Depression affective disorder

Affective (mood) disorders are characterized by changes in mood. The most common manifestation is depression, arranging from mild to severe forms. Psychotic depression is accompanied by hallucinations and illusions. Mania is less common than depression. In bipolar affective disorder, depression alternates with mania. 

Problems with mood are often called affective disorders. Depression and mania are often seen as opposite ends of an affective or mood spectrum. Classically, mania and depression are poles apart, thus generating the terms unipolar depression, in which patients just experience the down or depressed pole and bipolar disorder, in which patients at different times experience either the up (manic) pole or the down (depressed) pole. In practice, however, depression and mania may occur simultaneously, which is called a mixed mood state. Mania may also occur in lesser degrees, known as hypomania, or may switch so fast between mania and depression that it is called rapid cycling. ... 

Drugs Used to Treat Affective Disorders Depression and Bipolar Syndrome... 

Glueck et al. assessed hypocholesterolemia in 203 patients hospitalized with affective disorders (depression, bipolar disorder, and schizoaffective disorder), 1595 self-referred subjects in an urban supermarket screening, and 11,864 subjects in the National Health and Nutrition Examination Survey II (a national probability sample) [34], Low plasma cholesterol concentration (<160 mg/dL) was much more common in patients with affective disorders than in those found in urban supermarket screening subjects or in the National Health and Nutrition Examination Survey II subjects. When paired with supermarket screening subjects by age and sex, patients with affective disorders had much lower TC, LDL, HDL, and higher TG concentrations. However, there was no evidence that low plasma cholesterol could cause or worsen affective disorders [34]. 

Antipsychotics are also used for mania/bipolar affective disorder, depression, some anxiety disorders, and rapid tranquilisation (p442 144). 

Melatonin [73-31-4] C 2H N202 (31) has marked effects on circadian rhythm (11). Novel ligands for melatonin receptors such as (32) (12), C2yH2gN202, have affinities in the range of 10 Af, and have potential use as therapeutic agents in the treatment of the sleep disorders associated with jet lag. Such agents may also be usehil in the treatment of seasonal affective disorder (SAD), the depression associated with the winter months. Histamine (see Histamine and histamine antagonists), adenosine (see Nucleic acids), and neuropeptides such as corticotropin-like intermediate lobe peptide (CLIP) and vasoactive intestinal polypeptide (VIP) have also been reported to have sedative—hypnotic activities (7). 

VMATs are irreversibly inhibited by the potent antihypertensive drug reserpine. The depressive effects of reserpine helped to formulate the original monoamine hypothesis of affective disorders. Reseipine also appears to interact with the transporters near the site of substrate recognition. Tetrabenazine, which is used in treatment of movement disorders, inhibits VMAT2 much more potently than VMAT1, consistent with the less hypotensive action of this agent. 

Dean AJ, Bell J, Mascord DJ, et al A randomized, controlled trial of fluoxetine in methadone maintenance patients with depressive symptoms. J Affect Disord 72 ... 

The anxiety disorders are a case in point. They comprise a range of conditions contiguous with the affective disorders and the stress responses (Table 4.1). Much overlap and comorbidity exist. Furthermore, definitions and diagnostic criteria have changed substantially over the years. For example, generalized anxiety disorder is a rare condition in its pure form, but a common condition if comorbid phobic and depressive disorders are accepted. 

The usually accepted prevalences for generalized anxiety disorder (GAD) are around 1.6% for current, 3.1% for 1 year and 5.1% lifetime (Roy-Byrne, 1996). The condition is twice as common in women as in men (Pigott, 1999). A small minority (10%) have GAD alone, and about the same proportion suffer from mixed anxiety and depression. Morbidity is high. About a half of those with uncomplicated GAD seek professional help, but two-thirds of those with comorbid GAD do so. Up to a half take medication at some point. The condition may coexist with other anxiety disorders such as phobias, with affective disorders, or with medical conditions such as unexplained chest pain and irritable bowel syndrome. 

Depression and mania are both affective disorders but their symptoms and treatments are quite distinct. Mania is expressed as heightened mood, exaggerated sense of self-worth, irritability, aggression, delusions and hallucinations. In stark contrast, the most obvious disturbance in depression is melancholia that often co-exists with behavioural and somatic changes (Table 20.1). Some individuals experience dramatic mood swings between depression and mania. This is known as "bipolar disorder which, like mania itself, is treated with lithium salts or neuroleptics. 

QUESTION Does anything suggest that people who have taken these drugs or MDMA for a period of time are subject to episodes of depressive disorders or affective disorders ... 

Furukawa, T. A., Kitamura, T. Takahashi, K. (2000). Treatment received by depressed patients in Japan and its determinants naturalistic observation from multi-center collaborative follow-up study. /. Affect. Disord., 60(3), 173-9. 

Ikemi, Y. and S. Nakagawa, A Psychosomatic Study of Contagious Dermatitis , Kyoshu Journal of Medical Science 13 (1962) 335-50 Imel, Zac E., Melanie B. Malterer, Kevin M. McKay and Bruce E. Wampold, A Meta-Analysis of Psychotherapy and Medication in Unipolar Depression and Dysthymia , Journal of Affective Disorders no (2008) 197-206... 

Wampold, Bruce E., Takuya Minami, Thomas W. Baskin and Sandra Callen Tierney, A Meta-(Re)Analysis of the Effects of Cognitive Therapy Versus Other Therapies for Depression Journal of Affective Disorders 68 (2002) 159-65... 

In clinical psychiatric terms, the affective disorders can be subdivided into unipolar and bipolar disorders. Unipolar depression is also known as psychotic depression, endogenous depression, idiopathic depression and major depressive disorder. Bipolar disorder is now recognised as being heterogeneous bipolar disorder I is equivalent to classical manic depressive psychosis, or manic depression, while bipolar disorder II is depression with hypomania (Dean, 2002). Unipolar mania is where periods of mania alternate with periods of more normal moods. Seasonal affective disorder (SAD) refers to depression with its onset most commonly in winter, followed by a gradual remission in spring. Some milder forms of severe depression, often those with an identifiable cause, may be referred to as reactive or neurotic depression. Secondary depression is associated with other illnesses, such as neuro-degenerative or cardiovascular diseases, and is relatively common. 

Table 12.1. Symptoms of the affective disorders major depression and mania. 

Neurochemical theories for the affective disorders propose that there is a link between dysfunctional monoaminergic synapses within the central nervous system (CNS) and mood problems. The original focus was the neurotransmitter noradrenaline, or NA (note noradrenaline is called norepinephrine, or NE, in American texts). Schildkraut (1965) suggested that depression was associated with an absolute or relative deficiency of NA, while mania was associated with a functional excess of NA. Subsequently, another monoamine neurotransmitter 5-hydroxytryptamine (5-HT), or serotonin, was put forward in a rival indoleamine theory (Chapter 2). However, it was soon recognised that both proposals could be reconciled with the available clinical biochemical and pharmacological evidence (Luchins, 1976 Green and Costain, 1979). 

---