------LESSON

4-----
MOOD DISORDERS AND SUICIDE

Mood- Any short-lived emotional state, usually of low intensity (e.g., a cheerful mood, an
irritable mood)

MOOD DISORDERS

DSM I-II
• Depressive disorders
• Affective disorders
• Depressive neuroses

DSM III-V
• Mood disorder

DEPRESSION is an intense feeling of sadness or worthlessness associated with disturbed
cognitive and physical functions.
• Major Depressive Episode is the most common and most severe from depression.
o To be diagnosed with a major depressive episode, an individual must
manifest depressive mood or loss of interest or pleasure most of the day or
almost every day within at least two (2) weeks leading to impairment in
activity of daily living (ADL).
o A major depressive episode can also be seen through cognitive and physical
aspects.

COGNITIVE SYMPTOMS:
• Indecisiveness
• Worthlessness
• Recurrent thoughts of death
 PHYSICAL DYSFUNCTIONS:
• Sleep deprivation
• Lack or too much appetite
• Weight loss or gain
• Psychomotor agitation or retardation
• Fatigue or loss of energy

ANHENDONIA or LOSS OR INTEREST in everything in life is said to be the hallmark of
depression.

MANIA is used to describe an abnormal and exaggerated feeling of elation, joy, or
irritability most of the day or almost every day lasting for one (1) week.

• An individual who is in a manic state tends to have an extreme interest in every
activity resulting in sleep deprivation, grandiosity, risk-taking behavior, goal
increase, and distractibility.
• Flight of ideas or racing thoughts is the hallmark of mania that can be expressed
through a rapid stream of fantastic thoughts when speaking or behaving. The
less severe form of mania is the hypomania. Hypomania does not interfere with an
individual's activities of daily living (ADL) and lasts only for four (4) days.










TYPES OF MOOD DISORDERS










• Mood Disorders may be classified as a unipolar mood disorder or bipolar
disorder, or both.
• A mood disorder may be considered as unipolar mood disorder when it has only
one (1) pole of mood either depression or mania.
• While bipolar mood disorder involves alternate mood of the depression-elation
continuum.
• Mixed features are characterized by the presence of manic symptoms but feel
somewhat depressed or vice versa.


DEPRESSIVE DISORDERS

5 TYPES OF DEPRESSIVE DISORDERS

1. Major Depressive Disorder. A major depressive disorder is diagnosed when an
individual has experienced at least one (1) depressive episode without any
symptoms of mania or hypomania lasting for two (2) weeks or more.


 • The DSM-5 indicates severity rating (mild, moderate, or severe) and eight
(8) basic specifiers to describe depression.
a. With Psychotic Features. Noted when during the period of
depression, hallucination and delusion are experienced by an
individual.
b. With Anxious Distress. Diagnosed when depression is
accompanied by anxiety symptoms or anxiety disorders.
c. With Mixed Features. The depressive mood is dominant;
however, symptoms of mania are also observed.
d. With Melancholic Features. Diagnosed when more severe
somatic symptoms occur to an individual with a major depressive
disorder such as early-morning awakenings, weight loss, loss of
libido (sex drive), excessive or inappropriate guilt, and anhedonia.
e. With Catatonia. This is characterized by the absence of movement
or catalepsy or excessive but random or purposeless movement.
f. With Atypical Features. This involves characteristics that are not
commonly seen or diagnosed to a person with depression such as
oversleeping and overeating leading to weight gain, showing
interest or pleasure to some things.
g. With Peripartum Onset. Depression is experienced by women
during the period of pregnancy and the 6-month period
immediately following childbirth.
h. With Seasonal Pattern. An individual with this condition
experiences recurrent major depressive disorder during certain
seasons and is also known as Seasonal Affective Disorder (SAD).

2. PERSISTENT DEPRESSIVE DISORDER (ALSO KNOWN AS DYSTHYMIA). This
condition is more chronic than the former wherein few as two (2) symptoms of
depressive episodes are experienced but the symptoms of depression continue
to manifest for at least two (2) years for adults and one (1) year for children.

 3. DOUBLE DEPRESSION. A condition where an individual suffers from both major
depressive episodes and persistent depression.

