Mood, Dissociative and Personality Disorders – Psychological Disorders (PSY)

by Tarry Ahuja, MD

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    00:01 Now, let’s get into the second broad bin of psychological disorders that I would say is probably the most common would be mood disorders.

    00:11 So these are disorders characterized by a persistent pattern of abnormal mood and there’s what we’re referring to as affect and mood.

    00:21 So affect refers to an individual’s visible emotion in the moment, and mood is sustained internal emotion that reflects his or her view of life.

    00:29 So when we look at things like depression that would fall under mood disorder.

    00:34 This is sort of a long-term impact on their view on life and the emotion they’re going to portray.

    00:41 So somebody who is depressed isn’t going to be smiling all the time and super happy and smelling the roses.

    00:47 Emotionally speaking, the visible emotion that you see would be a little bit more downtrodden, will be a little bit more on the negative side, and their internal mood would be that they feel like what’s the point of living, I’m so unhappy, you know, and I don’t find happiness in the things that I should be finding happiness in.

    01:05 So, again, we’re going to look at five major mood disorders, with MDD or major depressive disorder being the first, and this is where you have one or more major depressive episodes.

    01:14 And what we mean by major depressive episodes are these are fairly dramatic and impactful and that you know, you have things like suicide ideation or attempts at suicide or you know, in unfortunate cases, successful suicide, is that these are serious episodes where you now are debating your existence saying, “Why should I be here? What’s the point?” Dysthymia or dysthymic disorder is a less intense chronic form of depression which lasts for two years and this could be less dramatic than MDD, but it’s still depression nonetheless.

    01:50 So this might be you have the blues, you’re not necessarily considering or thinking about killing yourself, but you’re also not happy.

    01:57 So you’re in that gray zone and we would call that dysthymic disorder.

    02:03 Bipolar disorder is one that actually includes two states.

    02:07 So it’s a state of mania and depression.

    02:11 So mania is when you’re overly optimistic and you are beyond happy and the exact opposite of, say, depression and you would cycle between these two states.

    02:21 And you have two different types of bipolar disorder, you have bipolar I and II, where you can have with bipolar I at least one manic and one mixed episode.

    02:31 With bipolar II you have one major depressive episode and one hypomanic or no mixed or manic state.

    02:36 So, again, it’s about the fact that there are two different types of states here, bipolar refers to two poles, so one being mania, one being depression.

    02:47 Cyclothymic disorder is similar to bipolar disorder but the moods are a little less extreme and so we say that we have a bit of a break between the two.

    02:59 Now, dissociative disorder, this is a psychological disorder that involves disruptions of breakdown of memory, awareness, identity, and perception and it’s thought to be caused by trauma.

    03:10 So we’ll break this down into something that’s a little bit more tangible.

    03:14 Let’s say there is a, and I eluded this before, say, a car accident or serious trauma and you, yourself, can’t deal with it.

    03:24 And so you disassociate yourself or remove yourself from the situation and you kind of tuck it away.

    03:29 And we say that this kind of happens due to self-preservation, your mind feels that it’s not equipped and doesn’t have the resources to deal with this, so you got to remove yourself in the situation.

    03:40 So things like any violence, you know, rape or domestic violence, being in a fight, being in a car accident, being in a plane accident, being involved in a war.

    03:49 You tend to block out things and forget things.

    03:53 You see this in courtroom dramas, where individuals kill their loved and they say, you know, do you remember walking into your husband’s room and stabbing him with an icepick 30 times.

    04:06 You’re like, “No, I don’t know, I don’t seem to recall that.” You’re like well, how do you not recall the icepick to the face 30 times.

    04:14 That’s something I think I would remember.

    04:16 So they say that, you know, that they were going through a dissociative episode and that the event was so traumatic and they forgot it or they’ve unconsciously decided to put that to the side.

    04:28 And with psychotherapy and some probing, it tends to come out and they say, “Actually, now I do remember bits and pieces,” and they start to deal with it.

    04:38 Now, different types of dissociative disorders.

    04:40 So you can see a trend here, we’re going to talk about one and go through a whole bunch of options, and again, my statement here is that this isn’t meant to be a catchall, this is just a sampling of some of the possible dissociative disorders.

