Depression and resilience: insights from cognitive, neuroimaging, and psychopharmacological studies
The symptoms of depression include persistent low mood, feelings of helplessness, hopelessness, or worthlessness, and anhedonia, or the inability to experience pleasure. Mood is influenced by a complex interaction of genetic, social, environmental, and other factors, such as substance abuse. Depression is further characterized by dysfunctional attitudes and negative automatic thoughts or ruminations. Psychiatric diagnostic criteria distinguish patients who experience only depressive episodes (unipolar depression or major depressive disorder, MDD) from patients who experience depressive episodes but also manic ones (bipolar disorder, BD). The symptoms of mania, on the other hand, include euphoria, over-activity, distractibility, socially inappropriate behaviour, increased appetite, and impaired insight. Thus, the emotional states of patients with depression and mania can be considered to represent two polar extremes on a mood spectrum. The states manifested in depression and mania are pathological in that they are extreme, disrupt quality of life, and are persistent and often recurrent. This chapter examines not only depression in MDD, but contrasts it with the, at times similar but at times diametrically opposed, symptoms of other disorders, such as BD, to achieve better insight. It also examines resilience in healthy individuals, i.e., how can mood remain normal despite factors such as adverse life events. Research on resilience has focused on determining the protective factors that allow some individuals to have more positive outcomes, despite being exposed to a variety of stressors.
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