Section 7. Mental Health Disorders

Chapter 101. Depression and Mania

Topics: Introduction | Depression | Mania | Manic-Depressive Illness

Introduction

Depression and mania represent the two extremes, or poles, of mood disorders. Mood disorders are mental health disorders in which emotional disturbances consist of prolonged periods of excessive sadness (depression) or excessive joyousness or elation (mania).

Mood disorders are sometimes called affective disorders. Affect (emphasis on the first syllable) means emotional state as revealed through facial expressions and gestures.

Sadness and joy are part of the normal experience of everyday life and differ from the depression and mania that characterize mood disorders. Sadness is a natural response to loss, defeat, disappointment, trauma, or catastrophe. Sadness may be psychologically beneficial because it permits a person to withdraw from offensive or unpleasant situations, which may aid recovery.

Grief or bereavement is the most common of the normal reactions to a loss or separation, such as the death of a loved one, divorce, or romantic disappointment. Bereavement and loss do not generally cause persistent, incapacitating depression except in people predisposed to mood disorders.

Joyousness or elation, usually linked to success and achievement, can sometimes be a defense against depression or a denial of the pain of loss. People who are dying sometimes have brief periods of elation and restless activity, and some recently bereaved people may even become elated rather than grieve normally. In people predisposed to mood disorders, these reactions may be the prelude to mania.

Depression or mania is diagnosed when sadness or elation is overly intense and continues beyond what would be expected for a particular event. Unlike normal emotional reactions, depression and mania greatly impair a person's ability to function physically, socially, and at work.

About 10% of the U.S. population experience depression severe enough to require medical attention. Of these people, one third have long-lasting (chronic) depression, and most of the remainder continue to have sporadic (recurring) episodes of depression separated by episodes of normal mood. Both chronic and recurring episodes of depression are termed unipolar. Nearly 2% of the U.S. population have a disorder called manic-depressive illness, or bipolar disorder, in which episodes of depression alternate with episodes of mania (or with episodes of less severe mania, known as hypomania). Mania without depression, also termed unipolar disorder, is very rare.

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