Disruptive Mood Dysregulation Disorder
Disruptive mood dysregulation disorder is a condition that occurs in children and youth ages 6 to 18. It involves a chronic and severe irritability resulting in severe and frequent temper outbursts. The temper outbursts can be verbal or can involve behavior such as physical aggression toward people or property. These outbursts are significantly out of proportion to the situation and are not consistent with the childs developmental age. They must occur frequently and typically in response to frustration. In between the outbursts, the childs mood is persistently irritable or angry most of the day, nearly every day. This mood is noticeable by others, such as parents, teachers, and peers.
In order for a diagnosis of disruptive mood dysregulation disorder to be made, symptoms must be present for at least one year in at least two settings and the condition must begin before age 10. Disruptive mood dysregulation disorder is much more common in males than females. It may occur along with other disorders, including major depressive, attention-deficit/hyperactivity, anxiety, and conduct disorders.
Disruptive mood dysregulation disorder can have a significant impact on the childs ability to function and a significant impact on the family. Chronic, severe irritability and temper outbursts can disrupt family life, make it difficult for the child/youth to make or keep friendships, and cause difficulties at school.
Treatment typically involves and/or medications.
Life Expectancy And The Risk Of Suicide
Depressed individuals have a shorter life expectancy than those without depression, in part because people who are depressed are at risk of dying of suicide. Up to 60% of people who die of suicide have a mood disorder such as major depression, and the risk is especially high if a person has a marked sense of hopelessness or has both depression and borderline personality disorder. About 2â8% of adults with major depression die by suicide, and about 50% of people who die by suicide had depression or another mood disorder. The lifetime risk of suicide associated with a diagnosis of major depression in the US is estimated at 3.4%, which averages two highly disparate figures of almost 7% for men and 1% for women . The estimate is substantially lower than a previously accepted figure of 15%, which had been derived from older studies of people who were hospitalized.
Depressed people have a higher rate of dying from other causes. There is a 1.5- to 2-fold increased risk of cardiovascular disease, independent of other known risk factors, and is itself linked directly or indirectly to risk factors such as smoking and obesity. People with major depression are less likely to follow medical recommendations for treating and preventing cardiovascular disorders, further increasing their risk of medical complications.Cardiologists may not recognize underlying depression that complicates a cardiovascular problem under their care.
Deterrence And Patient Education
Patient education has a profound impact on the overall outcome of major depressive disorder. Since MDD is one of the most common psychiatric disorders causing disability worldwide and people in different parts of the world are hesitant to discuss and seek treatment for depression due to the stigma associated with mental illness, educating patients is very crucial for their better understanding of the mental illness and better compliance with the mental health treatment. Family education also plays an important role in the successful treatment of MDD.
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Understand And Accept Depression
Learning more about depression can help people deal with the condition. Depression is a widespread and genuine mental health disorder. It is not a sign of weakness or a personal shortcoming.
Accepting that a depressive episode may occur from time to time might help people deal with it when it does. Remember, it is possible to manage symptoms with treatments, such as lifestyle changes, medication, and therapy.
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Separate Yourself From The Depression
A condition does not define a person they are not their illness. When depression symptoms begin, some people find it helpful to repeat: I am not depression, I just have depression.
A person should remind themselves of all the other aspects of themselves. They may also be a parent, sibling, friend, spouse, neighbor, and colleague. Each person has their own strengths, abilities, and positive qualities that make them who they are.
Demand To Feel Well Again
If you went through a severe depression, you may be relieved to just feel OK again. You might not be happy, but you’re grateful that you can get out of bed and go to work.
But that isn’t enough. It isn’t enough to just feel less miserable. You deserve to feel well again, to feel as good as you once did. If your current treatment isn’t allowing that, then you need to make certain everything is being done to improve symptoms as fully as possible. There are many different ways of treating depression — therapy, medicines, and lifestyle changes — that can help.
So don’t settle for feeling just OK. You and your health care provider need to work together. With some effort and good treatment, you can feel truly well again.
Show Sources
American Psychological Association, Diagnostic and Statistical Manual of Mental Disorders, Fourth edition, Text Revision, Washington American Psychiatric Association, 2000.Ã
American Psychiatric Association, Practice Guideline for the Treatment of Patients with Major Depression, 2000.Ã
Compton M. Ã ACP Medicine, Psychiatry II, 2003.Ã
Fochtmann, L. Focus, Winter 2005.Ã
National Mental Health Association: “Depression: What You Need to Know.”Ã
National Institute of Mental Health: “The Numbers Count: Mental Disorders in America.”Ã
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How Can I Find Help
If you think you may have depression, start by making an appointment to see your doctor or health care provider. This could be your primary care practitioner or a health provider who specializes in diagnosing and treating mental health conditions. Visit the NIMH Find Help for Mental Illnesses if you are unsure of where to start.
What Are The Signs And Symptoms Of Depression
At least five of the following symptoms must have been present during the same two-week period and at least one of the symptoms must be diminished interest/pleasure or a depressed mood.