4. PREMENSTRUAL DYSPHORIC DISORDER (PMDD). This kind of disorder is
common for women for it occurs during the final week before and after the
most menstrual period. During the said period, women with this disorder tend to
experience lability of affect (mood swings), irritability, depression, or
anxiety.
• However, this disorder can only be diagnosed when the aforementioned
symptoms continue to preceding years.

5. DISRUPTIVE MOOD DYSREGULATION DISORDER. A condition experienced by
children age 6 to 18 years old. Children with this condition are characterized by
severe irritability or outburst that may be expressed through verbal or action.

“Health is a state of complete physical, mental and social well-being and not merely the
absence of disease or infirmity. Mental health is an integral part of this definition.” – World
Health Organization.


BIPOLAR DISORDERS

• The distinguishable feature of bipolar disorders from depressive
disorders is the tendency of manic episodes to alternate with
depressive episodes.
• In addition to the specifiers being discussed under depressive disorders,
bipolar disorders include Rapid-Cycling Specifier. This specifier
highlights condition of quick alteration of manic episodes to a
depressive episode or vice versa.

 THREE (3) COMMON BIPOLAR DISORDERS

1. Bipolar II Disorder. A bipolar disorder that is characterized by at least
one (1) major depressive episode accompanied by at least one (1)
hypomanic episode without attaining the criteria of mania. Hypomanic
episodes (at least 4 days duration).
2. Bipolar I Disorder. The individual experiences a full manic episode
preceded by major depressive episodes or hypomania. Full manic
episodes (at least 1 week duration).
3. Cyclothymic Disorder. This kind of disorder is a milder but chronic
version of bipolar disorders.
• To be diagnosed with a cyclothymic disorder, a person must have
manic or hypomanic and depressive symptoms for at least two
(2) years without reaching the symptoms of manic and depressive
episodes.

SUICIDE
• Based on the statistics provided by the World Health Organization for the year
2016, an estimated 800, 000 people worldwide die due to suicide every year,
which may be converted to one (1) person every 40 seconds.
• Moreover, WHO (2016) mentioned that suicide is known to be the second
leading cause of death among 15 to 29-year-olds worldwide.
• Whereas, according to the Union of Catholic Asian News (2020), the WHO
revealed that during the periods of the CoViD-19 pandemic, the Philippine
mental health practitioners received an average of 30 to 35 calls a day from
March to May concerning issues of depression, compared with 13 to 15 daily
calls before the pandemic (May 2019 to February 2020). The said news also
gave citation that as of May 31, 2020, the monthly average calls related to suicide
also increased to 45 calls per month.
 • In terms of age, data from WHO (2011) showed that in the Philippines, people
who belong to old age have a greater number of suicide death rates compare
to younger age group; and, in terms of gender, males than females have a
greater number of suicide death per 100, 000 population.

DEFINITION OF TERMS
• Suicidal Ideation. The thought of committing suicide.
• Suicidal Plan. Formulation of medium or method to kill oneself.
• Suicidal Attempt. The suicide was committed yet the person survives.
• Attempters. People who harm their own selves with the intent to die.
• Gesturers. People who harm their own self not to die but to seek support or to
influence somebody.

CAUSES AND TREATMENTS
Emil Durkheim, a well-known sociologist, introduced four (4) types of suicide
explaining the role of the socio-cultural dimension to suicide.
• Altruistic Suicide. This is a courageous act of killing oneself for the benefit of
others. An example of this suicide type is hara-kiri in Japan.
• Egoistic Suicide. Suicide is committed due to isolated feelings or loss of
support to society or to loss of purpose to live.
• Anomic Suicide. A person commits suicide due to a stressful situation or
significant changes in life such as killing one’s own life after bankruptcy.
• Fatalistic Suicide. Suicide is committed due to excessive social regulations
that hinder individuation or free will
• Family history, low level of serotonin, the contribution of an existing
psychological disorder, and stressful life events are also considered as risk
factors of suicide.
• Treatments such as Cognitive-Behavioral Therapy, telephone hotlines, and
other crisis intervention services, or immediate hospitalization are advised
depending on the severity and circumstances.