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Here is a compilation of essays on ‘Mood Disorders’ for class 11 and 12. Find paragraphs, long and short essays on ‘Mood Disorders’ especially written for school and college students.
Essay on Mood Disorders
Essay Contents:
- Essay on Unipolar Disorder
- Essay on Bipolar Disorder
- Essay on Dysthymic Disorder
- Essay on Cyclothymic Disorder
- Essay on Rapid Cyclers
1. Essay on Unipolar Disorder:
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This is one of the commonest psychiatric disorders.
Classification:
(a) Unipolar and bipolar mood disorders:
Unipolar:
Unipolar those with a history of at least three separate episodes of retarded/psychotic depression, complete remission in between and no episode of mania.
Bipolar:
Bipolar those who had at least one episode of depression and one of mania; where repeated manic episodes occur, the disorder is also classified bipolar.
(b) Psychotic versus neurotic:
Confusing because psychotic does not necessarily describe the presence of delusions, hallucinations.
(c) Endogenous versus exogenous (reactive):
Table 16.2 shows the differences between endogenous and exogenous depression.
Clinical Picture:
The common symptoms are:
(i) Dysphoric mood
(ii) Loss of interest or pleasure
(iii) Changes in psychomotor activity:
Changes in psychomotor activity. There may be—Agitation, Retardation.
(iv) Changes in appetite and weight:
There is usually loss of appetite and weight. Occasionally there may be increased appetite and weight.
(v) Sleep:
Insomnia but sometimes with hypersomnia.
(vi) Sexual activity:
There is often lack of interest.
(vii) Sense of worthlessness, hopelessness, helplessness or excessive guilt.
(viii) Cognitive impairment.
(ix) Thoughts of death or suicide.
(x) Other features:
Other features menstrual or sexual disturbances, revival memories, sense of “presence”, fear, brooding, excessive concern with physical health and even mood-congruent and less often mood-incongruent delusions or hallucinations (hallucinations when present are transient, not elaborate and involve voices that criticize the individual for his or her shortcomings or sins).
(xi) Atypical Depression:
These are depressive syndromes which do not have classical or typical feature of depression. There may be depression with predominant anxiety, phobic anxiety depersonalization syndrome (described by Roth), non endogenous depression (due to stress) or hysteroid dysphoric syndrome.
(xii) Double Depression:
Major depressive episode on underlying dysthymia.
(xiii) Cotard’s Syndrome (Nihilistic delusions):
It is characterized by delusions of negative, to a varying degree. Patients may believe that their bodies or self has disappeared and they no longer exist, even that the whole universe no longer exists.
Differential diagnosis of major depressive episode:
(a) Organic Mood (Affective) Syndrome with depression.
(b) Primary Degenerative or Multi infarct Dementia.
(c) Schizophrenia
(d) Schizoaffective
(e) Dysthymic and Cyclothymic disorders
(f) Chronic Mental Disorders
(g) Anxiety disorders
(h) Uncomplicated bereavement
(i) Others, e.g. Primary hypochondriasis, traumatic neurosis or Adjustment disorder with depressive features.
2. Essay on Bipolar Disorder:
(Manic Episode):
Classification:
Bipolar I:
This is characterized by episodes of severe mania and severe depression.
Bipolar II:
There are episodes of hypomania (not requiring hospitalization) and severe depression.
(i) Hypomania:
Mild condition, characterized by predominant euphoria, over activity and dis-inhibition.
(ii) Acute mania:
Severe condition, showing transient grandiose delusions, a labile mood and sometimes incoherent talk.
(iii) Delusional mania:
Characterized by less excitement, more persistent grandiose delusions and even occasional hallucinations.
(iv) Bell’s mania or delirious mania:
Frenzied over activity, (depression, panic to excitement), variable delusions, vivid hallucinations, disorientation for time and place together with dehydration and lack of drinking and eating.
(v) Secondary mania:
Mania can be due to drugs (tricyclic antidepressants, MAO inhibitors, cortcosteroids, amphetamines, L- dopa and INH), thyrotoxicosis, acute and chronic organic mental syndrome, influenza, encephalitis, multiple sclerosis, rheumatic chorea, cerebral tumours and temporal lobe epilepsy.
(vi) Chronic mania:
The patients lose their euphoria, become irritable and resentful and acquire a paranoid-like attitude.
Clinical Picture:
(i) Mood:
Mood elevation Euphoria (mild elevation or Stage I), Elation (moderate or Stage II), Exaltation (severe or Stage III), ecstasy (very severe elevation or Stage IV), irritable or infectious, labile.
(ii) Psychomotor Activity:
Psychomotor Activity is often increased, increased sociability, buying sprees, reckless driving, foolish business investments and promiscuous sexual behaviour.
(iii) Speech:
Speech is typically loud, rapid and difficult to interrupt (i.e. pressure of speech). Sounds rather than meaningful conceptual relationships may govern word choice (clanging).
(iv) Thinking:
Thinking there is flight of ideas (i.e. nearly continuous flow of accelerated speech with abrupt changes from topic to topic usually based on understandably associations, distracting stimuli or plays on words).
(v) Attention:
Distractibility is usually present.