    04:52 Dissociative amnesia is suddenly forgetting some important personal info related to that traumatic event, which we kind of outlined there.

    04:58 Dissociative fugue is a patient goes on a journey with no recall or a personal history prior.

    05:03 So again, they went and did something, which is you know, a fairly long period of time of doing an actual task, like driving somewhere, dumping a body, and coming back home and they’re saying, “Well, do you remember doing that?” “Well, no, I don’t remember that at all.” You know, or during an attack or during a fight or seeing something and that whole period is removed.

    05:24 Dissociative identity disorder, again, same idea, you want to remove yourself from the situation because you can’t deal what’s presented and they do that by creating or moving to another personality.

    05:35 Depersonalization disorder is disconnected from one’s own body, thoughts, or emotions and you see a theme here, is that you’re dissociating yourself or removing yourself or depersonalizing yourself from a situation in one way, shape, or form because of its intensity.

    05:50 Okay. So now let’s get into some personality disorders.

    05:54 So this is a psychological disorder where personality traits deviate from cultural norms and it impairs functioning and causes distress to self or of those around you.

    06:03 So we’ll get into a couple of a PDs or personality disorders.

    06:08 These are some I think ones that you could grasp and understand and these are some of the more common ones.

    06:15 So BPD or borderline personality disorder is when there’s an instability in impulse control, or mood, or image of self and others.

    06:21 So in English, these individuals really, really don’t quite grasp their personality in what they’re expressing and there’s a change in that, and so you see that they act very odd and that they are starting to express behaviors that you might not normally associate with them saying well, that’s unlike them.

    06:43 So they have trouble actually defining their personality.

    06:48 So NPD is narcissistic personality disorder and this is when these individuals feel like they are better than everybody else and more than maybe some of the proud peacocks you might know.

    06:58 This is where they think that they are so self-important that they’re better than everybody else to the point where they -- they shouldn’t be around these people.

    07:07 They have no empathy, so if somebody’s hurt or needs help, they’re not there to help.

    07:13 They’re those who say, “Well, you deserve that,” or “Why should I help you?” These are individuals that might say, “Well, I’m God,” and it sounds as an statement but there are individuals who believe that saying, “I am so important and they get something that’s termed the god complex.

    07:29 And you see this sometimes with individuals who have -- do have highly impactful or important jobs.

    07:35 Things like doctors that are a world renowned neural surgeons and are saving lives, but that doesn’t necessarily mean that they’re better than, say, the nurse who’s assisting in the surgery.

    07:46 So if you are trying to get in medical don’t become narcissistic.

    07:51 So OCD is one that we’ve mentioned.

    07:53 This is something called obsessive-compulsive personality disorder and then this is where their personality now is shaped by their OCD.

    08:02 And so, they have overarching concern with things being perfect, so, concerned with orderliness, perfectionism, and control over one’s environment.

    08:12 So back to that, my example of their desk.

    08:14 They obsess about themselves and their room and their desk, everything needs to be perfect and to the point again where it supersedes and becomes the primary goal of their daily functioning.

    About the Lecture

    The lecture Mood, Dissociative and Personality Disorders – Psychological Disorders (PSY) by Tarry Ahuja, MD is from the course Individual Influences on Behavior. It contains the following chapters:

    • Mood Disorders (PSY)
    • Dissociative Disorders (PSY)
    • Personality Disorders (PSY)

    Included Quiz Questions

    1. Affect
    2. Mood
    3. Mood disorder
    4. Effect
    5. Discongruence
    1. Mood
    2. Affect
    3. Stressor
    4. Behavior
    5. Anhedonia
    1. Dysthymic disorder
    2. Minor depressive disorder
    3. Major depressive disorder
    4. Bipolar disorder
    5. Seasonal affective disorder
    1. Bipolar disoder
    2. Cyclothymia
    3. Schizophrenia
    4. Drug-induced psychosis
    5. Schizoaffective disorder
    1. Dissociative fugue
    2. Anterograde amnesia
    3. Depersonalization disorder
    4. Dissociative vocation disorder
    5. Dissociative identity disorder

    Author of lecture Mood, Dissociative and Personality Disorders – Psychological Disorders (PSY)

     Tarry Ahuja, MD

    Tarry Ahuja, MD

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