KLIKVID: Abnormal (Mood Disorder) Part 1

Main ideas / lessons conveyed

• The video explains mood disorders by first distinguishing mood vs. affect, then surveying unipolar (depressive) mood disorders using DSM-5 terminology.
• It highlights that depressive disorders:
  • can vary widely in symptoms and severity,
  • use diagnostic criteria involving duration, symptom count, functional impairment, and ruling out other causes (substances/medical conditions/other mental disorders),
  • differ by course (episodic vs. persistent) and context (e.g., seasonal patterns, menstrual-cycle related),
  • show notable differences across age groups, cultures, and gender.

---

Key concept: Mood vs. Affect

• Mood

  • Internal emotional state
  • Persistent/long-lasting
  • Example: feeling “very happy all day” as a sustained internal state

• Affect

  • External emotional expression
  • Shorter duration (seconds/minutes)
  • Changes quickly and is often strongly observable
  • Example: seeing an injured cat leading friends to become sad (an emotional reaction to a stimulus)

---

Overview of mood disorders (structure used in the video)

• The video references a comparison table:
  • Unipolar disorders (shown in red)
  • Bipolar disorders (shown in blue)
• This section focuses on unipolar disorders (depressive disorders).

---

Unipolar / depressive disorders covered (main points + DSM-style criteria)

1) Major Depressive Disorder (MDD)

Core description

• Characterized by:
  • deep sadness
  • loss of interest/pleasure (anhedonia)
  • physical + cognitive symptoms
  • significant disruption to daily life

Course / pattern

• Episodic (comes and goes)
• Recurrent (may return)
• Subclinical depression:
  • depressive symptoms present but not meeting full DSM-5 diagnostic criteria

Variability and severity

• Symptoms differ across patients (no single profile fits everyone)
• Severity lies on a continuum, based on:
  • number of symptoms
  • level of disturbance/impairment

Epidemiology (as stated)

• Prevalence around 16%
• Women ~2× as likely as men
• Onset often in the 20s (late 20s mentioned)
• More common in low socioeconomic status

Comorbidity (as stated)

• Anxiety disorders
• “substantive disorders” (as phrased in subtitles)
• Personality disorders

DSM-5 diagnostic criteria (method/instruction format)

Diagnose MDD when all are met:

• At least 5 symptoms total
• Symptoms last at least 2 weeks
• At least one of the 5 must be:
  • depressed mood or
  • loss of interest/pleasure
• The 9 symptom examples include:
  1. Depressed mood
  2. Loss of interest
  3. Change in weight or appetite
  4. Sleep disturbance (insomnia or hypersomnia)
  5. Psychomotor changes (agitation or retardation; observable)
  6. Fatigue / loss of energy
  7. Worthlessness or excessive guilt
  8. Concentration / decision-making difficulties
  9. Recurrent thoughts of death or suicide
• Additional requirements:
  • causes significant impairment in social/occupational/other important functioning
  • not due to substances or another medical condition
  • not better explained by another mental disorder (e.g., psychotic disorder)
  • no history of mania or hypomania episodes

---

2) Persistent Depressive Disorder (PDD) (previously dysthymia)

Core description

• Milder than MDD but more chronic
• Course comparison:
  • MDD: more extreme, episodic
  • PDD: chronic, lasting long periods

Duration

• Adults: at least 2 years
• Children/teens: at least 1 year

Key features

• Feeling depressed almost every day
• Can still function socially/work-wise, but with low energy and decreased motivation
• Sadness may be normalized as part of one’s “personality traits” due to chronic daily sadness

DSM-IV / DSM-5 difference mentioned

• DSM-IV described PDD as not overlapping with MDD
• DSM-5 allows that someone with PDD can also have MDD episodes in between

DSM-5 diagnostic criteria (method/instruction format)

Presented as Criterion A–H (briefly discussed):

• Depressed mood almost all day / most days for:
  • 2 years (adults) or 1 year (children/teens)
• During that time, at least 2 of 6 symptoms:
  1. decreased or increased appetite
  2. sleep disturbance (insomnia or hypersomnia)
  3. low energy / fatigue
  4. low self-esteem
  5. poor concentration or difficulty making decisions
  6. feelings of hopelessness
• Additional requirements:
  • no symptom-free period longer than 2 consecutive months
  • no manic/hypomanic episodes
  • not meeting criteria for bipolar disorder
  • not better explained by psychotic disorders or due to substances/medical conditions
  • causes significant impairment in functioning

---

3) Premenstrual Dysphoric Disorder (PMDD) (“PMD” in subtitles)

Core description

• A cyclical mood disorder occurring during the luteal/premenstrual phase
• Includes severe emotional and physical symptoms interfering with:
  • social functioning
  • work
  • interpersonal relationships

PMDD vs. PMS (as explained)

• PMS is far more common and includes physical symptoms + mood swings
• PMDD is much worse than PMS
• Not all women with PMS have PMDD

Prevalence (as stated)

• PMDD: ~1.8% to 5.8% of women of reproductive age
• PMS: about 75% of women
• Symptoms begin around ages 20–30
• Risk increases with a history of mood disorders

DSM-5 diagnostic criteria (method/instruction format)

PMDD requires:

• Symptoms occur in the week before menstruation
• Symptoms improve after menstruation begins or disappear after it ends
• At least one symptom from the mood/emotional category (Criterion A), including (examples given):
  • labile affect / rapid mood changes
  • easily crying
  • irritability or anger
  • depressed mood / feelings of hopelessness / self-deprecation
  • tense anxiety / feeling “on edge”
• At least 4–5 total additional symptoms from Criterion B, such as:
  • decreased interest in daily activities
  • difficulty concentrating
  • marked fatigue
  • appetite changes or food cravings
  • sleep disturbances
  • feeling overwhelmed / unable to control oneself
  • physical symptoms (breast tenderness, aches, bloating, weight gain)
• Additional requirements:
  • interferes with social/work/other important activities
  • not an exacerbation of another mental disorder (e.g., MDD or anxiety disorder)
  • symptom pattern confirmed across more than 2 menstrual cycles
  • not due to drugs/substances or other medical conditions
• The video emphasizes daily symptom monitoring to confirm timing and duration

---

4) Disruptive Mood Dysregulation Disorder (DMDD) (children/teens)

Core description

• A disorder for children and adolescents
• Characterized by:
  • severe, chronic mood-related irritability/anger
  • intense, repeated anger outbursts
  • irritability/anger between outbursts

Clarification made

• The speaker argues that “depression” isn’t only quiet withdrawal/tiredness—this disorder can involve anger-based “depression-like” presentations (as framed in subtitles).

Etiology (factors mentioned)

Biological

• Excessive amygdala activity (more angry reactions)
• Prefrontal cortex dysfunction (difficulty regulating impulses/emotions)
• Serotonin/dopamine dysregulation
• Genetic factor

Psychosocial

• Inconsistent parenting
• Prolonged violence/conflict within family
• Chronic stress or social rejection
• Difficult/highly reactive temperament

Epidemiology / comorbidity (as stated)

• Prevalence: 2–5% among children/adolescents
• More common in boys and at school age
• Often overlaps with ADHD, ODD, and anxiety disorders

DSM-5 diagnostic criteria (method/instruction format)

Diagnosis involves criteria A–K (outlined in subtitles), including:

• Severe, repeated outbursts of anger (verbal and/or behavioral) inappropriate for development
• Outbursts on average 3+ times/week
• Mood between outbursts: irritable/angry most of the day, nearly every day (observable by others)
• Duration:
  • lasts at least 1 year
  • no break > 3 consecutive months
• Setting requirement:
  • symptoms appear in at least 2 of 3 environments (e.g., home, school, playground)
• Onset:
  • diagnosis made ages 6–18
  • symptoms can begin as early as age 10
• Mania/hypomania exclusion:
  • never a period > 1 day meeting criteria for manic/hypomanic episode
• Not exclusively during MDD episodes and not better explained by other disorders (e.g., ODD, intermittent explosive disorder, psychotic disorder)
• Not due to substances/medical conditions

---

Additional depressive disorder mentioned (briefly)

Seasonal Affective Disorder (SAD)

• Recurring depressive episodes during autumn/winter
• More common in northern areas with shorter daylight
• Etiology factors mentioned:
  • Psychological: high self-criticism and negative thinking interpreting low energy as failure
  • Biological:
    • melatonin regulation linked to light/dark cycles
    • social anxiety disorder related to greater melatonin changes in winter
    • genetic differences in retinal light sensitivity

---

Depression epidemiology and factors (general points)

Prevalence figures (as stated)

• MDD: 16.4%
• PDD: 2.5%
• Prevalence varies by culture

Cultural symptom differences (examples given)

• Latin American culture: more complaints like tension and headaches
• Asian cultures: more weakness, tiredness, difficulty concentrating
• Developmental differences:
  • children: headaches/stomach aches
  • elderly: more cognitive complaints (distractibility, forgetfulness)

Comorbidity

• “Two out of three” people with MDD also meet criteria for anxiety disorders
• About 60% of MDD sufferers experience anxiety disorders
• Other comorbidities mentioned:
  • substance-related disorders
  • sexual dysfunction
  • personality disorders

Gender differences (as stated)

• Women about 2× more likely than men to experience MDD
• Explanations given:
  • biological/hormonal fluctuations (puberty, menstruation, postpartum, menopause)
  • social influences (sexual harassment, chronic stress, poverty, caregiving burden)
  • “cause of caring” phenomenon (bearing more emotional responsibility)
  • reactivity/stress management differences:
    • women: more self-critical attitudes, body image issues, relational stress sensitivity, emotion-focused coping
    • men: more stress tied to finances, action-focused coping, seeking distraction

---

Methodologies / step-like instruction elements included

• For PMDD: recommended daily monitoring to determine symptom timing and duration relative to menstruation.
• For DSM-based diagnosis (general approach): use DSM-5 rules requiring:
  • minimum symptom count
  • required duration
  • one or more core symptoms
  • functional impairment
  • exclusion of substances/medical conditions
  • exclusion of better explanations by other disorders
  • for unipolar disorders: absence of mania/hypomania history (explicitly stated for MDD and DMDD criteria)

---

Speakers / sources featured

Speakers

• Aisyah Hanan Askia (psychology student, “Clickfit” host/presenter)

Sources / references mentioned

• DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th edition)
• DSM-IV-TR (mentioned for comparison with PDD criteria)
• “Cen and Johnson” (as named by subtitles; likely a textbook/authors referenced)
• “e-books” (general mention; not a specific title)