564 CHAPTER 14
Major depressive disorder is the most common of the diagnosed disorders of
mood and is 1.5 to 3 times more likely in women than it is in men (American Psychiatric
Association, 2013). This is true even across various cultures (Kessler et al., 2012; Seedat
et al., 2009). Many possible explanations have been proposed for this gender difference,
including the different hormonal structure of the female system (menstruation, hormonal
changes during and after pregnancy, menopause, etc.) and different social roles played
by women in the culture (Blehar & Oren, 1997). Research has found little support for hor-
monal influences in general, instead finding that the role of hormones and other biological
factors in depression is unclear. Furthermore, studies have found that the degree of dif-
ferences between male and female rates of depression is decreasing and is nonexistent in
college students and single adults, leading some to conclude that gender roles and social
factors such as marital status, career type, and number of children may have more impor-
tance in creating the gender difference than biological differences do (McGrath et al., 1992;
Nolen-Hoeksema, 1990; Seedat et al., 2009; Weissman & Klerman, 1977). Women also tend
to ruminate, or repeatedly focus more on negative emotions, more than men, and this
may also be a contributing factor for reported gender differences in prevalence rates for
both depression and anxiety (Krueger & Eaton, 2015; Nolen-Hoeksema, 2012).
Some people find that they only get depressed at certain times of the year. In partic-
ular, depression seems to set in during the winter months and goes away with the coming
of spring and summer. Seasonal affective disorder (SAD) is a mood disorder that is caused
by the body’s reaction to low levels of light present in the winter months ( Partonen &
Lonnqvist, 1998). Despite the use of this term, recent research suggests there may not be
a valid category of depression that varies by season and raise questions about the contin-
ued use of this diagnosis (Traffanstedt et al., 2016).
BIPOLAR DISORDERS Major depressive disorder is sometimes referred to as a unipolar
disorder because the emotional problem exists at only one end, or “pole,” of the emo-
tional range. When a person experiences periods of mood that can range from severe
depression to manic episodes (excessive excitement, energy, and elation), that person is
said to suffer from a type of bipolar disorder (American Psychiatric Association, 2013).
However, while an individual may experience periods of mood at the two extremes, in
some instances the individual may only experience mood that spans from normal to
manic and may or may not experience episodes of depression, called bipolar I disorder.
In the manic episodes, the person is extremely happy or euphoric* without any real
cause to be so happy. Restlessness, irritability, an inability to sit still or remain inac-
tive, and seemingly unlimited energy are also common. The person may seem silly
to others and can become aggressive when not allowed to carry out the grand (and
sometimes delusional) plans that may occur in mania. Speech may be rapid and jump
from one topic to another. Oddly, people in the manic state are often very creative until
their lack of organization renders their attempts at being creative useless (Blumer, 2002;
McDermott, 2001; Rothenberg, 2001). In bipolar II disorder, spans of normal mood are
interspersed with episodes of major depression and episodes of hypomania, a level of
mood that is elevated but at a level below or less severe than full mania (American
Psychiatric Association, 2013).That sounds almost like a description of an overactive child—
can’t sit still, can’t concentrate—are the two disorders related?The answer to that question is actually part of an ongoing controversy. There
does seem to be a connection between attention-deficit/hyperactivity disorder (ADHD)
and the onset of bipolar disorder in adolescence (Carlson et al., 1998), but only a smallmanic
having the quality of excessive
excitement, energy, and elation or
irritability.
bipolar disorder
periods of mood that may range from
normal to manic, with or without
episodes of depression (bipolar I
disorder), or spans of normal mood
interspersed with episodes of major
depression and episodes of hypomania
(bipolar II disorder). *euphoric: having a feeling of vigor, well-being, or high spirits.