191 -10 Common Errors in the Diagnosis of Mood Disorders and PTSD – Addiction Counselor Training Series

Summary: Mood Disorders and PTSD Instructor: Dr. Dawn-Elise Snipes, PhD Executive Director: AllCEUs.com, Counselor Education and Training Podcast Host: Counselor Toolbox & Happiness Isn’t Brain Surgery Objectives ~ Bipolar 1 & 2 ~ Cyclothymic Disorder ~ Depressive Disorder ~ Persistent Depressive Disorder ~ Premenstrual Dysphoric Disorder ~ Circadian Rhythm Sleep Disorder ~ Generalized Anxiety ~ Social Anxiety ~ Panic Disorder ~ Agoraphobia ~ Acute Stress Disorder ~ PTSD Manic ~ A. (Often ego-syntonic) A distinct period of abnormally and persistently elevated, expansive, or irritable mood and increased activity or energy, lasting at least one week (or any duration if hospitalized). ~ Often the mood is irritable if due to the use of a substance or if the person’s wishes are denied ~ High mood liability is possible ~ In children, happiness, silliness inappropriate to context and developmental age ~ Depressive symptoms can occur during a manic episode lasting hours or a couple of days Manic ~ B. During the period of mood disturbance and increased energy or activity, 3+ of the following symptoms (four if the mood is only irritable) are present to a significant degree and represent a noticeable change from usual behavior: ~ 1) Inflated self-esteem (uncritical self-confidence) or grandiosity. ~ Despite no prior experience, person may undertake a grandiose task like writing a novel ~ Delusions of grandeur are possible ~ Children overestimate abilities and may think themselves better at things than they are ~ 2) Decreased need for sleep (eg, feels rested after only three hours of sleep). Manic ~ 3) More talkative than usual or pressure to keep talking. ~ 4) Flight of ideas or subjective experience that thoughts are racing. ~ 5) Distractibility (ie, attention too easily drawn to unimportant or irrelevant external stimuli), as reported or observed. ~ Heightened sense of smell hearing or vision may be reported ~ 6) Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation (ie, purposeless non-goal-directed activity). ~ Marked increase in sociability including talking to strangers is common ~ Dress may become markedly more seductive or flambouyant ~ Person may become aggressive or hostile Manic ~ 7) Excessive involvement in activities that have a high potential for painful consequences (eg, unrestrained buying sprees, sexual indiscretions, or foolish investments). ~ In children, developmentally inappropriate sexual preoccupations or taking on many tasks simultaneously ~ C. Causes marked impairment in social or occupational functioning or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features. ~ D. The episode is not attributable to the physiological effects of a substance (eg, a drug of abuse, a medication, other treatment) or to another medical condition. ~ Cocaine, amphetamines; Medications: steroids, L-Dopa, antidepressants, stimulants (ADHD, weight, decongestants); Light therapy, ECT, MS, Stroke, lupus, AIDS, encephalitis Manic/Hypomania ~ Hypomania: ~ A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood increased activity or energy, lasting at least four consecutive days (4 days vs. 1 week) ~ The episode is not severe enough to cause marked impairment in social or occupational functioning ~ Do not confuse with euthymia —elevated mood that occurs for a couple days following remission of major depression Major Depressive Disorder ~ A. 5 (or more) (2 or more for PDD) of the following symptoms have been present during the same 2-week period (2 years for PDD (1 in children) and represent a change from pre

191 -10 Common Errors in the Diagnosis of Mood Disorders and PTSD – Addiction Counselor Training Series

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