Marked by changes in mood, depression and bipolar disorder (also known as manic depression) are both highly treatable, medical illnesses. Unfortunately, many people don't get the help they need because of the misunderstanding surrounding the illnesses or the fear associated with stigma. The following are brief descriptions of depression and bipolar disorder. For more in-depth information, be sure to see our pages on depression and bipolar disorder and the differences between them.

Everyone, at various times in life, feels sad or blue. It's normal to feel sad on occasion. Sometimes, sadness is a result of things that happen in your life: for example, you move to a different city and leave friends behind...you lose your job...or a loved one dies. But what's the difference between "normal" feelings of sadness and the feelings caused by depression?

While it's normal for people to experience ups and downs during their lives, those living with depression experience specific symptoms daily for two weeks or more, making it difficult to function at work, at school or in relationships.

Depression is a treatable illness marked by changes in mood, thought and behavior. It affects people of all ages, races, ethnic groups and social classes. Although it can occur at any age, the illness often surfaces between the ages of 25 and 44. The "lifetime prevalence" of depression is 24 percent for women and 15 percent for men. This means that, at some point in their lives, 24 percent of women and 15 percent of men will experience an episode of major depression.

Kesedihan adalah sebahagian daripada pengalaman manusia. Orang mungkin berasa sedih atau tertekan apabila orang yang disayangi pergi/meninggal  atau apabila mereka menjalani cabaran hidup, seperti perceraian atau penyakit serius. Walau bagaimanapun, perasaan ini biasanya di alami dalam jangka masa yang pendek. Apabila seseorang mengalami perasaan kesedihan yang berterusan dan mendalam untuk jangka masa yang lama, maka mereka mungkin mengalami gangguan kemurungan utama / major depression diorder (MDD).

 

MDD, juga dirujuk sebagai kemurungan klinikal, iaitu keadaan perubatan yang penting yang boleh menjejaskan banyak bidang dalam hidup anda. Ia memberi kesan kepada mood dan tingkah laku serta pelbagai fungsi fizikal, seperti selera makan dan tidur. Orang dengan MDD sering kehilangan minat terhadap aktiviti yang pernah mereka nikmati dan menghadapi masalah untuk melakukan aktiviti seharian. Kadang-kadang, mereka juga mungkin merasa seolah-olah kehidupan tidak bernilai hidup.

 

Apakah gejala gangguan kemurungan utama?

Doktor anda atau profesional kesihatan mental boleh membuat diagnosis MDD berdasarkan gejala, perasaan, dan corak tingkah laku anda. Mereka akan bertanya kepada anda soalan tertentu atau memberi anda soal selidik supaya mereka dapat menentukan sama ada anda mempunyai MDD.

 

Untuk didiagnosis dengan MDD, anda perlu memenuhi kriteria gejala yang disenaraikan dalam Manual Diagnostik dan Statistik Gangguan Mental (DSM). Manual ini membantu profesional perubatan mendiagnosis keadaan kesihatan mental. Menurut kriterianya, anda harus mempunyai 5 atau lebih gejala berikut, dan mengalami mereka sekurang-kurangnya sekali sehari selama lebih dari 2 minggu:

 

·         Anda berasa sedih atau marah sepanjang hari, hampir setiap hari.

·         Anda kurang berminat dengan kebanyakan aktiviti yang pernah anda nikmati.

·         Anda tiba-tiba hilang atau bertambah berat atau mempunyai selera makan.

·         Anda mempunyai masalah tidur atau tidur lebih lama daripada biasanya.

·         Anda mengalami perasaan kegelisahan.

·         Anda merasa lelah dan kurang tenaga.

·         Anda merasa tidak bernilai atau bersalah, sering kali perkara-perkara yang biasanya tidak membuat anda merasa seperti itu.

·         Anda mempunyai kesukaran menumpukan, berfikir, atau membuat keputusan.

·         Anda memikirkan membahayakan diri sendiri atau melakukan bunuh diri.

 

 

 

 

Apa yang menyebabkan gangguan kemurungan utama?

Penyebab sebenar MDD tidak diketahui. Walau bagaimanapun, terdapat beberapa faktor yang boleh meningkatkan risiko membangunkan keadaan. Gabungan gen dan tekanan boleh mempengaruhi kimia otak dan mengurangkan keupayaan untuk mengekalkan kestabilan mood. Perubahan dalam keseimbangan hormon juga mungkin menyumbang kepada pembangunan MDD.