- Depressed mood: For children and adolescents, this can also be irritability
- Significant weight change or appetite disturbance: Failure to gain weight in children and weight gain in adults
- Anhedonia
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How To Tell If You Have Depression
Depression affects people in different ways and can cause a wide variety of symptoms.
They range from lasting feelings of unhappiness and hopelessness, to losing interest in the things you used to enjoy and feeling very tearful. Many people with depression also have symptoms of anxiety.
There can be physical symptoms too, such as feeling constantly tired, sleeping badly, having no appetite or sex drive, and various aches and pains.
The symptoms of depression range from mild to severe. At its mildest, you may simply feel persistently low in spirit, while severe depression can make you feel suicidal, that life is no longer worth living.
Most people experience feelings of stress, anxiety or low mood during difficult times. A low mood may improve after a short period of time, rather than being a sign of depression.
Seek Support For Symptoms Of Depression
Depression is often not recognised and can go on for months or even years if left untreated. Its important to seek support as early as possible, as the sooner a person gets treatment, the sooner they can recover.
Untreated depression can have many negative effects on a persons life, including serious relationship and family problems, difficulty finding and holding down a job, and drug and alcohol problems.
There is no one proven way that people recover from depression. However, there is a range of effective treatments and health professionals who can help people on the road to recovery.
There are also many things that people with depression can do for themselves to help them recover and stay well. The important thing is to find the right treatment and the right health professional for a persons needs.
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How Is Depression Diagnosed
Depression can happen along with other medical conditions. These include heart disease, or cancer, as well as other mental health conditions. Early diagnosis and treatment is key to recovery.
A diagnosis is made after a careful mental health exam and medical history done. This is usually done by a mental health professional.
Treatment For Major Depressive Disorder
There are several treatment methods for major depression disorder. These approaches include psychotherapy, antidepressant medications, electroconvulsive treatment , and other somatic therapies. However, ECT is generally avoided, except in extreme circumstances, in favor of both psychotherapy and antidepressants. A medical psychiatrist can provide both psychotherapy services and prescribe antidepressants, which differ for each person based on individual needs.
If you find yourself experiencing any of the symptoms or relating in any way to major depression disorder, you should seek assistance from a medical professional. Thankfully, major depressive disorder has become much less stigmatized in recent years. There is plenty of in-depth information available about depression, and your chosen medical professional is often likely to go through it with you so you can choose the best treatment for your lifestyle.
You should feel as though you have options. You most likely will not have to be burdened by this disease and the negativity that often comes with symptoms of depression. Talking to a counselor and a medical professional is the first step to living a happier, more fulfilling life.
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Enhancing Healthcare Team Outcomes
An interdisciplinary approach is essential for the effective and successful treatment of MDD. Primary care physicians and psychiatrists, along with nurses, therapists, social workers, and case managers, form an integral part of these collaborated services. In the majority of cases, PCPs are the first providers to whom individuals with MDD present mostly with somatic complaints. Depression screening in primary care settings is very imperative. The regular screening of the patients using depression rating scales such as PHQ-9 can be very helpful in the early diagnosis and intervention, thus improving the overall outcome of MDD. Psychoeducation plays a significant role in improving patient compliance and medication adherence. Recent evidence also supports that lifestyle modification, including moderate exercises, can help to improve mild-to-moderate depression. Suicide screening at each psychiatric visit can be helpful to lower suicide incidence. Since patients with MDD are at increased risk of suicide, close monitoring, and follow up by mental health workers becomes necessary to ensure safety and compliance with mental health treatment. The involvement of families can further add to a better outcome of the overall mental health treatment. Meta-analyses of randomized trials have shown that depression outcomes are superior when using collaborative care as compared with usual care.
What Is A Depressive Episode
A depressive episode occurs when someone experiences five or more depressive symptoms that last for a period of two weeks or longer. Depression symptoms that can be considered part of a depressive episode include:
- Depressed mood
- Difficulty concentrating
- Suicide ideation or attempt
A depressive episode can be brought on by a variety of different reasons, including major life events or medical illnesses. A person will not meet the criteria for a depressive episode if symptoms are caused by substance abuse or a reaction to a prescribed medication.
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Depression Is Different From Sadness Or Grief/bereavement
The death of a loved one, loss of a job or the ending of a relationship are difficult experiences for a person to endure. It is normal for feelings of sadness or grief to develop in response to such situations. Those experiencing loss often might describe themselves as being depressed.
But being sad is not the same as having depression. The grieving process is natural and unique to each individual and shares some of the same features of depression. Both grief and depression may involve intense sadness and withdrawal from usual activities. They are also different in important ways:
- In grief, painful feelings come in waves, often intermixed with positive memories of the deceased. In major depression, mood and/or interest are decreased for most of two weeks.
- In grief, self-esteem is usually maintained. In major depression, feelings of worthlessness and self-loathing are common.
