Depressive Disorders
Name the Depressive Disorder:
In the majority of menstrual cycles, at least five symptoms must be present in the final week before the onset of menses, start to improve within a few days after the onset of menses, and become minimal or absent in the week postmenses.
Marked affective lability (e.g., mood swings; feeling suddenly sad or tearful, or increased sensitivity to rejection).
Marked irritability or anger or increased interpersonal conflicts.
Marked depressed mood, feelings of hopelessness, or self-deprecating thoughts.
Marked anxiety, tension, and/or feelings of being keyed up or on edge.
One (or more) of the following symptoms must additionally be present, to reach a total of five symptoms when combined with symptoms from Criterion B above.
Decreased interest in usual activities (e.g., work, school, friends, hobbies).
Subjective difficulty in concentration.
Lethargy, easy fatigability, or marked lack of energy.
Marked change in appetite; overeating; or specific food cravings.
Hypersomnia or insomnia.
A sense of being overwhelmed or out of control.
Physical symptoms such as breast tenderness or swelling, joint or”
“muscle pain, a sensation of “bloating,” or weight gain.
Note: The symptoms in Criteria A–C must have been met for most menstrual cycles that occurred in the preceding year.
The symptoms cause clinically significant distress or interference with work, school, usual social activities, or relationships with others (e.g., avoidance of social activities; decreased productivity and efficiency at work, school, or home).
Premenstrual Dysphoric Disorder
Name the Mood Disorder:
For at least 2 years (at least 1 year in children and adolescents) there have been numerous periods with hypomanic symptoms that do not meet criteria for a hypomanic episode and numerous periods with depressive symptoms that do not meet criteria for a major depressive episode.
During the above 2-year period (1 year in children and adolescents), Criterion A symptoms have been present for at least half the time and the individual has not been without the symptoms for more than 2 months at a time.
Criteria for a major depressive, manic, or hypomanic episode have never been met.
The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Cyclothymic Disorder
Name the Disorder:
The presence of one (or more) delusions with a duration of 1 month or longer.
Hallucinations, if present, are not prominent and are related to the delusional theme (e.g., the sensation of being infested with insects associated with delusions of infestation).
Apart from the impact of the delusion(s) or its ramifications, functioning is not markedly impaired, and behavior is not obviously bizarre or odd.
If manic or major depressive episodes have occurred, these have been brief relative to the duration of the delusional periods.
The disturbance is not attributable to the physiological effects of a substance or another medical condition and is not better explained by another mental disorder, such as body dysmorphic disorder or obsessive-compulsive disorder.
Delusional Disorder
Name the Disorder:
A problematic pattern of alcohol use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period:
Alcohol is often taken in larger amounts or over a longer period than was intended.
There is a persistent desire or unsuccessful efforts to cut down or control alcohol use.
A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects.
Craving, or a strong desire or urge to use alcohol.
Recurrent alcohol use resulting in a failure to fulfill major role obligations at work, school, or home.
Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol.
Important social, occupational, or recreational activities are given up or reduced because of alcohol use.
Recurrent alcohol use in situations in which it is physically hazardous.
Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol.
Tolerance, as defined by either of the following:
A need for markedly increased amounts of alcohol to achieve intoxication or desired effect.
A markedly diminished effect with continued use of the same amount of alcohol.
Withdrawal, as manifested by either of the following:
The characteristic withdrawal syndrome for alcohol (refer to Criteria A and B of the criteria set for alcohol withdrawal).
Alcohol (or a closely related substance, such as a benzodiazepine) is taken to relieve or avoid withdrawal symptoms.
Alcohol Use Disorder
What's the difference between an independent mental disorder and a substance-induced disorder?
The substance-induced mood disorder will mimic its corresponding independent affective disorder. Thus, substance-induced depression will follow diagnostic criteria used to evaluate for depressive disorders, and substance-induced bipolar disorder will reflect that of the bipolar spectrum disorders. As implied by the title 'substance-induced', either admission of the ingestion of a substance or a positive laboratory test is necessary for a valid diagnosis. Temporality is the easiest feature to differentiate an independent affective disorder from a substance-induced one. As mentioned previously, symptoms of a substance-induced mood disorder will resolve following the cessation of severe intoxication or acute withdrawal (up to 1 month).