 

MDD juga boleh dikesan oleh:

 

·         penyalahgunaan alkohol atau dadah

·         keadaan perubatan tertentu, seperti kanser atau hipotiroidisme

·         jenis ubat tertentu, termasuk steroid

 

Bagaimanakah gangguan kemurungan utama dirawat?

MDD sering dirawat dengan ubat dan psikoterapi. Sesetengah pelarasan gaya hidup juga boleh membantu meringankan gejala tertentu. Orang yang mempunyai MDD yang teruk atau yang berfikiran merosakkan diri mereka mungkin perlu tinggal di hospital semasa rawatan. Ada juga yang perlu mengambil bahagian dalam program rawatan pesakit sehingga gejala bertambah baik.

Penyedia penjagaan utama sering memulakan rawatan untuk MDD dengan menetapkan ubat antidepresan.

Seramon serotonin reuptake selektif (SSRIs). Antidepresan ini sering diresepkan. SSRI berfungsi dengan membantu menghalang kerosakan serotonin di otak, mengakibatkan jumlah neurotransmiter yang lebih tinggi.

Serotonin adalah bahan kimia otak yang dipercayai bertanggungjawab terhadap mood. Ia boleh membantu meningkatkan mood dan menghasilkan pola tidur yang sihat. Orang dengan MDD selalunya mempunyai serotonin yang rendah. SSRI boleh melegakan gejala MDD dengan meningkatkan jumlah serotonin yang ada di dalam otak.

SSRI termasuk ubat-ubatan terkenal seperti fluoxetine (Prozac) dan citalopram (Celexa). Mereka mempunyai kesan sampingan yang agak rendah yang kebanyakan orang bertoleransi dengan baik.

 

Psikoterapi, juga dikenali sebagai terapi psikologi atau terapi perbincangan, boleh menjadi rawatan yang efektif untuk orang yang mempunyai MDD. Ia melibatkan pertemuan dengan ahli terapi secara berkala untuk membicarakan tentang keadaan dan isu berkaitan anda. Psikoterapi boleh membantu anda:

 

 

·         menyesuaikan diri dengan krisis atau peristiwa tekanan yang lain

·         menggantikan kepercayaan dan tingkah laku negatif dengan yang positif dan sihat

·         meningkatkan kemahiran komunikasi anda

·         mencari cara yang lebih baik untuk menghadapi cabaran dan menyelesaikan masalah

·         meningkatkan harga diri anda

·         mendapatkan kembali kepuasan dan kawalan dalam hidup anda

 

Selain mengambil ubat-ubatan dan mengambil bahagian dalam terapi, anda boleh membantu meningkatkan gejala MDD dengan membuat beberapa perubahan pada tabiat harian anda.

 

Makan dengan betul: Pertimbangkan untuk makan makanan yang mengandungi asid lemak omega-3, seperti salmon. Makanan yang kaya dengan vitamin B, seperti kacang dan biji-bijian, juga telah ditunjukkan untuk membantu sesetengah orang dengan MDD. Magnesium juga telah dikaitkan dengan memerangi gejala MDD. Ia didapati dalam kacang, biji, dan yogurt.

 

Menghindari alkohol dan makanan yang diproses: Memang berguna untuk mengelakkan alkohol, kerana ia merupakan sistem depresi yang saraf yang boleh membuat gejala anda lebih teruk. Selain itu, makanan tertentu yang halus, diproses dan digali mengandungi asid lemak omega-6, yang boleh menyumbang kepada MDD.

 

Mendapatkan banyak latihan: Walaupun MDD boleh membuat anda merasa sangat letih, penting untuk menjadi aktif secara fizikal. Berolahraga, terutama di luar dan dalam cahaya matahari yang sederhana, boleh meningkatkan mood anda dan membuat anda berasa lebih baik.

 

Tidur dengan baik: Sangat penting untuk mendapatkan sekurang-kurangnya 6 hingga 8 jam tidur setiap malam. Bercakap dengan doktor anda jika anda menghadapi masalah tidur.

When you become depressed, you may feel sad or hopeless and lose interest or pleasure in most activities. When your mood shifts to mania or hypomania (less extreme than mania), you may feel euphoric, full of energy or unusually irritable. These mood swings can affect sleep, energy, activity, judgment, behavior and the ability to think clearly.