(vi) Sleep:
Decreased need for sleep.
(vii) Self-worth:
There is inflated self-esteem.
(viii) Lability of Mood.
(ix) Libido:
It is often increased.
Differential diagnosis of manic episode:
(a) Organic Mood (Affective) Syndrome
(b) Paranoid Schizophrenia
(c) Schizo affective disorder
(d) Cyclothymic Disorder
Diagnosis:
A reliable detailed history, mental state examination, and clinical response usually with full remission help diagnosing an affective disorder.
Laboratory tests which can be used in the diagnosis and treatment of depression are:
(i) Dexamethasone Suppression Test (DST):
About half of depressed patients respond normally but the other half fail to suppress Cortisol production.
(ii) TRH (Thyrotrophic releasing hormone) Stimulation Test:
TRH (Thyrotrophic releasing hormone) Stimulation Test 30 – 40%, depressives fail to increase the levels of TSH.
(iii) Alteration in Sleep:
Decreased REM latency, increased density of REM sleep in the first half of sleep, decreased percentage of deep sleep.
Complications:
Substance abuse, financial losses, illegal activities, sexual promiscuity, assaults and suicide, homicides and drug abuse.
3. Essay on Dysthymic Disorder (Depressive Neurosis):
The essential feature of this disorder is a chronic disturbance of mood (depressive) of at least two years duration but not of sufficient severity and duration to meet the criteria of a depressive syndrome.
Epidemiology:
4.5% to 10.5% (ratio of females: males is 2-3:1).
Clinical Picture:
The symptoms are less severe and are not pervasive (as in major depression) and of more than two years duration. There are also normal periods which may last a few days to a few weeks. If the remission is more than a few months, then the diagnosis is not made.
There are no delusions or hallucinations.
Differential Diagnosis:
(a) Major depressive episode
(b) Other personality disorders e.g. Borderline, Histionic and dependant personality disorder.
(c) Chronic mental disorders. Alcohol dependence with depressive symptoms.
(d) Normal fluctuations of mood.
4. Essay on Cyclothymic Disorder:
The essential characteristic of this disorder is a chronic mood disturbance of at least two years duration, involving numerous periods of depression and hypomania, but not of sufficient severity and duration to meet the criteria for a major depressive or a manic episode.
Epidemiology:
Less than 1% of the population, more common in females.
Clinical Features:
The clinical features of depressive aspect of cyclothymic disorder are same as discussed for dysthymic disorder. There is also hypomanic episode which is similar to manic episode except that the individual does not suffer marked impairment of functioning.
Differential Diagnosis:
Major mood disorders, personality disorders and substance abuse disorder.
5. Essay on Rapid Cyclers:
In 1974, Dunner and Fieve coined the term ‘rapid’ cyclers to describe a subgroup of bipolar patients who have frequent affective episodes (more than four or more per year) and often respond poorly to lithium carbonate prophylaxis.
Etiology of Mood Disorders:
(a) Biochemical theories Neurotransmitters:
(i) Deficiency of Norepinephrine and Serotonin has been found in depressed patients.
(ii) Levels of norepinephrine, 5-HT and its metabolites are elevated in mania.
(b) Genetic theories:
(i) In First Degree Relatives, prevalence is approximately 20% for bipolar disorder, 10- 15% for unipolar disorder with 1-3% in general population.
(ii) Twins: Monozygotic versus Dizygotic: 68: 20%.
(iii) Genetic marker is linked to short arm of Chromosome II.
(c) Psychological theories:
(i) Early Childhood Experiences:
a. ‘Maternal deprivation’.
b. Prolonged absence of a parent
(ii) Sociological:
a. Life events.
b. Environmental stress
c. Chronic conditions
(iii) Behavioural:
Depression is conditioned by the repeated losses in the past.
(iv) Psychoanalytic theories:
i. Depression results due to loss of a ‘love object’.
(v) Premorbid personality:
i. Cyclothymic personality.
(d) Organic causes:
(i) Endocrine disorders
(ii) Anemia.
(iii) Infective.
(iv) Neurological, Epilepsy, Encephalitis, Head injury, Stroke.
(v) Drugs e.g., reserpine, alpha-methyldopa, clonidine, L-dopa, steroids, barbiturates, amphetamines, alcohol, neuroleptics (cause depression), anti-depressants (mania) etc.
(vi) Others e.g., Dialysis, chronic renal failure, cerebral ischaemia, Porphyria, temporal arteritis, Wilson’s disease etc.
(e) Biological theories:
(i) Circadian rhythm:
Disruption in circadian rhythms.
(ii) Seasonal affective disorder:
A subgroup of depressed individuals who are afflicted only during the months with fewer hours of sunlight known as seasonal mood disorder have been identified. These patients have been treated with increased exposure to light.
(iii) Anatomical studies:
The lesions in frontal or temporal region may be associated with affective disorders (left-sided associated with depression and right sided with mania).
(iv) CT Scan:
15-25% of the patients show enlarged venricles.
Course:
Both major depressive episodes and mania remit spontaneously in a majority of cases, but have tendency to relapse. An untreated manic episode lasts for about 6 months whereas an untreated depressive episode lasts for about 9 months.