The disorder is not better explained by an independent mental disorder. The disorder preceded the onset of intoxication or withdrawal or exposure to the medication. The full mental disorder persisted for at least 1 month after cessation of acute withdrawal or intoxication or taking the medication.
Intoxication and withdrawal induced disorders resolve without psychotropic medications. Occasionally psychotropic medications may be needed for agitation. Independent disorders may require psychotropic medications
Name the Depressive Disorder:
Severe recurrent temper outbursts manifested verbally (e.g., verbal rages) and/or behaviorally (e.g., physical aggression toward people or property) that are grossly out of proportion in intensity or duration to the situation or provocation.
The temper outbursts are inconsistent with developmental level.
The temper outbursts occur, on average, three or more times per week.
The mood between temper outbursts is persistently irritable or angry most of the day, nearly every day, and is observable by others (e.g., parents, teachers, peers).
Criteria A–D have been present for 12 or more months. Throughout that time, the individual has not had a period lasting 3 or more consecutive months without all of the symptoms in Criteria A–D.
Criteria A and D are present in at least two of three settings (i.e., at home, at school, with peers) and are severe in at least one of these.
The diagnosis should not be made for the first time before age 6 years or after age 18 years.
By history or observation, the age at onset of Criteria A–E is before 10 years.
There has never been a distinct period lasting more than 1 day during which the full symptom criteria, except duration, for a manic or hypomanic episode have been met.
Disruptive Mood Dysregulation Disorder
Name the Mood Disorder:
Criteria have been met for at least one hypomanic episode and at least one major depressive episode.
There has never been a manic episode.
At least one hypomanic episode and at least one major depressive episode.
The symptoms of depression or the unpredictability caused by frequent alternation between periods of depression and hypomania causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Hypomanic Episode
A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 4 consecutive days and present most of the day, nearly every day.
During the period of mood disturbance and increased energy and activity, three (or more) of the following symptoms (four if the mood is only irritable) have persisted, represent a noticeable change from usual behavior, and have been present to a significant degree:
Inflated self-esteem or grandiosity.
Decreased need for sleep (e.g., feels rested after only 3 hours of sleep).
More talkative than usual or pressure to keep talking.
Flight of ideas or subjective experience that thoughts are racing.
Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli), as reported or observed.
Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation.
Excessive involvement in activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments).
The episode is associated with an unequivocal change in functioning that is uncharacteristic of the individual when not symptomatic.
The disturbance in mood and the change in functioning are observable by others.
The episode is not severe enough to cause marked impairment in social or occupational functioning or to necessitate hospitalization.
Bipolar II Disorder
Name the Mood Disorder:
Two (or more) of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated). At least one of these must be (1), (2), or (3):
Delusions.
Hallucinations.
Disorganized speech (e.g., frequent derailment or incoherence).
Grossly disorganized or catatonic behavior.
Negative symptoms (i.e., diminished emotional expression or avolition).
An episode of the disorder lasts at least 1 month but less than 6 months.
1) no major depressive or manic episodes have occurred concurrently with the active-phase symptoms, or 2) if mood episodes have occurred during active-phase symptoms, they have been present for a minority of the total duration of the active and residual periods of the illness.
The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.
Schizophreniform Disorder
Which substances have the higher severities of tolerance/withdrawal potential?
Which substances require detox?
SEVERE (DETOX):
ALCOHOL
BENZOS
OPIOIDS
MINOR:
CAFFEINE
CANNABIS
STIMULANTS
TOBACCO
NONE:
INHALANTS
PCP
HALLUCINOGENS
What defines "full remission" during a depressive episode?
What are the names of the MDD specifiers and the symptoms of atypical features specifier?
Major depressive disorder, partial remission: Symptoms of the immediately previous major depressive episode are present but full criteria are not met, or there is a period lasting less than 2 months without any significant symptoms of a major depressive episode following the end of such an episode.
Major depressive disorder, in full remission--During the past 2 months, no significant signs or symptoms of the disturbance were present.
MDD specifiers:
Mild: Few, if any, symptoms in excess of those required to make the diagnosis are present, the intensity of the symptoms is distressing but manageable, and the symptoms result in minor impairment in social or occupational functioning.
moderate: The number of symptoms, intensity of symptoms, and/or functional impairment are between those specified for “mild” and “severe.”