Mania and hypomania

Mania and hypomania are two distinct types of episodes, but they have the same symptoms. Mania is more severe than hypomania and causes more noticeable problems at work, school and social activities, as well as relationship difficulties. Mania may also trigger a break from reality (psychosis) and require hospitalization.

Both a manic and a hypomanic episode include three or more of these symptoms:

Symptoms of bipolar disorder can be difficult to identify in children and teens. It's often hard to tell whether these are normal ups and downs, the results of stress or trauma, or signs of a mental health problem other than bipolar disorder.

Children and teens may have distinct major depressive or manic or hypomanic episodes, but the pattern can vary from that of adults with bipolar disorder. And moods can rapidly shift during episodes. Some children may have periods without mood symptoms between episodes. The most prominent signs of bipolar disorder in children and teenagers may include severe mood swings that are different from their usual mood swings.

The exact cause of bipolar disorder is unknown, but several factors may be involved, such as:

Factors that may increase the risk of developing bipolar disorder or act as a trigger for the first episode include:

Bipolar disorder can result in serious problems that affect every area of your life, such as problems related to drug and alcohol use, suicide or suicide attempts, legal or financial problems, damaged relationships, and poor work or school performance. Besides that,  you may also have another health condition that needs to be treated along with bipolar disorder such as Anxiety Disorders, Eating Disorders and Attention Deficit Hyperactivity Disorder (ADHD)

There's no sure way to prevent bipolar disorder. However, getting treatment at the earliest sign of a mental health disorder can help prevent bipolar disorder or other mental health conditions from worsening.

If you've been diagnosed with bipolar disorder, some strategies can help prevent minor symptoms from becoming full-blown episodes of mania or depression:

sumber:  https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/symptoms-causes/syc-20355955

further example : https://www.youtube.com/watch?v=DYZMnjEeyv0 

-The biological view says that mood disorders are caused by abnormalities in a person's brain. For example, maybe Eva's bipolar disorder is caused by an imbalance of chemicals in the brain, called neurotransmitters. Because the chemical balance is off, she experiences the extreme highs and lows of bipolar disorder.

-There is evidence to support the biological view of mood disorders, including many studies that show that people with mood disorders have neurotransmitter imbalances. The strongest evidence in favor of the biological view, though, is the high success rate of medication that stabilizes the levels of neurotransmitters in the brain.

-As we mentioned before, people with bipolar disorder, like Eva, are given mood stabilizers, and people with unipolar depression are given antidepressant medications. Both of these types of drugs work on the levels of chemicals in a person's brain. Because so many people get better after taking the drugs, it suggests that there is a biological foundation for mood disorders.

 

Biopsychosocial perspective refers to the body's physiological, adaptive responses to fear. It also refers to genetic traits, and the brain functioning that we "inherit.

- This personality type describes a person who is more reactive, more sensitive, and/or more easily excitable in the presence of stress.

-The psychological factors in the biopsychosocial persperctive refer to our thoughts, beliefs, and perceptions about our experiences, our environment, and ourselves. These cognitive patterns affect our perceived sense of control over our environment. These cognitive patterns also influence how we assess and interpret events in our environment as either threatening or non-threatening.

-These thoughts (cognitions) about our environment, and ourselves, play a key role in the formation of an anxiety disorder. For instance, one child's mother makes a correction to her son's homework. He interprets this as helpful and indicative of his parent's confidence in his ability to learn. Another child's mother makes a correction to her daughter's homework, and instead of interpreting this as helpful, the daughter interprets this as an indication of her limitations, and her parent's lack of confidence in her abilities. This furthers strengthens her own lack of confidence in herself.

 

-The biological view says that mood disorders are caused by abnormalities in a person's brain. For example, maybe Eva's bipolar disorder is caused by an imbalance of chemicals in the brain, called neurotransmitters. Because the chemical balance is off, she experiences the extreme highs and lows of bipolar disorder.

-There is evidence to support the biological view of mood disorders, including many studies that show that people with mood disorders have neurotransmitter imbalances. The strongest evidence in favor of the biological view, though, is the high success rate of medication that stabilizes the levels of neurotransmitters in the brain.

-As we mentioned before, people with bipolar disorder, like Eva, are given mood stabilizers, and people with unipolar depression are given antidepressant medications. Both of these types of drugs work on the levels of chemicals in a person's brain. Because so many people get better after taking the drugs, it suggests that there is a biological foundation for mood disorders.

