Mood Disorders and Suicide
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Kay Redfield Jamison, a psychologist who studies mood disorders, is uniquely qualified to report and reflect on such disorders. Not only has she made mood disorders her area of professional expertise, but she has also lived with such a disorder. In her memoir, An Unquiet Mind (1995), Jamison recounts her experiences. The youngest of three children in a military family, she and her siblings attended four different elementary schools—some in foreign countries—by the time she was in 5th grade. She describes her father, a meteorologist and Air Force officer, as enthusiastic, with infectious good moods, and impulsive, often giving the children gifts. However, he also suffered periods when he was immobilized by depression, and he generally had trouble regulating his emotions.
As we’ll see in this chapter, Jamison herself developed difficulties regulating her emotions. She recounts that when she was a senior in high school, her mood became so dark that her thinking
…was torturous. I would read the same passage over and over again only to realize that I had no memory at all for what I had just read. Each book or poem I picked up was the same way. Incomprehensible…I could not begin to follow the material presented in my classes…. It was very frightening…[my mind] no longer found anything interesting or enjoyable or worthwhile. It was incapable of concentrated thought and turned time and time again to the subject of death: I was going to die, what difference did anything make? Life’s run was only a short and meaningless one, why live?…I dreaded having to talk with people, avoided my friends whenever possible…. (Jamison, 1995, p–38)
CHAPTER OUTLINE
Depressive Disorders
Major Depressive Episode
Major Depressive Disorder
Depression in Children and Adolescents
Persistent Depressive Disorder
Understanding Depressive Disorders
Treating Depressive Disorders
Bipolar disorders
Mood Episodes for Bipolar Disorders
The Two Types of Bipolar Disorder
Cyclothymic Disorder
Understanding Bipolar Disorders
Treating Bipolar Disorders
Suicide
Suicidal Thoughts and Suicide Risks
Understanding Suicide
Preventing Suicide
Mood disorders Psychological disorders characterized by prolonged and marked disturbances in mood that affect how people feel, what they believe and expect, how they think and talk, and how they interact with others.
In this passage, Jamison describes problems arising from her mood, a persistent emotion lurking in the background, regardless of what is occurring. The general category of psychological disorders referred to as Mood disorders encompasses prolonged and marked disturbances in mood that affect how people feel, what they believe and expect, how they think and talk, and how they interact with others. In any particular year, about 9% of Americans experience a mood disorder (Centers for Disease Control and Prevention [CDC], 2010a). Mood disorders are among the leading causes of disability worldwide (World Health Organization [WHO], 2008).
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DSM-5 distinguishes between two categories of mood disorders: depressive disorders and bipolar and related disorders. Depressive disorders are mood disorders in which someone’s mood is consistently low; in contrast, bipolar disorders are mood disorders in which a person’s mood is sometimes decidedly upbeat, perhaps to the point of being manic, and sometimes may be low. Mood disturbances that are part of depressive disorders and bipolar disorders are not the normal ups and downs that we all experience; they are more intense and longer lasting than just feeling “blue” or “happy.”
DSM-5 defines three types of mood episodes as the foundations of mood disorders: major depressive episode, manic episode, and hypomanic episode (see TABLE 5.1). If a patient experiences different types of mood episodes over time (or a different mixture of such episodes), his or her diagnosis may change. We will first examine depressive disorders—what they are and their causes and treatments—and then consider bipolar and related disorders. Once we know more about mood disorders, we’ll examine what is known about suicide and how to prevent it.