Severe without psychotic features: The number of symptoms is substantially in excess of that required to make the diagnosis, the intensity of the symptoms is seriously distressing and unmanageable, and the symptoms markedly interfere with social and occupational functioning.
recurrent: A recurrent depressive disorder is characterized by repeated episodes of depression without any history of independent episodes of mood elevation and increased energy or mania. There has been at least one previous episode lasting a minimum of two weeks and separated by the current episode of at least two months. At no time in the past has there been any hypomanic or manic episodes.
“Atypical features are HEAVY:”
- Heavy weight (overeating),
- heavy sleep (hypersomnia)
- heavy limbs (leaden paralysis in arms or legs)
- heavily affected by the perceived rejection by others (i.e. interpersonal rejection sensitivity)
Mood reactivity (i.e., mood brightens in response to actual or potential positive events).
Two (or more) of the following:
Significant weight gain or increase in appetite.
Hypersomnia.
Leaden paralysis (i.e., heavy, leaden feelings in arms or legs).
A long-standing pattern of interpersonal rejection sensitivity (not limited to episodes of mood disturbance) that results in significant social or occupational impairment
With anxious distress = Feeling keyed up or tense. Feeling unusually restless. Difficulty concentrating because of worry. Fear that something awful may happen. Feeling that the individual might lose control of himself or herself.
With mixed features = some manic/hypomanic symptoms
With melancholic features =
Loss of pleasure in all, or almost all, activities.
Lack of reactivity to usually pleasurable stimuli (does not feel much better, even temporarily, when something good happens)
Three (or more) of the following:
A distinct quality of depressed mood characterized by profound despondency, despair, and/or moroseness or by so-called empty mood.
Depression that is regularly worse in the morning.
Early-morning awakening (i.e., at least 2 hours before usual awakening).
Marked psychomotor agitation or retardation.
Significant anorexia or weight loss.
Excessive or inappropriate guilt.
With psychotic features = delusions, psychosis and/or hallucinations
With catatonia = catatonic features
With peripartum onset = onset during pregnancy or 4 weeks following delivery
With seasonal pattern =
“There has been a regular temporal relationship between the onset of major depressive episodes in major depressive disorder and a particular time of the year (e.g., in the fall or winter).
Note: Do not include cases in which there is an obvious effect of seasonally related psychosocial stressors (e.g., regularly being unemployed every winter).
Full remissions also occur at a characteristic time of the year (e.g., depression disappears in the spring).
In the last 2 years, two major depressive episodes have occurred that demonstrate the temporal seasonal relationships defined above and no nonseasonal major depressive episodes have occurred during that same period.
Seasonal major depressive episodes (as described above) substantially outnumber the nonseasonal major depressive episodes that may have occurred over the individual’s lifetime.
Name the Depressive Disorder:
Depressed mood for most of the day, for more days than not, as indicated by either subjective account or observation by others, for at least 2 years.
Presence, while depressed, of two (or more) of the following:
Poor appetite or overeating.
Insomnia or hypersomnia.
Low energy or fatigue.
Low self-esteem.
Poor concentration or difficulty making decisions.
Feelings of hopelessness.
During the 2-year period (1 year for children or adolescents) of the disturbance, the individual has never been without the symptoms in Criteria A and B for more than 2 months at a time.
Criteria for a major depressive disorder may be continuously present for 2 years.
There has never been a manic episode or a hypomanic episode.
The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Persistent Depressive Disorder
What are the Bipolar Specifiers/Severities?
Define them
Rapid cycling: Presence of at least four mood episodes in the previous 12 months that meet the criteria for manic, hypomanic, or major depressive episode in bipolar I disorder or that meet the criteria for hypomanic or major depressive episode in bipolar II disorder.
Episodes are demarcated by either partial or full remissions of at least 2 months or a switch to an episode of the opposite polarity (e.g., major depressive episode to manic episode).
The essential feature of a rapid-cycling bipolar disorder is the occurrence of at least four mood episodes during the previous 12 months. These episodes can occur in any combination and order. The episodes must meet both the duration and the symptom number criteria for a major depressive, manic, or hypomanic episode and must be demarcated by either a period of full remission or a switch to an episode of the opposite polarity. Manic and hypomanic episodes are counted as being on the same pole. Except for the fact that they occur more frequently, the episodes that occur in a rapid-cycling pattern are no different from those that occur in a non-rapid-cycling pattern. Mood episodes that count toward defining a rapid-cycling pattern exclude those episodes directly caused by a substance (e.g., cocaine, corticosteroids) or another medical condition.