 

Biopsychosocial perspective refers to the body's physiological, adaptive responses to fear. It also refers to genetic traits, and the brain functioning that we "inherit.

- This personality type describes a person who is more reactive, more sensitive, and/or more easily excitable in the presence of stress.

-The psychological factors in the biopsychosocial persperctive refer to our thoughts, beliefs, and perceptions about our experiences, our environment, and ourselves. These cognitive patterns affect our perceived sense of control over our environment. These cognitive patterns also influence how we assess and interpret events in our environment as either threatening or non-threatening.

-These thoughts (cognitions) about our environment, and ourselves, play a key role in the formation of an anxiety disorder. For instance, one child's mother makes a correction to her son's homework. He interprets this as helpful and indicative of his parent's confidence in his ability to learn. Another child's mother makes a correction to her daughter's homework, and instead of interpreting this as helpful, the daughter interprets this as an indication of her limitations, and her parent's lack of confidence in her abilities. This furthers strengthens her own lack of confidence in herself.

ASAL-USUL GANGGUAN EMOSI (ORIGIN OF MOOD DISORDER) - KHALIS

1.PANDANGAN PSIKOLOGI
-APATHETIC: Tidak menunjukkan sebarang minat
-INACTIVE: Tidak aktif
-Ramai orang mempunyai Depressive Disorder mempunyai External Locus of Control
-External Locus of Control: Mereka percaya sesuatu kejyaan dan kegagalan itu adalah sesuatu perkara yang tidak boleh di kawal. sebagai contoh seperti nasib,ketidakdilan dan bias.
-kemurungan dan Learned Helplessness: Terjadi apabila manusia atau haiwan berasa tidak berdaya untuk elak daripada situasi negatif

"Depression occurs when people expect that bad events will occur and that there is nothing they can do to prevent them, or cope with them"

- Faktor Kognitif juga boleh menyumbang kepada kemurungan
Sebagai contoh: Seorang yang perfectionist

Seligman (1996) suggest that when things go wrong, we may think of the causes of failure as either internal or external, stable or unstable, global or specific.
-Attributional Styles can be illustrated using the example of having a date that does not work out.

 

 People with bipolar disorder experience periods of unusually intense emotion, changes in sleep patterns and activity levels, and unusual behaviors. These distinct periods are called “mood episodes.” Mood episodes are drastically different from the moods and behaviors that are typical for the person. Extreme changes in energy, activity, and sleep go along with mood episodes. 

people with manic episode:-

people with depressive episode:-

 Sometimes a mood episode includes symptoms of both manic and depressive symptoms. This is called an episode with mixed features. People experiencing an episode with mixed features may feel very sad, empty, or hopeless, while at the same time feeling extremely energized. 

 Some bipolar disorder symptoms are similar to other illnesses, which can make it hard for a doctor to make a diagnosis:-

 It is likely that many factors contribute to the illness or increase risk. 

 Bipolar disorder is a lifelong illness. Episodes of mania and depression typically come back over time. Between episodes, many people with bipolar disorder are free of mood changes, but some people may have lingering symptoms. Long-term, continuous treatment helps to control these symptoms. 

 Different types of medications can help control symptoms of bipolar disorder.:-

 Anyone taking the medication should:-

 Some psychotherapy treatments used to treat bipolar disorder include:-

Other treatment options:-

-Suicide is second leading cause of death among college students after motor vehicle accidents.

-Suicide rates are actually highest among adults aged 65 and older

-Suicide in older adults:

·         Older people are more susceptible to diseases such as cancer and Alzheimer’s, which can leave them with feelings of helplessness and hopelessness that, in turn, can give rise to depression and suicidal thinking.

·         also suffer a mounting accumulation of losses of friends and loved ones, leading to social isolation.

·         Not surprisingly, the highest suicide rates in older men are among those who are widowed or socially isolated.

·         society should focus its attention on the quality of life that is afforded our elderly, in addition to providing them the medical care that helps make longer life possible.

-Gender and ethnic/racial differences

·         More women attempt suicide, but more men “succeed” . For every female suicide, there are four male suicides. More males “succeed” in large part because they tend to choose quicker-acting and more lethal means, such as handguns.

·         more common among (non-Hispanic) White Americans and Native Americans than African Americans, Asian Americans, or Hispanic Americans.

·         Hopelessness and exposure to others who have attempted or committed suicide may contribute to the increased risk of suicide among Native American youth.

