1. Mood Disorders
Understanding & Best Treatments for Depression, Mania and Bipolar Issues

2. Two key components of moods
Depression
Low, sad emotions when life seems hopeless and overwhelming
Mania
State of breathless excitement and high energy

3. Depression
About 10% of people per year (US) feel so depressed they develop a psychological problem that needs clinical treatment. Starting in the teen years, women have twice the number of depressive episodes as men. Similar stats found across western world.
Five clinical symptoms must persist for at least two weeks. The five areas where depression expresses itself can be: BCEMS (behavior, cognition, emotions, motivation and somatic (physical). Two or more symptoms can occur in one or more of the five areas.

4. BCEMS Symptoms Defined (2 weeks plus)
Behavioral symptoms – acting less energetic & productive
Cognitive symptoms – thinking in a pessimistic way about negative way about oneself & others.
Emotional symptoms – feels little pleasure, sad, miserable or empty
Motivational symptoms – shows no drive or initiative (but up to 15% commit suicide)
Physical (Somatic) symptoms – have bodily pain or discomfort with sleeping and eating problems.

5. Types of Mood Disorders
Major depression. Having less interest in usual activities, feeling sad or hopeless, and other symptoms for at least 2 weeks may indicate depression.
Dysthymia. This is a chronic, low-grade, depressed, or irritable mood that lasts for at least 2 years.
Bipolar disorder. This is a condition in which a person has periods of depression alternating with periods of mania or elevated mood.

6. Types of Mood Disorders
Mood disorder related to another health condition. Many medical illnesses (including cancer, injuries, infections, and chronic illnesses) can trigger symptoms of depression.
Substance-induced mood disorder. Symptoms of depression that are due to the effects of medicine, drug abuse, alcoholism, exposure to toxins, or other forms of treatment.

7. Explanations for Depression
Genetic inheritance (30% depression in certain families, shown in twin studies), stressful events or life (too many pressures in a short time period, poverty), hormones (one week before menses some women have clinical signs or abnormal cortisol), and brain chemicals (low serotonin & norepinephrine).

8. Cognitive Issues – Depressive Thoughts
Seligman says people feel helpless and then hopeless because their thoughts are: internal (all my fault), stable (will not change) and global (applies to everything I do). Need to change those ideas to be more rational (more external, variable and particular).

9. Social & Cultural Issues
Depression differs a lot by gender (50% more common in women) and somewhat by social circumstances (those in poverty or with social isolation have more).
Married people have significantly less than those who are divorced. Native Americans on reservations have significantly higher rates than others.

10. Treatments: Cognitive-Behavioral Therapy
Change activity levels (Lewinsohn) and challenge your thinking (Ellis & Beck). ACT means accept & understand the depressive patterns but commit yourself to a healthy life.
1st Generation Cognitive therapy encourages people to start doing more activities while also listening to their negative or irrational thinking. Need to identify depressive thought patterns (automatic ideas, bad attitudes, errors, or believing your past, present & future are hopeless).
Once you understand your depressive thinking, you should challenge & change the messages in order to feel better and move forward.

11. Treatments for Depression
Biological therapies include psychotropic drugs (e.g. antidepressants like Prozac) or ECT (electro-convulsive therapy). Drugs increase the amount of serotonin and norepinephrine in brain. ECT involves electric shocks to brain.
ECT or shock therapy given 2-3 times per week for a few weeks stimulates the brain and restores balance in more than 65% of suicidal people.