Name the Mood Disorder:
Two (or more) of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated). At least one of these must be (1), (2), or (3):
Delusions.
Hallucinations.
Disorganized speech (e.g., frequent derailment or incoherence).114
Grossly disorganized or catatonic behavior.
Negative symptoms (i.e., diminished emotional expression or avolition).”
For a significant portion of the time since the onset of the disturbance, level of functioning in one or more major areas, such as work, interpersonal relations, or self-care, is markedly below the level achieved prior to the onset (or when the onset is in childhood or adolescence, there is failure to achieve expected level of interpersonal, academic, or occupational functioning).
Continuous signs of the disturbance persist for at least 6 months. This 6-month period must include at least 1 month of symptoms (or less if successfully treated) that meet Criterion A (i.e., active-phase symptoms) and may include periods of prodromal or residual symptoms. During these prodromal or residual periods, the signs of the disturbance may be manifested by only negative symptoms or by two or more symptoms listed in Criterion A present in an attenuated form (e.g., odd beliefs, unusual perceptual experiences).
Schizoaffective disorder and depressive or bipolar disorder with psychotic features have been ruled out because either 1) no major depressive or manic episodes have occurred concurrently with the active-phase symptoms, or 2) if mood episodes have occurred during active-phase symptoms, they have been present for a minority of the total duration of the active and residual periods of the illness.
The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.
If there is a history of autism spectrum disorder or a communication disorder of childhood onset, the additional diagnosis of schizophrenia is made only if prominent delusions or hallucinations, in addition to the other required symptoms of schizophrenia, are also present for at least 1 month (or less if successfully treated).”
Schizophrenia
What are the signs of alcohol intoxication?
What are the prolonged effects of Alcohol Use Disorder?
1. Impaired Control
Amounts increasing despite intentions
Can’t cut down
Time spent obtaining, using, recovering
Cravings or strong urges to use
2. Social Impairment
Failure to fulfill roles
Interpersonal problems persistent
Activities given up
3. Risky Use
Physically hazardous situations
Use despite consequences
4. Pharmacological Criteria
Tolerance
Withdrawal
What are the sections of the mental status exam?
Orientation
Level of Consciousness
Recent Memory
Remote Memory
Speech
Mood (angry, anxious, depressed, euphoric, fearful, full range, guilty, irritable, labile, sad, stable)
Behavior (aggressive, agitated, anxious, apathetic, calm, catatonic, compulsions, cooperative, grossly disorganized, guarded, hostile, hyperactive, hypersexual, hyperverbal, hypervigilant, interactive, intrusive, isolative, lethargic, odd, responding to internal stimuli, restless, self-injurious, sundowning behavior, suspicious, tearful, uncooperative, unpredictable, violent/assaultive, wandering behavior, withdrawn)
Affect (congruent with situation, full range,
Thought Process
Thought Content
Delusions
Delusions Type
Hallucinations
Appearance, Dress, Hygiene
Psychomotor
Name the Depressive Disorder:
Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.
Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad, empty, hopeless) or observation made by others (e.g., appears tearful).
Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation).
Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. (Note: In children, consider failure to make expected weight gain.)
Insomnia or hypersomnia nearly every day.
Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down).
Fatigue or loss of energy nearly every day.
Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick).
Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others).
Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.
The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Major Depressive Disorder
Name the Mood Disorder:
A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 1 week and present most of the day, nearly every day (or any duration if hospitalization is necessary).
During the period of mood disturbance and increased energy or activity, three (or more) of the following symptoms (four if the mood is only irritable) are present to a significant degree and represent a noticeable change from usual behavior:
Inflated self-esteem or grandiosity.
Decreased need for sleep (e.g., feels rested after only 3 hours of sleep).
More talkative than usual or pressure to keep talking.
Flight of ideas or subjective experience that thoughts are racing.
Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli), as reported or observed.
Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation (i.e., purposeless non-goal-directed activity).
Excessive involvement in activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments).
The mood disturbance is sufficiently severe to cause marked impairment in social or occupational functioning or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features.
Bipolar I Disorder
Name the Disorder:
An uninterrupted period of illness during which there is a major mood episode (major depressive or manic) concurrent with Criterion A of schizophrenia.
