Major Depressive Disorder ( Mdd )

Disco Di further fits the diagnostics for MDD. Disco Di has experienced a major depressive episode with the following symptoms: recurrent thoughts of suicide accompanied by attempts, feelings of worthlessness, diminished pleasure in most activities, depressed mood for most days, and alternating increases and decreases of appetite (Comer, 2012). Further, Disco Di does not fit the requirements for a manic or hypo-manic episode, therefore she qualifies for the diagnosis of MDD (Comer, 2012).

Major depressive disorder, we all have probably heard of it, but do we really know what is it is ? Major depressive disorder is “a mood disorder that causes a persistent feeling of sadness and loss of interest… major depressive disorder or clinical depression, affects how you feel, think and behave and can lead to a variety of emotional and physical problems”(Mayo Clinic Staff). Having this disorder puts you in a very unstable position because you are constantly feeling depressed so it affects the way you think and feel and that can be very dangerous. Sometimes this happens to a person for one day, but put yourself in the shoes of someone who experiencing this for more than two weeks? When you have major depressive disorder, the signs of depression disorder can last for two weeks or more(myers646). This dis order must be treated immediately because “depression may make you feel as if life isn 't worth living”(Mayo Clinic Staff). Feeling this way can lead you to doing things that you can not take back such as committing suicide and sadly that can happen when you have major depressive disorder. Kiyohara and Yoshimasu conducted a research that showed that 90% of suicides have were dealing with major depressive disorder(qtd. in The World Health Organization). Throughout this paper I will be discussing the causes, symptoms and treatment when dealing with major depressive disorder.

Major depressive disorder is a condition when a person experiences two or more weeks of depressed mood or lack of interest in things that usually gave them pleasure not due to any drugs or other medical condition. For this condition to be present a person must show at least five signs of depression (classified as: depressed mood most of the day; diminished interest in activities; significant weight loss or weight gain when not dieting; insomnia or too much sleep; lethargy; fatigue; feelings of worthlessness or inappropriate guilt; difficulty concentrating or thinking; and recurrent thoughts of death or suicide). Bipolar disorder on the other hand is when an individual alternates between hopelessness and an overexcited state of mania. Mood disorders run in families. Women are at twice the risk of having depression and today we find that depression is widespread. Although the majority of depressive episodes end on their own they are usually induced by a stressful event. The risk of suicide or self-injury is higher in individuals who are

Depression is a clinical condition associated with the normal emotions of bereavement and sadness. However, this condition does not pass on when the external causes of these emotions dissolve and is usually inconsistent to their cause. In essence, the classic severe conditions of depression have not been attributed to external precipitating cause. One of the most common conditions of depression is Major Depressive Disorder (MDD), which is a psychiatric condition that impairs moods, behavioral patterns, and thoughts for a protracted duration. This psychiatric illness tends to impair the patient’s social functioning and quality of life due to its impacts on cognitive functioning. Some of the most common symptoms of the condition include difficulty in concentration, weight change, minimal interest in pleasure, high rate of suicide, and physical impairment. The severity of this disease was evident in the year 2000 when the World Health Organization ranked it as the fourth cause of disability and premature death across the globe.

Clinical Manifestations and DSM 5 Criteria Bipolar major depression causes clinically significant distress or impairment in social, occupational or daily functioning that is not attributed by another medical condition or current substance abuse (APA, 2013). During a two week period of time, the patient will display at least five or more the following depressive symptoms daily or nearly every day: 1) depressed mood most of the day, feels sad, empty, hopeless 2) markedly diminished interest or pleasure in nearly all activities 3) significant weight loss or weight gain without purposeful dieting, increased or decreased appetite 4) insomnia or hypersomnia nearly every day 5) psychomotor agitation or retardation observable by others 6) fatigue or loss of energy 7) feelings of worthlessness or excessive feelings of guilt 8) diminished ability to think, or concentrate, indecisiveness 9) recurrent thoughts of death, suicidal ideation with or without specific plans or attempts (APA, 2013)

The purpose of this essay is to discuss the clinical differences in the diagnosis of both Major Depressive Disorder (Unipolar depression) and Bipolar Depression can be made on the basis of characteristics of a Major Depressive Episode (MDE). That is, can an MDE in patients with Major Depressive Disorder be differentiated from a MDE in patients with Bipolar Disorder? Firstly, the extremes in mood, Major Depressive Episode and mania/hypomania will be defined and it will be explained how they contribute to a diagnosis of MDD or Bipolar Disorder based on the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders. Secondly, the importance of differentiating the two disorders based on MDE characteristics will be explained. Thirdly, the literature on the clinical characteristics of MDE in Bipolar and Unipolar Depression will be reviewed. Lastly, this essay will touch on what this means for clinicians in their decisions in diagnosing patients with Major Depressive Disorder or Bipolar disorder.

