[MUSIC] So what are mood disorders? Mood disorders can be categorized based on the following. So either they involve depressed mood, here we're talking about things like clinical depression, also terms like polar depression, or major depression. Also can be categorized based on mood or elevated mood, things like mania or hypomania. And also cycling mood and in this case, we're talking about bipolar disorder. Some common features across these disorders would be the presence of sad, empty, or irritable mood accompanied by somatic and cognitive changes, or symptoms that affect the individual's capacity of function in normal daily life. So what differs across these different mood disorders, factors that are important, are the duration, timing, and the underlying causes. So we're talking about depression first. And major depressive disorder represents sort of the classic condition that most people associate with mood disorders. With major depressive disorder we're talking about at least two weeks of clear-cut changes in mood or affect and cognition. A diagnosis of major depressive disorder can be based on a single two week episode. However, the disorder's oftentimes is recurrent and episodes typically last longer than two weeks. Two weeks is the minimum. So these are characterized by, well I should say, normal sadness and grief are distinct from a major depressive episode. So obviously, bereavement and loss can cause suffering and sadness and grief. But that is distinct from what we're talking about with a major depressive episode. So some symptoms [COUGH] and signs of depression, and of course as we just talked about these need to last at least two weeks and be present for nearly every day. But here we're talking about things like persistent sad, anxious, or empty mood, feelings of hopelessness, irritability, feelings of guilt and worthlessness. A loss of interest or pleasure in usual hobbies and activities, decreased energy or fatigue, moving or talking more slowly. Feeling restless or having trouble sitting still, difficulty concentrating or remembering or making decisions, difficulty sleeping, appetite or weight changes. Thoughts of death or suicide, and aches and pains without a clear physical cause. Okay, so that's one example of a mood disorder. The other main mood disorder that we're going to talk about is bipolar. It is much less common than major depression, but is considered a serious mental illness. There are four basic types, all of them involve clear changes in mood and energy and activity level. And the moods range from periods of extremely up, elated, energized behavior. This is what we're talking about when we talk about manic phases or episodes. To very sad, down, or hopeless periods, here we're talking about the depression episodes. So less severe manic periods are known as hypomanic episodes, which you'll hear about more as we go forward. It's broken down into bipolar I and bipolar II. Bipolar I disorder is defined by manic episodes that last at least 7 days, or by manic symptoms that are so severe that the person needs immediate hospital care. Usually depressive episodes occur as well and this typically lasts at least 2 weeks. Bipolar II is defined by pattern of depressive episodes, and hypomanic episodes right. So here, not the full blown manic episodes we described above. And then finally, there's Cyclothymic Disorder is defined by numerous periods of hypomanic symptoms, as well as numerous periods of depressive symptoms lasting for at least two years. Okay so, what exactly are manic symptoms and here's a list of things that sort of fall in that category. Things like inflated self esteem or grandiosity, decreased need for sleep, more talkative than usual, or more pressure to keep talking. Flight of ideas, or feeling like thoughts are racing. Distractibility, increase in goal directed activity, or psychomotor agitation. Excessive involved in activities that have a high potential for painful consequences or carry a high amount of risk, things like unrestrained buying, sexual indiscretions or foolish investments. Okay, so that basically summarizes what major depression is and what bipolar disorder is. Now we're going to talk about psychosis, what is psychosis? It's important to find out here that psychosis itself is not a specific mental disorder. Psychosis is more a state of being, it's a break with reality. And so schizophrenia happens to be the most common psychotic disorder and psychosis can also happen in the context of for example depression or bipolar or substance use. But again schizophrenia is the most common psychotic disorder. Schizophrenia requires two or more symptoms. It is present for a significant portion of time during a one month period. Things like delusions, hallucinations, disorganized speech, disorganized behavior or negative symptoms for a significant portion of the time since onset functioning in one or more major areas is markedly below prior levels. So there's a big decrease in terms of functioning after the onset of the disorder, functioning may fall off in the areas of work or interpersonal relations or self care. And then also, schizophrenia is characterized by continuous signs of disturbance for at least 6 months, it can't be due to depression or bipolar or due to some kind of a medication, drug, or other medical condition. And so as you could probably imagine, if you didn't already, schizophrenia is a serious lifelong disorder that has a negative impact in terms of how a person thinks and feels and behaves. And typically the signs and symptoms that go along with schizophrenia are classified as either positive symptoms, or negative symptoms, and we will talk more about that in a second. People with schizophrenia may sometimes talk about strange or unusual ideas. They may sit for hours without moving or talking. And sometimes people with schizophrenia seem perfectly fine, until you start talking to them and then you realize that there's something wrong in terms of the way they're thinking. It's important to note that people with schizophrenia are not typically violent. So what are positive symptoms? Positive symptoms are additional behaviors, basically not generally seen in healthy people. These things include hallucinations, so basically a person who's seeing or hearing things that are not real. Hearing voices is the most common hallucination for people with schizophrenia. Delusions, another positive symptom is delusions. That's when a person believes things that are not true. So for example, they may believe that a person is communicating them through radio waves directly from the television into their head. Disordered thought, this is when a person has ways of thinking that are odd or illogical. And disordered movement, when a person exhibits abnormal body movements. So negative symptoms refer to the absence of something. So for example, social withdrawal or absence of emotions, difficulty showing emotions, talking in a dull voice, not showing facial expression, having trouble experiencing happiness. Having trouble planning and, or sticking with plans. Talking very little to other people even though it might be important. And you can imagine that the negative symptoms are often more difficult to recognize since we're talking about the absence of something. It also can be mistaken sometimes for depression. There are also cognitive symptoms and again sometimes these are not obvious. But these are the kind of things that can make it hard for a person with schizophrenia to have a job or take care of themselves. It's also important to note that the level of cognitive function, so cognitive functioning, is one of the best predictors of future improvement for people with schizophrenia. Cognitive symptoms include things like difficulty processing information, difficulty making decisions, problems using information immediately after learning it, and difficulty paying attention. So in terms of conclusions for this lecture, the depression is characterized by persistent sad mood and associated symptoms for at least 2 weeks. And bipolar characterized by manic or hypomanic episodes oftentimes interspersed with depression. Psychosis is state when a person loses touch with reality and may see or hear things that are not there. And the most common psychotic disorder is schizophrenia.
