Is a mood disorder that is characterized by extreme mood swings that include one or more episodes of mania An overly excited unrealistically optimistic state?

Video transcript

- [Instructor] One disorder that is very related to depression is bipolar disorder. And this disorder used to be referred to as manic depressive disorder. But this term, bipolar disorder, it describes a condition where an individual swings from extreme emotional highs to extreme emotional lows. And people generally have ups and down in their life, and that is totally normal. But this is something that's different. The individual will have periods of depression with all of the symptoms that we would see with major depressive disorder. But in addition to this, they will also have periods of mania, an over excited unrealistically optimistic state. People experiencing mania have a ton of energy. They are euphoric and optimistic, and they have very high self esteem. And maybe you're thinking to yourself, that really doesn't sound that bad. Sounds like it would be a good time, and I could probably get a lot of work done. And for mild forms of mania which are sometimes referred to as hypo mania, this can be true. They do have a lot of energy and they don't really need to sleep a lot so they get a lot done. And they also feel good so they might also deny that anything is wrong. But if the manic stage continues, if it becomes full blown mania, then all of this is taken to the extreme. And they begin to make poor decisions without any regard for the consequences. They might max out their credit cards while shopping. Or they could end up in financial distress or lose their life savings, because they impulsively backed an unrealistic business venture. They also might engage in reckless behavior. Things like driving too fast or engaging in risky sexual behavior. And while they might have initially benefited from the creative out-of-the-box thinking that can come on with the onset of mania, these thoughts can soon transform into delusions of grandeur and completely unrealistic ideas. So if depression feels like everything is going in slow motion, mania would be everything going in fast forward. They don't sleep. Their heart races. They have racing thoughts. And after all of this, they crash, because mania is often followed by intense depressive episodes. But as we implied before, not all hypo manic episodes develop into full mania. And when they do, we refer to it as bipolar one disorder. And when they don't, when they cycle through hypo mania without going into a full manic state, we refer to this as bipolar two disorder. The way I like to think about these two disorders, and how they relate to major depressive disorders is using a graph. And let's say that this line here represents the normal mood of a completely average person. So here we have positive moods, and down here we have negative moods. And let's say that average Joe is basically a happy guy. He usually has a good mood, and he also has the normal ups and downs that happen in life. Maybe he gets a job and then loses that job, and maybe he meets someone he loves. But through everything that occurs, he basically has normal cycling around this average line. Individuals with depression might also cycle normally for a bit, but sometimes their moods can plunge down to incredibly negative moods. Well below what we would expect to see. And then we have bipolar disorder, and let's look at bipolar disorder one first. And I'll use this pink color for it. And these individuals might also start off cycling normally, but sometimes they will also show periods of mania as well as periods of depression. Bipolar two disorder has a somewhat similar trajectory. These individuals can also cycle normally, but then they have periods of depression and periods of hypo mania. And so this part up here represents hypo mania. And you can see that it's higher than the normal positive moods that average Joe has. But it's also lower than what we would see with bipolar one. And obviously this chart is not up to scale. There is no line here indicating exactly how positive someone's mood is or how negative it is. But if you're trying to picture how these disorders relate to each other, this graph is a pretty good way to do it.

Learning Objectives

• Evaluate scenarios and descriptions to identify and differentiate between psychological disorders

As you’ve learned, there are many different categories of mental disorders, and many different facets of human behavior and personality that can become disordered. Keep reading to review each of the main categorizations you learned about in this module. Note that this module did not cover all mental disorders—eating disorders and sleep disorders, for example, are discussed in other modules. Other topics covered in the DSM include disorders such as substance abuse disorders, sexual dysfunctions, stress disorders, elimination disorders, gender dysphoria, or paraphillic disorders.

Anxiety or fear that interferes with normal functioning may be classified as an anxiety disorder. Commonly recognized categories include specific phobias: a specific unrealistic fear; social anxiety disorder: extreme fear and avoidance of social situations; panic disorder: suddenly overwhelmed by panic even though there is no apparent reason to be frightened; agoraphobia: an intense fear and avoidance of situations in which it might be difficult to escape; and generalized anxiety disorder: a relatively continuous state of tension, apprehension, and dread. Posttraumatic stress disorder is similar disorder, although classified as a trauma- and stressor-related disorder.

Link to Learning

Learn more about each of the psychological disorders through the National Institute of Mental Health.

Or for an interesting application of the various mental disorders, take a look at this YouTube playlist showing disorders as they are characterized in popular media. These case studies were developed by students in Dr. Caleb Lack’s psychology class.

While similar to anxiety disorders, obsessive compulsive disorders and posttraumatic stress disorders now have their own distinct categories of classification within the DSM-5 because symptoms of anxiety are not necessarily present. With obsessive-compulsive disorder, a person is obsessed with unwanted, unpleasant thoughts and/or compulsively engages in repetitive behaviors or mental acts, perhaps as a way of coping with the obsessions. PTSD is as a disorder in which the experience of a traumatic or profoundly stressful event, such as combat, sexual assault, or natural disaster, produces a constellation of symptoms that must last for one month or more. These symptoms include intrusive and distressing memories of the event, flashbacks, avoidance of stimuli or situations that are connected to the event, persistently negative emotional states, feeling detached from others, irritability, proneness toward outbursts, and a tendency to be easily startled.

