Detecting the Mood Disorder Major Depressive Disorder Case

Detecting the Mood Disorder

Major Depressive Disorder

Case Study 1 Gary is a 19 -year-old who withdrew from local college recently after an incident involving Campus Police (“I took the responsibility to pull multiple fire alarms in my dorm to ensure that they worked, given the life or death nature of fires”). He changed his major from engineering to philosophy and increasingly reduced his sleep, spending long hours engaging his friends in conversations about the nature of reality. He had been convinced about the importance of his ideas, stating frequently that he was more learned and advanced than all his professors. He told others that he was on the verge of revolutionizing his new field, and he grew increasingly irritable and intolerant of any who disagreed with him. He also started drinking and engaging in sexual behaviors in a way that was unlike his previous history. At the present time, he has returned home and is living with his parents.

Case Study 2 Sara is 45 -year-old woman presents with a one-month history of poor sleep and irritable mood. She mentions several stressful events going on in her life right now. She is currently dealing with a recent divorce and ongoing custody battle with her former husband over their 2 teenage children. She has also just had a bad performance review at work due to her inability to meet deadlines and is fearful of losing her job. She explains that her work problems have arisen because she has been unable to keep her concentration focused on work. She expresses feelings of worthlessness and wonders sometimes what is the point of living. She has to force herself to stay engaged in her children's activities and other interests that she used to enjoy; she feels she is "just going through the motions". Her exam is notable for poor eye contact and frequent tears.

Three types of Bipolar Disorders I. Bipolar I Disorder: At least 1 or more Manic Episodes (may include one or more Depressive Episodes) II. Bipolar II Disorder: At least 1 Hypomanic Episode and at least 1 Depressive Episode III. Cyclothymic Disorder: Chronic cycling between mild hypomanic and depressive symptoms for at least a year that do not meet criteria for a Hypomanic or Depressive Episode

Diagnostic Criteria: Manic Episode A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased goal-directed activity or energy, lasting at least 1 week and present most of the day, nearly every day B. During the period of mood disturbance and increased energy or activity, three (or more) of the following symptoms (four if the mood is only irritable) are present to a significant degree and represent a noticeable change from usual behavior: 1. Inflated self-esteem or grandiosity. 2. Decreased need for sleep (e. g. , feels rested after only 3 hours of sleep). 3. More talkative than usual or pressure to keep talking. 4. Flight of ideas or subjective experience that thoughts are racing 5. Distractibility 6. Increase in goal-directed activity or psychomotor agitation 7. Excessive involvement in activities that have a high potential for painful consequences C. The mood disturbance is sufficiently severe to cause marked impairment in social or occupational functioning or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features. D. The episode is not attributable to the physiological effects of a substance or to another medical condition.

Diagnostic Criteria: Hypomanic Episode A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased goal-directed activity or energy, lasting at least 4 consecutive days and present most of the day, nearly every day B. During the period of mood disturbance and increased energy or activity, three (or more) of the following symptoms (four if the mood is only irritable) are present to a significant degree and represent a noticeable change from usual behavior: 1. Inflated self-esteem or grandiosity. 2. Decreased need for sleep (e. g. , feels rested after only 3 hours of sleep). 3. More talkative than usual or pressure to keep talking. 4. Flight of ideas or subjective experience that thoughts are racing 5. Distractibility 6. Increase in goal-directed activity or psychomotor agitation 7. Excessive involvement in activities that have a high potential for painful consequences C. The mood disturbance is sufficiently severe to cause marked impairment in social or occupational functioning or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features. D. The episode is not attributable to the physiological effects of a substance or to another medical condition.

Diagnostic Criteria: Major Depressive Disorder (MDD) DSM-V A. Five (or more) of the following symptoms have been present during the same 2 -week period and represent a change from previous functioning: at least one of the symptoms either (1) depressed mood or (2) loss of interest or pleasure. 1. 2. 3. 4. 5. 6. 7. 8. 9. Depressed mood most of the day, nearly every day, as indicated by either subjective report or observation made by others Anhedonia: Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day Significant weight loss when not dieting or weight gain, or decrease or increase in appetite nearly every day. Insomnia or hypersomnia nearly every day. Psychomotor agitation or retardation nearly every day Fatigue or loss of energy nearly every day. Feelings of worthlessness or excessive or inappropriate guilt nearly every day Diminished ability to think or concentrate, or indecisiveness, nearly every day Recurrent thoughts of death, and/or recurrent suicidal ideation

Diagnostic Criteria: Major Depressive Disorder (MDD) DSM-V B. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. C. The episode is not attributable to the physiological effects of a substance or to another medical condition. D. The occurrence of the major depressive episode is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified and unspecified schizophrenia spectrum and other psychotic disorders. E. There has never been a manic episode or a hypomanic episode.