When in a manic state, a person will typically show behaviors that include being very high energy, feeling very “up”, having increased activity levels, having trouble sleeping, talking really fast, thinking they can do a lot of things at one, feeling very reckless, doing risky things, and more (1). These symptoms are notably different compared to the typically behavior of the person and one can tell a distinct change in behavior. The depressive episode is characterized by symptoms that include feelings of depressed mood for most of the day, loss of interest in activities/things that normally would be pleasurable, significant weight loss or gain, changes in appetite, fatigue or lack of energy, feelings of worthlessness or guilt, and/or recurrent thoughts of death or suicide

296.32 (F33.1) Major Depressive Disorder, recurrent episode, moderate severity, with anxious distress. Ms. Client meets eight of the nine diagnostic criteria for Major Depressive Disorder (MDD). Specifically, during several periods of time she experienced depressed mood, diminished interest in things she enjoyed to do, hypersomnia, psychomotor agitation, fatigue, feelings of worthlessness, decreased concentration, and suicidal thoughts without intent. Additionally, as Ms. Client expressed, these symptoms are source of continuing distress and interfere with her academics and social functioning. Also, her symptoms started four years prior to the psychological assessment and persisted intermittently since then, lasting for several weeks to several months, with the most recent period of extended length (enduring two weeks) approximately one year ago. Since the last episode she has experienced these symptoms for two to three days at a time. Although the last episode that met the criterion of two weeks duration occurred approximately a year ago, the symptoms have not disappeared, but they occur periodically since then and when they do, they cause considerable distress and impairment in functioning. Thus, the disorder cannot be coded as ‘in partial or full remission’. The specifier ‘with anxious distress’ was given, because Ms. Client reports feelings of difficulty in concentration because of worry and restlessness.

Manic-Depressive illness is also known as bipolar disorder. This is a severe medical illness that can affect your life in crucial ways. Some people are able to read information about the disease and know they have it while others may need to a have help deciding if they are affected by a doctor. Medical tests are still not available for detecting manic-depressive illness. So, it can be very tricky discovering whether you suffer from it or another mental illness with similar symptoms. Bipolar Disorder is a brain disorder and has many serious signs and symptoms you can look for. Extreme ups and downs are the most commonly known symptoms of bipolar. Though, they vary in many different ways. Some of the symptoms include, but are not limited to:

However, at the time of publication, DMDD was unsupported by empirical evidence (Axelson, 2013). Instead, DMDD is an adapted version of severe mood dysregulation (SMD), conceptualised as a broad-phenotype of PBD (Leibenluft, Charney, Towbin, Bhangoo, & Pine, 2003). Following the elimination of the hyperarousal criterion and a decrease in the age of onset criterion, DMDD is left with just two symptoms; (1) persistently irritable or angry mood, most of the time and, (2) severe, recurrent temper outbursts inconsistent with developmental level and grossly disproportionate to the situation (for full diagnostic criteria see: APA, 2013). Neither empirical nor anecdotal justifications for the modifications have been provided by the DSM-5 work group, although it is reasonable to suggest the elimination of the hyperarousal criterion was intended to clarify the boundary between DMDD and BD/ADHD. As for the age of onset adjustment, reasoning remains elusive (Copeland et al., 2013; Hart, 2014; Johnson & McGuinness, 2014; Rao, 2014).

The Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5) describes BDII as an instability of mood categorized by the lifetime prevalence of at least one major depressive episode and at least one hypomanic episode (American Psychiatric Association, 2013). Generally speaking, a major depressive episode consists of a depressed or consistent low mood for a period of at least two weeks. A hypomanic episode on the other hand, consists of a period of elevated, expansive, or irritable mood lasting at least 4 consecutive days. Both episodes generally cause serious implications on the individual’s daily living in regards to social, academic, and work environments.

The diagnostic criteria established in the (DSM-IV TR) Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision: DSM-IV-TR, (2000), or the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (2007), represents the bench mark by which mental health care professionals in the United States diagnose mood disorders. The evaluation of an individual with a suspected mood disorder should ideally begin with a comprehensive examination by a physician. As medical conditions and side effects of medications must be ruled out as potential causes of symptoms. The medical examination should then be followed by an evaluation with a mental health professional. The evaluation by the mental health professional should include a complete history of symptoms, including when they started, how long they have lasted and how severe they are. It should also note whether the individual has experienced these symptoms before and, if so, whether and how they were treated. The

For an individual to have experienced a major depressive episode specific symptoms must last for a duration of at least two weeks where the person experiences depressed moods and showcase a lack of interest or pleasure in the majority of activities. In young adults and children the mood may seem more irritable than depressed, however this is not seen across all individuals. People suffering from this depressive state will also have to experience at least four additional symptoms for it to be classed as MDD, these can include; Fluctuations in weight; changes to the individuals sleep pattern, and psychomotor activity; feelings of worthlessness or guilt. Individuals may also find it difficult to think, concentrate, or to make decisions. Recurrent thoughts of death and/or suicide are also typical symptoms that an individual might have when suffering with MDD (DSM IV, 2005).

For the study’s purpose, MDD is separated into two different categories based on the age-of-onset: EOD and LOD.  Previous studies have indicated that EOD patients suffer more suicide attempts, irritability, sadness, childhood-onset anxiety disorders, neuroticism, and other atypical symptoms than LOD patients. Additionally, it has been found that EOD patients have a high familial risk of MDD. Though psychological and genetic correlations have been studied, little attention has been dedicated to the psychobiological differences between EOD and LOD in MDD.