Other affective (emotion/mood) processes can also become disordered. Mood disorder involving unusually intense and sustained sadness, melancholia, or despair is known as major depressive disorder. Milder but still prolonged depression can be diagnosed as persistent depressive disorder. Bipolar disorder is characterized by mood states that vacillate between sadness and euphoria; a diagnosis of bipolar disorder requires experiencing at least one manic episode, which is defined as a period of extreme euphoria, irritability, and increased activity. Mood disorders appear to have a genetic component, with genetic factors playing a more prominent role in bipolar disorder than in depression. Both biological and psychological factors are important in the development of depression. People who suffer from mental health problems, especially mood disorders, are at heightened risk for suicide.

Patterns of belief, language use and perception of reality can also become disordered (e.g., delusions, thought disorder, hallucinations). The most common psychotic disorder in this domain is schizophrenia, which is a severe disorder characterized by a complete breakdown in one’s ability to function in life. People with schizophrenia experience hallucinations and delusions, and they have extreme difficulty regulating their emotions and behavior. Thinking is incoherent and disorganized, behavior is extremely bizarre, emotions are flat, and motivation to engage in most basic life activities is lacking. Considerable evidence shows that genetic factors play a central role in schizophrenia; however, adoption studies have highlighted the additional importance of environmental factors. Neurotransmitter and brain abnormalities, which may be linked to environmental factors such as obstetric complications or exposure to influenza during the gestational period, have also been implicated. A promising new area of schizophrenia research involves identifying individuals who show prodromal symptoms and following them over time to determine which factors best predict the development of schizophrenia. Future research may enable us to pinpoint those especially at risk for developing schizophrenia and who may benefit from early intervention.

The main characteristic of dissociative disorders is that people become dissociated from their sense of self, resulting in memory and identity disturbances. Dissociative disorders listed in the DSM-5 include dissociative amnesia, depersonalization/derealization disorder, and dissociative identity disorder. A person with dissociative amnesia is unable to recall important personal information, often after a stressful or traumatic experience.

Depersonalization/derealization disorder is characterized by recurring episodes of depersonalization (i.e., detachment from or unfamiliarity with the self) and/or derealization (i.e., detachment from or unfamiliarity with the world). A person with dissociative identity disorder exhibits two or more well-defined and distinct personalities or identities, as well as memory gaps for the time during which another identity was present.

Dissociative identity disorder has generated controversy, mainly because some believe its symptoms can be faked by patients if presenting its symptoms somehow benefits the patient in avoiding negative consequences or taking responsibility for one’s actions. The diagnostic rates of this disorder have increased dramatically following its portrayal in popular culture. However, many people legitimately suffer over the course of a lifetime with this disorder.

Personality—the fundamental characteristics of a person that influence thoughts and behaviors across situations and time—may be considered disordered if judged to be abnormally rigid and maladaptive. Individuals with personality disorders exhibit a personality style that is inflexible, causes distress and impairment, and creates problems for themselves and others. The DSM-5 recognizes 10 personality disorders, organized into three clusters. The disorders in Cluster A include those characterized by a personality style that is odd and eccentric. These include paranoid, schizoid, and schizotypal personality disorders. Cluster B includes personality disorders characterized chiefly by a personality style that is impulsive, dramatic, highly emotional, and erratic (antisocial, histrionic, narcissistic, and borderline) and those in Cluster C are characterized by a nervous and fearful personality style (avoidant, dependent, and obsessive-compulsive).

Neurodevelopmental disorders are a group of disorders that are typically diagnosed during childhood and are characterized by developmental deficits in personal, social, academic, and intellectual realms; these disorders include attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorder. ADHD is characterized by a pervasive pattern of inattention and/or hyperactive and impulsive behavior that interferes with normal functioning. Genetic and neurobiological factors contribute to the development of ADHD, which can persist well into adulthood and is often associated with poor long-term outcomes. The major features of autism spectrum disorder include deficits in social interaction and communication and repetitive movements or interests. As with ADHD, genetic factors appear to play a prominent role in the development of autism spectrum disorder; exposure to environmental pollutants such as mercury have also been linked to the development of this disorder. Although it is believed by some that autism is triggered by the MMR vaccination, evidence does not support this claim.

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Review the psychological disorders you learned about in the module in the following interactive.

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What is a disorder characterized by extreme emotions?

What dysfunction is behavior that is deviant maladaptive or personally distressful over a relatively long period of time?

What is a mood disorder that is characterized by extreme mood swings that include one or more episodes of mania an overexcited unrealistically optimistic state?

Is an anxiety disorder in which the individual experiences recurrent sudden onsets of intense terror often without warning and with no specific cause?