Affective Disorders Health Article

Definition

Affective disorders are psychiatric diseases with multiple aspects, including biological, behavioral, social, and psychological factors. Major depressive disorder, bipolar disorders, and anxiety disorders are the most common affective disorders. The effects of these disorders—such as difficulties in interpersonal relationships and an increased susceptibility to substance abuse—are major concerns for parents, teachers, physicians, and the community. Affective disorders can result in symptoms ranging from the mild and inconvenient to the severe and life-threatening; the latter account for more than 15% of deaths due to suicide among those with one of the disorders.

Major depressive disorder (MDD), also known as monopolar depression or unipolar affective disorder, is a common, severe, and sometimes life-threatening psychiatric illness. MDD causes prolonged periods of emotional, mental, and physical exhaustion, with a considerable risk of self-destructive behavior and suicide. Major studies have identified MDD as one of the leading causes of work disability and premature death, representing an increasingly worldwide health and economic concern.

Bipolar affective diseases are divided into various types according to the symptoms displayed: Type I (bipolar I, or BPI) and Type II (bipolar II or BPII) disease, cyclothymic disorder, and hypomania disorder. Other names for bipolar affective disease include manic-depressive disorder, cyclothymia, manic-depressive illness (MDI), and bipolar disorder. People with bipolar diseases experience periods of manic (hyper-excitable) episodes alternating with periods of deep depression. Bipolar disorders are chronic and recurrent affective diseases that may have degrees of severity, tending however to worsen with time if not treated. Severe crises can lead to suicidal attempts during depressive episodes or to physical violence against oneself or others during manic episodes. In many patients, however, episodes are mild and infrequent. Mixed states may also occur with elements of mania and depression simultaneously present. Some people with bipolar affective disorders show a rapid cycling between manic and depressive states.

Anxiety disorders are also common psychiatric disorders, and are considered one of the most under-treated and overlooked health problems. Among its common manifestations are panic syndromes, phobias, chronic generalized anxiety disorder, obsessive-compulsive disorder, and post-traumatic disorder. Anxiety disorders are important contributors to other diseases such as hypertension, digestive and eating disorders, and cardiac arrhythmia. Severe anxiety disorders often lead to tobacco addiction, alcohol abuse, and drug abuse.

Description

People with major depressive disorder (MDD) experience periods of at least two weeks of symptoms that often include sadness, emotional heaviness, feelings of worthlessness, hopelessness, guilt, anguish, fear, loss of interest for normal daily activities, social withdrawal, inability to feel pleasure, physical apathy, difficulty in concentrating, and recurrent thoughts about death. Changes in sleeping pattern, with insomnia during the night and hypersomnia (excessive sleep) during the day, chronic fatigue, and a feeling of being physically drained and immobile may also occur. Irritability and mood swings may be present, and loss of appetite or overeating are common features. In severe cases, MDD may last for months, with those affected experiencing profound despair and spending most of their time isolated or prostrate in bed, considering or planning suicide. Approximately 50% of MDD patients attempt suicide at least once in their lives.

In bipolar I disease (BPI), the manic episodes are severe, lasting from one week to three months or more if untreated, and often require hospitalization. Manic episodes are characterized by hyperactivity, feelings of grandiosity or omnipotence, euphoria, constant agitation, obsessive work or social activity, increased sexual drive, racing thoughts and surges of creativity, distractibility, compulsive shopping or money spending, and sharp mood swings and aggressive reactions, which may include physical violence against others. Depressive episodes may not occur in some BPI patients, but when present, the signs are similar to those of MDD and tend to last for months if untreated.

In bipolar II disease (BPII), milder and fewer manic episodes occur than for those people suffering from BPI, and at least one major depressive episode is experienced. BPII depression is the most common form of bipolar disease. Depressive episodes are usually more frequent than manic episodes, and can also last for extended periods if untreated.

Cyclothymia disorder is less severe, but tends to be chronic with frequent mood swings and single episodes lasting for at least two years. In some individuals, cyclothymic disorder is the precursor to a progressive bipolar disease. In others, the cyclothymic disorder remains chronic.

Hypomania is a mild degree of mania, manifested as brief and mild episodes of inflated self-esteem and excitability, irritability, impatience, and demanding attitude. Those with hypomania often find it disturbing or impossible to relax or to remain idle. Feelings of urgency to work longer hours and accomplish several tasks simultaneously are common.