Facts About Mood and Anxiety Disorders

Depression

There are several types of depression - major depression, dysthymia, bipolar depression, and Seasonal Affective Disorder.

Clinical depression or major depression is a serious and common disorder of mood that is pervasive, intense and attacks the mind and body at the same time. Current theories indicate that clinical depression may be associated with an imbalance of chemicals in the brain that carry communications between nerve cells that control mood and other bodily systems. Other factors may also come into play, such as negative life experiences including stress or loss, medication, other medical illnesses, and certain personality traits and genetic factors.

Symptoms of depression:

• Persistent sad, anxious or empty mood
• Feelings of hopelessness or pessimism
• Feelings of guilt, worthlessness, or helplessness
• Loss of interest or pleasure in ordinary activities
• Decreased energy, a feeling of fatigue
• Difficulty concentrating or making decisions
• Restlessness or irritability
• Inability to sleep or oversleeping
• Changes in appetite or weight
• Unexplained aches and pains
• Thoughts of death or suicide

Dysthymia is a milder form of depression that lasts two years or more. It is the second most common type of depression but because people with dysthymia may only have two or three symptoms, may be overlooked and go undiagnosed and untreated.

Seasonal Affective Disorder is a type of depression that follows seasonal rhythms, with symptoms occurring in the winter months and diminishing in spring and summer. Current research indicates that the absence of sunlight triggers a biochemical reaction that may cause symptoms such as loss of energy, decreased activity, sadness, and excessive eating and sleeping. (See SAD article.)

Bipolar Disorder

Bipolar disorder, also known as manic-depression, is a type of mental illness that involves a disorder of affect or mood. The person's mood usually swings between overly "high" or irritable to sad and hopeless, and then back again, with periods of normal mood in between.

Symptoms include:

• Extreme irritability and distractibility
• Excessive "high" or euphoric feelings
• Increased energy, activity, restlessness
• Racing thoughts, rapid speech
• Decreased need for sleep
• Unrealistic beliefs in one's abilities and powers
• Increased sexual drive
• Abuse of drugs or alcohol
• Reckless behavior such as spending sprees, rash business decisions, or erratic driving
• In severe cases, hallucinations and loss of reason

Mental health specialists refer to bipolar disorder by type: Type I bipolar disorder involves extreme upswings in mood (mania) coupled with downward spirals. In Type II, the upward swings are more mild (hypomania), but the frequency and intensity of the depressive phase is often severe. Since the elevated mood states of Type II are relatively mild, they are often missed and the bipolar nature of the illness goes undiagnosed.

Generalized Anxiety Disorder (GAD)

Generalized Anxiety Disorder (GAD) is characterized by excessive, unrealistic worry that lasts six months or more. In adults, the anxiety may focus on issues such as health, money, or career. In addition to chronic worry, GAD symptoms include trembling, muscular aches, insomnia, abdominal upsets, dizziness, and irritability.

Symptoms include:

• Excessive worry about everyday things that interferes with daily functioning
• Physical symptoms such as sweating, nausea, clammy hands
• Associated with higher risk for suicide

Post-traumatic Stress Disorder (PTSD)

Post-traumatic Stress Disorder is a complex health condition that can develop in response to a traumatic experience - a life-threatening or extremely distressing situation that causes a person to feel intense fear, horror or a sense of helplessness.

Symptoms include:

• Re-experiencing the event through intrusive thoughts or dreams
• Avoiding conversations or situations that remind the sufferer of the event
• A sense of detachment
• Irritability, anxiousness, hypervigilance
• Outbursts of anger

Men:

• In the United States, depression affects nearly 7% of men (6 million men).
• Four times as many men as women die by suicide in the U.S.
• Men often deal with depression by withdrawing from others and throwing themselves into their work, engaging in risky or dangerous behavior, and/or becoming angry, frustrated and abusive.
• It remains unclear whether depression is actually less common among men, or if men are just less likely to recognize and acknowledge the symptoms than women.

Women:

• Women 18 to 45 years of age account for the largest proportion of people suffering from depression.
• Twenty to 40 percent of menstruating women experience premenstrual mood and behavioral changes.
• Approximately 2 to 10 percent of women experience Premenstrual Dysphoric Disorder, a severe form of premenstrual syndrome that is characterized by severely impairing behavior and mood changes.
• In one major study, 100 percent of women who had experienced severe childhood sexual abuse developed depression later in life.
• Although bipolar disorder is equally common in women and men, research indicates that approximately three times as many women as men experience rapid cycling.
• Other research findings indicate that women with bipolar disorder may have more depressive episodes and more mixed episodes than do men with the illness.

Postpartum Depression:

• As many as 10 percent to 15 percent of women experience a clinical depression during pregnancy or after the birth of a baby.
• There is a three-fold increase in risk of depression during or following a pregnancy among women with a history of mood disorders. Once a woman has experienced a postpartum depression, her risk of having another reaches 70 percent.
• As many as 80 percent of women experience the "postpartum blues," a brief period of mood symptoms that is considered normal following childbirth.