The major depressive episode must include Criterion A1: Depressed mood.
Delusions or hallucinations for 2 or more weeks in the absence of a major mood episode (depressive or manic) during the lifetime duration of the illness.
Symptoms that meet criteria for a major mood episode are present for the majority of the total duration of the active and residual portions of the illness.
The disturbance is not attributable to the effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.
B.
DELUSIONS/HALLUCINATIONS/DISORGANIZED SPEECH/DISORGANIZED/CATATONIC BEHAVIOR, no required functional impairment, but can be severe.
1 day to 1 month
1+ Symptoms
A. Schizoaffective Disorder
B. Brief Psychotic Disorder
Which substances have the ability to mimic independent mental disorders?
ALCOHOL: MDD, BORDERLINE PERSONALITY DISORDER
BENZODIAZEPINES: HYPERSOMNOLENCE DISORDER
CAFFEINE: GENERALIZED ANXIETY DISORDER, HYPOMANIA/MANIA
CANNABIS: SCHIZOPHRENIA SPECTRUM, ADHD
COCAINE/METH: SCHIZOPHRENIA SPECTRUM, MANIA
HALLUCINOGENS: SCHIZOPHRENIA SPECTRUM, SCHIZOTYPAL PERSONALITY DISORDER
PCP: SCHIZOPHRENIA SPECTRUM
OPIOIDS: HYPERSOMNOLENCE DISORDER
TOBACCO: N/A
What are the neurotransmitters involved in Schizophrenia Spectrum Disorders?
Neurotransmitters involved in schizophrenia spectrum disorders:
Imbalance of dopamine, serotonin, and glutamate.
This overall imbalance affects the way a person’s brain reacts to stimuli—which explains why a person with schizophrenia may be overwhelmed by sensory information (loud music or bright lights), which other people can easily handle. This problem in processing different sounds, sights, smells, and tastes can also lead to hallucinations or delusions.
Name the Depressive Disorder:
Johnny "JJ" Johnson is a 28 year-old male. He loves the color orange. He comes to therapy and describes that he's been feeling "down" lately after losing a lot of money betting on the Puppy Bowl. Johnny says that ever since the puppy bowl (4 months before the present day), he's had periods of feeling really sad, saying "I just don't have that dawg in me anymore. I'm always asking myself, what the sigma is going on?" Johnny says these periods of sadness last around three weeks before returning back to normal. Before the Puppy Bowl, Johnny says "I used to be Bussin! I was working and hanging out with all of my friends...my rizz was off the charts back then." During these periods, Johnny states he "is straight up not having a good time" almost every day during these weeks. He reports feeling really "sluggish" a lot and sleeps almost 11 hours a day. Johnny says he doesn't "mew" as much as he used to, an activity he used to love along with Fortnite. Instead, Johnny just stays in bed most of the day and has gained 50 pounds--mostly from Costco double chocolate chunk cookies he saw on TikTok. He gets annoyed because his mother thinks he's "a lazy, smelly sloth" for laying in bed all day and not moving. She said his movements and reaction times are "really slow...almost like he's moving in slow motion." You notice Johnny is slumped in the chair during the session. When asked about the validity of these claims, Johnny says "whatever bro...she's just mad I'm in my "Chill" era."
Major Depressive Disorder.
Meets criteria for more than 2 week periods.
Depressed Mood, present most of the day. Represents change in functioning. Diminished interest in activities. Significant weight gain. Hypersomnia nearly every day. Psychomotor retardation (observable by others). Fatigue/loss of energy.
