Hockenbury Discovering Psychology 5th txtbk

Mood Disorders547Emotional symptoms• Feelings of sadness, hopelessness,helplessness, guilt, emptiness, orworthlessness• Feeling emotionally disconnectedfrom others• Turning away from other peopleCognitive symptoms• Difficulty thinking, concentrating,and remembering• Global negativity and pessimism• Suicidal thoughts orpreoccupation with deathBehavioral symptoms• Dejected facial expression• Makes less eye contact; eyes downcast• Smiles less often• Slowed movements, speech, andgestures• Tearfulness or spontaneousepisodes of crying• Loss of interest or pleasure inusual activities, including sex• Withdrawal from social activitiesPhysical symptoms• Changes in appetite resulting insignificant weight loss or gain• Insomnia, early morning awakening,or oversleeping• Vague but chronic aches and pains• Diminished sexual interest• Loss of physical and mental energy• Global feelings of anxiety• Restlessness, fidgety activityWatkins, 2008). This pervasive negativity and pessimism are often manifested insuicidal thoughts or a preoccupation with death. Rates of completed suicide bythose diagnosed with major depression range from 7 to 22 percent (Woo &Keatinge, 2008).Abnormal sleep patterns are another hallmark of major depression. The amountof time spent in nondreaming, deeply relaxed sleep is greatly reduced or absent (seeChapter 4). Rather than the usual 90-minute cycles of dreaming, the person experiencessporadic REM periods of varying lengths. Spontaneous awakenings occur repeatedlyduring the night. Very commonly, the depressed person awakens at 3:00 or4:00 A.M., then cannot get back to sleep, despite feeling exhausted. Less commonly,some depressed people sleep excessively, sometimes as much as 18 hours a day.To be diagnosed with major depression, a person must display most of the symptomsdescribed for two weeks or longer (DSM-IV-TR, 2000). In many cases, theredoesn’t seem to be any external reason for the persistent feeling of depression. Inother cases, a person’s downward emotional spiral has been triggered by a negativelife event, stressful situation, or chronic stress (Hammen, 2005; Southwick & others,2005).One significant negative event deserves specialmention: the death of a loved one. If a family memberor close friend dies, it is completely normal to feel despondentand sad for several months as part of themourning or bereavement process. Even so, mostpeople resume attending to the routine duties of lifewithin a few weeks. Privately, they may still feel astrong sense of loss, but they function adequately, ifnot optimally. As a general rule, if a person’s ability tofunction after the death of a loved one is still seriouslyimpaired after two months, major depression is suspected(DSM-IV-TR, 2000).Although major depression can occur at any time,some people experience symptoms that intensify atcertain times of the year. For people with seasonalaffective disorder (SAD), repeated episodes of majordepression are as predictable as the changing seasons,especially the onset of autumn and winter whenthere is the least amount of sunlight. Seasonal affectivedisorder is more common among women andamong people who live in the northern latitudes(Partonen & Pandi-Perumal, 2010).Figure 13.3 The Symptoms of MajorDepression The experience of majordepression can permeate every aspect oflife. This figure shows some of the mostcommon emotional, behavioral, cognitive,and physical symptoms of that disorder.Sheryl Crow Grammy awardwinningsinger Sheryl Crow hasstruggled with depression sinceshe was a young child. Of herchronic depression, she has said,“I grew up in the presence ofmelancholy, a feeling of loss. . . .It is a shadow for me. It’s part ofwho I am. It is constantly there. Ijust know how, at this point, tosort of manage it.”