defined as a menstruation of extreme euphoria, irritability, and increased activity. Mood disorders announced to have a genetic component, with genetic factors playing a more prominent role in bipolar disorder than in low. Both biological and psychological factors are important in the evolution of depression. People who suffer from mental health problems, especially mood disorders, are at heightened take chances for suicide.

Self Check Questions

Critical Thinking Question

1. Draw several of the factors associated with suicide.

Personal Application Question

2. Think of someone y'all know who seems to have a trend to make negative, self-defeating explanations for negative life events. How might this tendency lead to hereafter bug? What steps practise you think could be taken to alter this thinking way?

Answers

one. The risk of suicide is high among people with mental wellness problems, including mood disorders and substance abuse problems. The gamble is also high among those who take made a prior suicide attempt and who have lethal means to commit suicide. Rates of suicide are higher amongst men and during the springtime, and they are higher in the mountain states of the west than in other regions of the U.s.a.. Research has also shown that suicides can have a "contagious" effect on people, and that it is associated with serotonin dysfunction.

Glossary

bipolar and related disorders group of mood disorders in which mania is the defining feature

bipolar disorder mood disorder characterized by mood states that vacillate between depression and mania

depressive disorder one of a group of mood disorders in which low is the defining characteristic

flight of ideas symptom of mania that involves an abruptly switching in chat from one topic to another

hopelessness theory cerebral theory of depression proposing that a fashion of thinking that perceives negative life events as having stable and global causes leads to a sense of hopelessness and so to depression

major depressive disorder commonly referred to equally "depression" or "major depression," characterized by sadness or loss of pleasance in usual activities, as well other symptoms

mania state of farthermost elation and agitation

manic episode period in which an private experiences mania, characterized by extremely cheerful and euphoric mood, excessive talkativeness, irritability, increased activity levels, and other symptoms

mood disorder one of a group of disorders characterized by astringent disturbances in mood and emotions; the categories of mood disorders listed in the DSM-5 are bipolar and related disorders and depressive disorders

peripartum onset subtype of depression that applies to women who feel an episode of major depression either during pregnancy or in the 4 weeks post-obit childbirth

persistent depressive disorder depressive disorder characterized by a chronically sad and melancholy mood

rumination in depression, tendency to repetitively and passively dwell on one's depressed symptoms, their meanings, and their consequences

seasonal pattern subtype of low in which a person experiences the symptoms of major depressive disorder only during a particular time of twelvemonth

suicidal ideation thoughts of decease by suicide, thinking about or planning suicide, or making a suicide attempt

suicide death acquired past intentional, self-directed injurious behavior

williamssligized.blogspot.com

Source: https://courses.lumenlearning.com/psychx33/chapter/mood-disorders/

Share this post