Abnormal Psychology (COR1737)

Student ID: 4426237

Assignment 4

Question: Distinguish between normal and abnormally depressed moods and define the

term “mood disorder”.

Answer: Moods are subjective states or pervasive emotions that colour our

psychological lives. We all go through numerous emotional states – negative, positive

and neutral - during the course of a day. We all feel upset; can feel low, angry, overjoyed,

curious, fearful, and anxious and so on. Such moods or emotional states are variable for

different people but when are these feeling overly intense, inappropriate, lasting to long

and need investigation? Scientists from many different disciplines have struggled with the

issue of defining what is normal and what is abnormal or pathological with respect to

human bodily or mental states and human behavior (Mehu et al., 2015). Nevertheless,

when an individual experiences frequent or immensely intense emotional upheaval or

mood disturbances that they disrupt the daily life, including work and relationships, it may

be a sign of an underlying condition that needs treatment (Angst et al., 1884).

The fluctuations in our moods and emotions are dependent both on internal changes

within our lives as well as stimuli in our environment. For example, one may feel elated

when one’s favorite contestant wins a reality show. It is natural to feel downcast or

dejected when a long-term relationship ends in a break-up and yet again, sometimes it is

normal to feel gloomy or miserable for no particular reason. People with mood disorders

also go through such mood fluctuations but their fluctuations lend them a distorted view

of life, are acute and impair their ability to function. Such ‘mood swings’ are often

described as “rollercoaster” of emotions and contentment to anger, irritability, and even

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depression. Even though a person may recognize the trigger that cause the shift in mood

such as not doing well in a test or another stressful event at work but it is not uncommon

of such mood swings to occur without any obvious reason.

Mood disorder: a persistent feeling of either extreme sadness or extreme

happiness.

Image source: TOI/timesofindia.indiatimes.com

Mood disorder, hence, can be defined as a condition that primarily affects a person's

emotional state wherein s/he may experience long periods of extreme happiness,

sadness, or both that can cause changes in behavior and affect a person's ability to

function in daily life, such as at work or school. Major depressive disorder is a common

mood disorder.

Question: Distinguish between unipolar and bipolar disorders. Include definitions and

outline the features of major depressive, dysthymic, bipolar and cylcothymic disorders.

Answer: Mood disorders are those in which a person experiences severe and intense

disturbances and moods and emotional states. Mood disorders are classified into two

major categories: Unipolar and Dipolar Disorders.

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Consider the following figure showing mood continuum:
cont

Mood Thermometer: The figure shows the spectrum of moods that individuals experience. The
two ends of this line segment signify the two extreme states of depression and mania. A
gradient of moods occupy t he space in in-between including the normal levels of emotional
states.

Image source: practicalpainmanagement.com

As the name suggest, unipolar disorders are single poled. They occupy one end of the

mood spectrum and included lower to lowest emotional states including major

depressive disorder and persistent depressive disorders as well as dysthymia. On

poled and occupy both sides of the mood

the other hand bipolar disorders are dual-poled

thermometer signifying varying levels of severity of emotions between depression and

mania and include bipolar II, bipolar II and cylcothymic disorders..

epressive disorders are a group of disorders in which depression is the main

Unipolar depressive

feature. Depression is a vague term that, in everyday language, refers to an intense and

state it consists of a broad

persistent sadness. Depression is a heterogeneous mood state—it

Depressed people feel sad, discouraged,

spectrum of symptoms that range in severity. Depressed

and hopeless. These individuals lose interest in activities once enjoyed, often experience

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a decrease in drives such as hunger and sex, and frequently doubt personal worth.

Depressive disorders vary by degree, but this module highlights the most well-known:

major depressive disorder (sometimes called unipolar depression).

Bipolar 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, behave recklessly, or attempt to take on many tasks

simultaneously. The most recognized of these disorders is bipolar disorder.

Unipolar disorders: As mentioned earlier, unipolar disorders include major depressive

disorder and persistent depressive disorder.

As the name suggests, the most striking feature or symptom of major depressive

disorder is depression, most of the day, nearly every day and loss of interest and

pleasure in usual activities (APA 2013). People with this depression will no longer show

interest or enjoyment in activities that previously were gratifying, such as hobbies, sports,

sex, social events, time spent with family, and so on. Along with depressed mood and

lack of interest in usual activities, major depression is mostly associated with symptoms

such as changes in appetite, sleep patterns, feelings of fatigue and of energy being

sapped, sense of worthlessness or low self esteem, misplaced guilt, trouble focusing and

thinking clearly, suicidal ideation and attempts or psychotic tendencies and behaviors

including hallucinations and delusions.