Name the Mood Disorder:
Michael Hawk--otherwise known as Mike--walks into therapy. He is a 40 year-old male who is married to his wife Helga--who's a certified baddie. He finally comes to therapy after his wife gives him an ultimatum, "either you go to therapy or I will not give you that gluck gluck anymore." Mike says that he's been "feeling cooked" for a long time. He estimates these feelings started ever since he moved to South Whocaresville, Nebraska just about three years ago. Since then, Mike has experienced periods where he'll feel extremely 'stoked' and energetic one week and then will feel "skibidi and lame" for a week and a half after that. He says, "rarely do I go a month without feeling this roller coaster. Sometimes I'll feel normal, though. I'll always count my days on the "it's been ___ days since I've felt like booty" whiteboard, and the most I've gotten to is 29!" When Mike is going through his "happy periods," he says he goes a full week where he feels "on top of the world" and spends all day flexing in the mirror, admiring his gyatt and how "yolked" he is despite having no muscle definition. Mike tells his wife he's thinking about signing up to be the next Mr. Nebraska. Mike describes being "caught in 4k" by his wife during these weeks taking mirror selfies and sending large sums of money to "male order baddies," only to realize later he misspelled 'mail.' His wife says "you glaze yourself up so much, they should call you Krispy Kreme." Mike says his sleep has been constantly normal throughout his time in Nebraska, not too long or too short, and that he hasn't noticed any "wild, racing thoughts." During the 'happy periods,' he can have normal conversations and he can focus on tasks easily. He even finds ways to continue to apply to a couple of jobs during these weeks--just like he does when he feels "normal." Meanwhile, during his "low" periods, Mike feels pretty "meh" for around 10 days. Mike says he usually loses "a ton of weight," feels tired a lot of the days and has trouble focusing, leading him to lose progress in his hunt for a job. "It's giving depressed" Mike says to his wife. His self-esteem is still intact, he denies having suicidal thoughts and he still enjoys watching Migos music videos at night. But aside from watching music, he usually has low mood for most of his time during this week and a half period. Mike does not drink, smoke or take any other substances: "I'm straight, yo," he says. He does not have any medical conditions and does not take any medications. Because of these symptoms, Mike has lost the ability to obtain employment after losing his job just after moving to Nebraska. He's been unemployed for years because of these "ups and downs" and cannot find a way to rizz up his wife, leading to unhappiness in his marriage. His wife is forced to sell pictures of her feet on FeetFinder to make ends meet.
Cyclothymic Disorder:
Feeling this way for over 2 years.
Feelings of "extreme happiness and energy" lasting one week (7 days). Exhibits inflated self-esteem/grandiosity (selfies/flexing in the mirror) and an excessive involvement in activities that have high potential for painful consequences (sending money). However sleep is normal, he isn't more talkative, no racing thoughts, no distractibility and no increase in goal-oriented activity. Feelings of sadness lasting a week and a half (10 days), not two weeks. Does exhibit depressed mood, weight loss, fatigue and diminished ability to think or concentrate. But does not have SI/feelings of worthlessness/ psychomotor agitation/ unhealthy sleep patterns/ diminished interest in activities. Periods in between these highs and lows do not last 2 months--they last 29 days or less than a month. These symptoms do cause significant impairment in occupational and social functioning
How does Schizophrenia affect the brain?
What is a Rapid Cycling Specifier?
Reduced frontal lobe activity (voluntary movement, expressive language, executive functioning, i.e. planning, organization, execution).
Excess dopamine in the frontal lobe to cause hallucinations/delusions.
Reduction in gray matter: Person’s ability to think and reason. Grey matter aids in information processing: dealing with sensation, perception, voluntary movement, learning, speech, cognition.
Reduced temporal lobe activity (speech, language, object recognition, memory formation, understanding of the world around you, processing emotions).
Other factors:
Genetic heritability
Exposure to toxins in utero
Malnutrition
Psychedelic use in the developing brain
Rapid Cycling Specifier:
At least four mood episodes in the previous 12 months that:
- meet the criteria for manic, hypomanic, or major depressive episode in bipolar I disorder,
-or that meet the criteria for hypomanic or major depressive episode in bipolar II disorder.
Episodes are demarcated by either partial or full remissions of at least 2 months or a switch to an episode of the opposite polarity (e.g., major depressive episode to manic episode).
What is cannabis's effect on the development of mental disorders in users under 25?
And the evidence is growing of marijuana’s association with psychiatric disorders such as depression, bipolar disorder and schizophrenia, especially in young men.
One of the studies, from researchers in Denmark in collaboration with the U.S. National Institutes of Health, found evidence of an association between cannabis use disorder and schizophrenia. The finding was most striking in young men ages 21-30, but was also seen in women of the same age.
Another study, led by Sultan and Columbia researchers published earlier this month, found that teenagers who use cannabis only recreationally are two to four times more likely to develop psychiatric disorders, including depression and suicidality, than teenagers who don’t use cannabis at all.
Who's gonna ace this test?
NOT YOU...LOL!
...SIKE, YOU WILL DO AMAZIN <3