Mental Illnesses are complex medical disorders that effect every aspect of life. CANMAT focuses on mood and anxiety disorders, providing up-to-date scientific information, treatment guidelines and educational opportunities for clinicians as well as clear and useful information about symptoms and treatments for patients and families.
Depression is a psychiatric disorder that affects far more than mood. Also known as major depressive disorder (MDD), depression is associated with emotional, physical and cognitive symptoms that may have a profound impact on an individual’s functioning in all areas of life (e.g. work, home, school).
The diagnosis of MDD may include feelings of sadness and/or a loss of interest or pleasure in activities or experiences that are usually enjoyable. The symptoms of MDD must be present for the majority of days, all day, for 2 or more weeks in order to meet the diagnostic criteria.
MDD is not a temporary or transient change in mood, but a serious and potentially chronic and progressive illness that requires a timely, accurate diagnosis and early, effective treatment.
Bipolar disorder (previously known as manic-depression) is actually a collection of mood disorders characterized by cyclic mood changes.
The diagnosis of bipolar I disorder must include at least one manic episode, often referred to as a “high” or “elevated” mood. Symptoms include little or no need for sleep, racing thoughts, high energy or frenetic behavior, and high-risk behaviors, such as heightened and unsafe sexual activity, excessive spending or reckless, dangerous behaviors that put lives at risk.
Bipolar I disorder is characterized by a loss of insight; thus when manic most people do not recognize their behavior as abnormal. Manic episodes often include psychotic symptoms, particularly grandiose delusions, which are false beliefs that one is extremely powerful, famous, wealthy or chosen by God to perform some divine activity. Others may experience paranoid delusions, which are false beliefs that one is being monitored or is the target of potential harm. Those with bipolar I disorder often experience episodes of depression, but that is not required to make the diagnosis.
Bipolar II disorder is characterized by alternating episodes of depression and hypomania, which are symptoms similar to mania but milder or far less extreme. Psychotic symptoms are not present in hypomanic episodes, and while risky behavior is common, it is not as extreme or potentially life-threatening as the behaviors associated with a manic episode.
Some individuals experience chronic mood instability, with frequent mood dips into feelings of depression, but do not experience the highs of mania or hypomania. This is often referred to as “soft bipolar”, because it does not meet the full criteria for bipolar I or II disorder, but does include the characteristic cyclic mood changes and seriously impacts functioning in all realms of life.
The term “anxiety” has a broad range of meanings. When describing the experience of anxiety, some might use words like feeling tense, on edge, keyed up, panicky or worried. Anxiety might also include physical symptoms like chest pressure or tightness, racing or pounding heart, or upset stomach and diarrhea. All mental illnesses may have associated anxiety symptoms. The presence of anxiety has a significant impact on prognosis and treatment, particularly resulting in illness that is less responsive to treatment. Most importantly, anxiety symptoms heighten the risk of suicidal thoughts and actions.
Anxiety disorders are a group of mental illnesses that have anxiety symptoms as their most recognizable and disabling feature. In the DSM -5, anxiety disorders include separation anxiety disorder, selective mutism, specific phobia, social anxiety disorder, panic disorder, agoraphobia, generalized anxiety disorder. Classically, obsessive compulsive disorder (OCD) was included in the anxiety disorder group, however in DSM-5, due to its unique neurobiology, OCD and related disorders are now included in a separate diagnostic category.
DSM-5 included a new “with anxious distress” specifier, applicable to depression and bipolar disorders. This was added because anxiety symptoms are frequently associated with mood disorders, their presence impacts prognosis and treatment and there is a powerful correlation between anxiety symptoms in mood disorders and suicide risk.