Major depressive disorder (MDD) is considered episodic: its symptoms are typically

present at their full magnitude for a certain period of time and then gradually abate. That

said, nearly 50-60% of people who experience major depression have greater probability

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of a repeat incidence at some point in future and there is high likelihood similar episodes

thereafter.

MDD can have incapacitating and devastating effect on the quality of one’s life which

often results in unavailability for work or education, abandonment of promising careers,

and lost wages; occasionally, the condition requires hospitalization. At societal level,

majority of people with MDD face some kind of discrimination, have trouble initiating

relationships and finding work and education for which they are very well qualified. It also

impacts health of people who already have pre-existing heart conditions leading to

adverse cardiovascular outcomes and onset of heart diseases in healthy MDD patients

(Whooley, 2006).

Major Depressive Disorder: A person with MDD may feel like it’s not worth
living anymore

Image source: istockphoto.com/Antonuk

Persistent depressive disorder (PDD), as the name suggests, are emotional states that

persist most of the day, nearly every day lasting at least two years as well as at least two

of the other symptoms of major depressive disorder. People with PDD may have either

chronic MDD or milder form of depression called Dysthymia. Dysthymic tendencies

often begin in childhood and take chronic shape through adulthood making the

depressive states persistent. People with persistent depressive disorder are chronically

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sad and melancholy, but do not meet all the criteria for major depression. However,

episodes of full-blown major depressive disorder can occur during persistent depressive

disorder. Due to its chronic nature, the PDD becomes a deeply ingrained part of the

personality. The ramifications of the latter can be seen people’s perception of individual’s

with PDD as irrational whining or complaining. Resultantly, the impact of such

perceptions may reflect adversely in the social circle and occupational functioning of

people with PDD.

In both MDD and PDD the mood disturbance travels downwards which means they are

unipolar disorders while some people may have mood disturbances fluctuating in both

directions to variable degrees, towards both poles exceeding the usual ups and downs of

everyday life. Such disorders are bipolar disorders.

Bipolar disorders: A person with bipolar disorder (commonly known as manic

depression) often experiences mood states that vacillate between depression 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). Since in bipolar

disorders, mania is the defining feature, for a person to be diagnosed with bipolar

disorder a person must have experienced at least one manic episode in his life despite of

not having any past or present major depressive disorder.

The different types of mood episodes experienced by people with bipolar disorder include

manic episodes, hypomanic episodes, major depressive episodes, and mixed types.

Manic episodes are distinct periods of abnormally and persistently elevated or irritable

mood that begin abruptly while they last for at least one week and can cause marked

social or occupational impairments when they are severe. During a manic episode, some

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experience a mood that is almost euphoric and become excessively talkative, sometimes

spontaneously starting conversations with strangers; others become excessively irritable

and complain or make hostile comments. The person may talk loudly and rapidly – with

pressured speech, exhibiting flight of ideas, abruptly switching from one topic to

another. These individuals are easily distracted, which can make a conversation very

difficult. They may exhibit grandiosity, in which they experience inflated but unjustified

self-esteem and self-confidence.

Like manic episodes, hypomanic episodes are also periods of abnormally and

persistently elevated or irritable moods but hypomanic episodes last for at least four

consecutive days and present at most hours of the day nearly every day. One could say

that these are toned down manic episodes. Hypo means "under," and it is used in

hypomania because this mood state is under, or less manic, than mania.

Mixed episodes are periods where mania and depression occur at the same time. For

example, someone may experience the extreme agitation and restlessness associated

with mania and the suicidal thinking more attributed to depression at the same time

during a mixed episode.

Bipolar disorder: transmigration between extremes of elation and

depressive states

Image source: electravk/gettyimages

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The duration, frequency and nature of episodes define the type of disorder a person has.

As mentioned earlier, there are three types of bipolar disorders: bipolar disorder I, bipolar

II and cylcothymic disorder (refer to the table below).

Main Feature Bipolar I Disorder Bipolar II Disorder Cylcothymic Disorder

Mania At least one manic episode At least on hypomanic At least two years (recurrent

episode chronic pattern) of hypomanic

symptoms (no manic episodes)

Depression Not necessary but could At least one major At least two years of depressive

lead to a major depressive depressive episode symptoms (no major depressive

episode episodes)

Bipolar and unipolar disorders, hence, share the same symptoms with three main

differences:

1) Bipolar depression is more episodic than unipolar,

2) Bipolar depression may tip into mania

3) Due to the mania risk, bipolar depression treatment is different than unipolar

depression treatment.