- In grief, thoughts of death may surface when thinking of or fantasizing about joining the deceased loved one. In major depression, thoughts are focused on ending ones life due to feeling worthless or undeserving of living or being unable to cope with the pain of depression.
Grief and depression can co-exist For some people, the death of a loved one, losing a job or being a victim of a physical assault or a major disaster can lead to depression. When grief and depression co-occur, the grief is more severe and lasts longer than grief without depression.
Major Depression A Chronic Illness
Major depression is a serious mental illness. It is classified as a mood disorder, which means that it is characterized by negative patterns in thoughts and emotions that dont line up with a persons actual circumstances. It is also a chronic mental illness. This means it is not curable and that it can come and go, sometimes for a persons entire life. Someone diagnosed with depression may feel fine for a long period of time and then have symptoms. The period during which someone experiences the symptoms is called a depressive episode.
Most people with major depression live with it as a chronic illness. Episodes come and go, although they may be made less severe and less frequent with good treatment. In some cases, though, a person may experience a singular episode of depression, just once in a lifetime. Often these episodes of depression are triggered by a situational event: a death in the family, the loss of a job or relationship, or some kind of trauma, like a physical assault. This single depressive episode may be just as serious as those experienced by someone with recurrent major depression, with all the same symptoms and persistence.
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Major Depression Vs Dysthymia
Major depressive disorder and dysthymia overlap in some ways. But there are key differences.
Dysthymia, now usually called persistent depressive disorder , involves fewer symptoms. But they last longer, at least 2 years. You can be diagnosed with MDD if you have symptoms for 2 weeks.
Both mood disorders are serious. Sometimes dysthymia can disrupt your life more, even with fewer symptoms.
The Symptoms Of A Major Depressive Episode
The diagnostic criteria for major depression include nine possible symptoms. To be diagnosed, a person must experience at least five of these symptoms and significant impairment as a result of those symptoms. The symptoms must last for at least two weeks. This is a depressive episode. The nine possible symptoms of major depressive episodes are:
- Depressed mood. A feeling of depression, sadness, and hopelessness that is intense and persistent. This may seem more like irritability in children, teens, and men.
- Loss of interest. A significant loss of interest or pleasure in doing normal activities, including daily activities like chores but also hobbies, work, or school.
- Weight changes. Significant loss of weight or weight gain that is not intentional but is triggered by overeating or loss of appetite.
- Sleep changes. Either excessive sleep or insomnia and difficulty sleeping.
- Agitation or retardation. Agitated and restless expression or slowed down affect that is notable to anyone observing.
- Fatigue. Fatigue and loss of energy that is more than normal and cant be explained simply by lack of sleep or low quality sleep.
- Excessive guilt. Feelings of deep guilt and shame, a feeling of being worthless.
- Impaired thinking. Difficulty concentrating, making decisions, and focusing on anything, even just watching television.
- Suicidal thoughts. Thoughts of death, suicide, and suicidal planning or suicidal attempts.
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Understanding Depression: Dysthymia Vs Major Depressive Disorder
To say that a person is depressed can mean a few different things. Some people casually use it to refer to a low mood they might be experiencing that day. However, the clinical definition of depression refers to a low mood and other symptoms that persist for weeks, months, or even years. Read on to understand the differences between dysthymia and major depressive disorder , the two main forms of depression, their root causes, and how theyre treated.
Defining dysthymia and MDD
According to Harvard Health, the two chief forms of clinical depression are dysthymia and major depressive disorder, or MDD. A study from the National Institute of Health defined MDD as a depressive episode lasting at least two weeks, and involving one or more of the following symptoms: persistently low or depressed mood, decreased interest in pleasurable activities, feelings of guilt or worthlessness, lack of energy, poor concentration, appetite changes, psychomotor retardation or agitation, sleep disturbances, or suicidal thoughts.
Meanwhile, the American Psychiatric Association defines dysthymia as a depressed mood most of the time for at least two years, along with at least two of the following symptoms: poor appetite or overeating insomnia or excessive sleep low energy or fatigue low self-esteem poor concentration or indecisiveness and hopelessness.
Looking for root causes
Identifying symptoms and differences
What treatments are available?
What Is The Mean Duration Of Depressive Episodes
The American Psychiatric Association defines depression as a common and serious medical illness that negatively affects how a person feels, thinks and acts. Though the duration of a depressive episode can vary, the mean duration is thought to be six to eight months long. People can experience one or several episodes of depression in their lifetime. These episodes may also vary from mild to severe symptoms.
Depressive episodes can occur at any age, although it is most commonly seen in the age groups of 18 to 29, 30 to 44, 45 to 64 and 65 years and older. Depression causes feelings of sadness and/or a loss of interest in activities once enjoyed. It can lead to various emotional and physical problems and reduce a persons ability to function at work and home.
Fortunately, depression is treatable. With appropriate medical treatment, therapy and emotional support, 70 to 80 percent of patients may be cured or at least experience a drastic reduction of their symptoms.
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