Depressive Illness and Latinos:

• According to a 1997 National Ambulatory Medical Care Survey, the number of Latinos diagnosed with a depressive illness increased 72.9% since 1992 .
• A recent study found that Latinos are disproportionately diagnosed as having major depression compared with the other ethnic groups .
• Latinos are more likely to present "somatic" symptoms of depression, like body aches and nervousness .
• In the year 2002, 37% of Latinos were uninsured - nearly twice the rate as Caucasians .

Children:

• About 2% of school-aged children (i.e. children 6-12 years of age) appear to have a major depression at any one time. With adolescence, girls, for the first time, have a higher rate of depression than boys. This greater risk for depression in women persists for the rest of life. Depression is diagnosable before school age (i.e. ages 2-5) where it is somewhat more rare but definitely occurs. Overall, approximately 20% of youth will have one or more episodes of major depression by the time they become adults.
• Bipolar disorder is more likely to affect the children of parents who have the disorder. When one parent has bipolar disorder, the risk to each child is estimated to be 15-30%. When both parents have bipolar disorder, the risk increases to 50-75%.
• According to the American Academy of Child and Adolescent Psychiatry, up to one-third of the 3.4 million children and adolescents with depression in the United States may actually be experiencing the early onset of bipolar disorder.

Adolescents:

• About 4% of teenagers have major depressive disorder (MDD) at any one time. Among teens, girls are more often affected than boys. MDD frequently interferes with home, school and family life, including causing a lot of family stress. Suicide is the third leading cause of death among teenagers, with about half of these associated with depression. This makes depression a common and serious illness that is important to identify and treat early in the course of the disease.
• Up to 90% of bipolar disorders start before age 20.

Older adults:

• Depression in its many forms affects more than 6.5 million of the 35 million Americans who are 65 years or older.
• Symptoms in older persons may differ somewhat from symptoms in other populations. Depression in older people is often characterized by memory problems, confusion, social withdrawal, loss of appetite, inability to sleep, irritability, and, in some cases, delusions and hallucinations.
• Somatic symptoms of depressive disorders, such as aches and pains, can sometimes be obscured by other physical problems in older adults.

African Americans:

• Adult Caucasians who have either depression or an anxiety disorder are more likely to receive treatment than adult African Americans with the same disorders even though the disorders occur in both groups at about the same rate, taking into account socioeconomic factors.
• More than 2.5 million African Americans have bipolar disorder.
• According to the 2001 Surgeon General's report on mental health, the prevalence of mental disorders is believed to be higher among African-Americans than among whites, and African Americans are more likely than whites to use the emergency room for mental health problems.
• African Americans with depression were less likely to receive treatment than whites (16 percent compared to 24 percent).
• Only 26 percent of African-Americans with diagnosed generalized anxiety disorder received treatment for their disorder compared to 39 percent of whites with a similar diagnosis, according to the 2001 Surgeon General's report on mental health.

Parental Depression:

• Preschool children of depressed mothers have been reported to have lower social competence.
• School age and adolescent children of depressed parents have more difficulty relating to peers, higher rates of depression and anxiety, and increased rates of disruptive behavior problems.
• Sons of depressed fathers show decreased levels of cognitive performance.

PTSD Statistics:

• An estimated 70 percent of adults in the United States have experienced a traumatic event at least once in their lives, and up to 20 percent of these people go on to develop Post-traumatic Stress Disorder, or PTSD.
• An estimated 5 percent of Americans - more than 13 million people - have PTSD at any given time.
• Approximately 8 percent of all adults - one of 13 people in this country - will develop PTSD during their lifetime.
• An estimated one out of 10 women will get PTSD at some time in their lives. Women are about twice as likely as men to develop PTSD. This may be due to the fact that women tend to experience interpersonal violence (such as domestic violence, rape or abuse) more often than men.
• Almost 17 percent of men and 13 percent of women have experienced more than three traumatic events in their lives.

General Info:

• Mental disorders are the leading cause of disability (lost years of productive life) in North America, Europe and, increasingly, in the world. By 2020, Major Depressive illness will be the leading cause of disability in the world for women and children.
• Mental illnesses strike individuals in the prime of their lives, often during adolescence and young adulthood. All ages are susceptible, but the young and the old are especially vulnerable.
• 10-15% of all depressions are triggered by other medical conditions (such as thyroid disease, cancer or neurologic problems) or by medications. The use of drugs and alcohol can also cause depression.
• The lifetime prevalence of Major Depressive Disorder is 16.2% (32.6-35.1 million US adults) and the one year prevalence is 6.6% (13.1-14.2 million US adults).
• Bipolar Disorder is often missed, with delays in diagnosis of 8-10 years.
• About 2.8% of the U.S. population (4 million Americans) has Generalized Anxiety Disorder (GAD) during a year's time. GAD most often strikes people in childhood or adolescence, but can begin in adulthood, too. It affects women more often than men.
• PTSD can occur at any age and symptoms can occur even years after the trauma.

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