Unipolar and bipolar depression will look the same on a depression scale. The way a

person thinks, talks, and acts will be the same. The main difference is in treatment

protocol due to bipolar depression’s close association with mania.

When looked at in wave graph, the unipolar and bipolar wave formats succinctly differ in

amplitudes and frequency of key elements of depression and mania as shown in the

wave graph below:

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 Mood changes overtime bipolar I, bipolar II and recurrent unipolar depressive disorder
(M= mania; m= hypomania; D=depression)

Source: https://tpb.psy.ohio-state.edu/6853-6854

Mood disorders – both unipolar and bipolar - should be properly evaluated and treated by

a mental health professional, such as a psychiatrist. If any of the symptoms interfere with

an individual’s life, particularly if it involves suicidal thoughts, help should be sought

immediately.

Question: Discuss seasonal affective disorder and postpartum depression.

Answer: Seasonal affective disorder and postpartum depression are two subtypes of

major depressive disorder.

Season affective disorder (SAD) 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) when sunlight is not as readily available and usually improves with the arrival

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of spring. Common symptoms of SAD include fatigue, even with too much sleep, and

weight gain associated with overeating and carbohydrate cravings. SAD symptoms can

vary from mild to severe. In everyday language, people often refer to this subtype as the

winter blues. However, SAD is more than just winter blues. The symptoms can be

distressing and overwhelming and can interfere with daily functioning. It is more common

in women than in men and younger adults. The incidence of SAD increases with the

decrease in daylight hours – moving away from equator.

SAD has been linked to biochemical imbalance in brain prompted by changes in seasons

resulting in a shift in the biological internal clock that regulates the body temperature and

sleep-wake cycles. It is also linked with deficient transmission of serotonin (mood-

regulating neurotransmitter) during winter months. Whatever the etiology, SAD can be

effectively treated in several ways, including light therapy (phototherapy), antidepressant

medications (Prozac), talk therapy or some combination of these. Phototherapy, involves

sitting in front of a light therapy box that emits a very bright light (and filters out harmful

ultraviolet (UV) rays) 30 minutes to 3 hours a day. Light directed towards eyes works

better than light directed towards skin. While symptoms will generally improve on their

own with the change of season, symptoms may improve more quickly through a

combination of treatments.

Peripartum onset (commonly referred to as postpartum depression), applies to

women who experience major depression during pregnancy or in the four weeks

following the birth of their child. This depression is a serious, but treatable medical

condition involving feelings of extreme sadness, indifference and/or anxiety, low self-

esteem, as well as changes in energy, sleep, and appetite. The severity of symptoms

may vary and may cause mothers to feel isolated, guilty or ashamed as well. Postpartum

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depression is different from the “baby blues” in that it is emotionally and physically

debilitating and even though it remits during first three months after childbirth, in some

cases it may continue for years. Even though postpartum depression is a global

phenomenon, cultural factors may place a significant role dealing with such depression.

They may trigger postpartum depression as well as contribute to the alleviation of its

depressive symptoms (Bina, 2008). It could be due to stigma associated with depression

and non-availability of social support during depression which may influence the inability

to report depressive symptoms. However, the gravity of postpartum depression must not

be made light of as some women with this disorder may fall prey to suicidal ideation.

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References:

Angst J, Dobler-Mikola A. The Zurich study: II. The continuum from normal to

pathological depressive mood swings. Archiv für Psychiatrie und Nervenkrankheiten.

1984;234(1):21-29.

Bina R. The Impact of Cultural Factors Upon Postpartum Depression: A Literature

Review

August 2008Health Care For Women International 29(6):568-92

Mehu M., Scherer K. R. Normal and Abnormal Emotions--The Quandary of Diagnosing

Affective Disorder: Introduction and Overview. Emotion Review, 2015; 7 (3): 201 IN :

SAGE Publications. (2015, June 25). Are your emotional responses normal or abnormal?

Report examines the difference between normal, abnormal emotion in how we diagnose

depression. ScienceDaily. Retrieved March 26, 2021 from

www.sciencedaily.com/releases/2015/06/150625080932.htm

Whooley MA, de Jonge P, Vittinghoff E, Otte C, Moos R, Carney RM, Ali S, Dowray S,

Na B, Feldman MD, Schiller NB, Browner WS: Depressive symptoms, health behaviors,

and risk of cardiovascular events in patients with coronary heart disease. JAMA. 2008,

300: 2379-2388. 10.1001/jama.2008.711. IN: Freedland, K.E., Carney, R.M. Depression

as a risk factor for adverse outcomes in coronary heart disease. BMC Med 11, 131

(2013). https://doi.org/10.1186/1741-7015-11-131

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