·         Knowledge that peers have attempted or completed suicide renders suicide a highly visible escape from psychological pain..

WHY DO PEOPLE COMMIT SUICIDE?

·         Depression- allowing ideas like "Everyone would all be better off without me" to make rational sense.

·         Psychotic- Malevolent inner voices often command self-destruction for unintelligible reasons.

·         Impulsive- Often related to drugs and alcohol, some people become maudlin and impulsively attempt to end their own lives. Once sobered and calmed, these people usually feel emphatically ashamed.

·         Crying out for help- These people don't usually want to die but do want to alert those around them that something is seriously wrong.

·         Have a philosophical desire to die- The decision to commit suicide for some is based on a reasoned decision, often motivated by the presence of a painful terminal illness from which little to no hope of reprieve exists. These people aren't depressed, psychotic, maudlin, or crying out for help.

·         They’ve made a mistake- typically young people flirt with oxygen deprivation for the high it brings and simply go too far. The only defense against this, it seems to me, is education.

 

 

 

 

THEORITICAL PERSPECTIVES ON SUICIDAL

 

These draw on the classic psychodynamic model of anger turned inward; the role of social alienation; and learning, social-cognitive, and biologically based perspectives.

·         The classic psychodynamic model views depression as the turning inward of anger against the internal representation of a lost love object.

·         In his later writings, Freud speculated that suicide may be motivated by the “death instinct,” a tendency to return to the tension-free state that preceded birth. Existential and humanistic theorists relate suicide to the perception that life is meaningless and hopeless. Suicidal people report they find life duller, emptier, and more boring than nonsuicidal people (Mehrabian & Weinstein, 1985).

·         social thinker Emile Durkheim (1897/1958) noted that people who experienced anomie—who feel lost, without identity, rootless—are more likely to commit suicide.

·         Learning theorists focus largely on the lack of problem-solving skills for handling significant life stress. According to Shneidman (1985), those who attempt suicide wish to escape unbearable psychological pain and may perceive no other way out. People who threaten or attempt suicide may also receive sympathy and support from loved ones and others, perhaps making future—and more lethal—attempts more likely.

·         Social-cognitive theorists suggest that suicide may be motivated by personal expectancies, such as beliefs that one will be missed by others or that survivors will feel guilty for having mistreated the person, or that suicide will solve one’s own problems or even other people’s problems (e.g., “He won’t have to worry about me any longer”) in one fell swoop.

·         Social-cognitive theorists also focus on the potential modeling effects of observing suicidal behavior in others, especially among teenagers who feel overwhelmed by academic and social stressors. A social contagion, or spreading of suicide in a community, may occur in the wake of suicides that receive widespread publicity. Teenagers, who seem to be especially vulnerable to these modeling effects, may even romanticize the suicidal act as one of heroic courage. The incidence of suicide among teenagers sometimes rises markedly in the period following news reports about suicide. Copycat suicides may be more likely to occur when reports of suicides are sensationalized, so that other teenagers expect their deaths to have a meaningful impact on their communities (Kessler et al., 1990).

·         Biological factors are also implicated in suicide, including reduced utilization or availability of the mood-regulating chemical serotonin (Joiner, Brown, & Wingate, 2005; Malone et al., 2003). Because serotonin is linked to depression, the relationship with suicide is not surprising. Yet serotonin also acts to curb or inhibit nervous system activity, so perhaps lowered serotonin activity leads to disinhibition, or release, of impulsive behavior that takes the form of a suicidal act in vulnerable individuals. Suicide also tends to run in families, which hints at genetic factors. Genes may influence susceptibility to suicide by affecting the regulation of serotonin in the brain (Lemonde et al., 2003; Zhou et al., 2005).

·         Mood disorders in family members and parental suicide are also connected with suicide risk (Brent et al., 2002). But what are the causal connections? Do people who attempt suicide inherit vulnerabilities to mood disorders that are connected with suicide? Does the family atmosphere promote feelings of hopelessness? Does the suicide of one family member give others the idea of doing the same thing? Does one suicide create the impression that other family members are destined to kill themselves? These are all questions researchers need to address.

·         Suicide is often motivated by the desire to escape from unbearable emotional pain. Here, the celebrated actress Patty Duke, who rose to acclaim in childhood by playing the role of Helen Keller in the movie The Miracle Worker and who battled bipolar disorder throughout much of her life, expresses how the desire to escape pain motivated many of the suicide attempts she had made in her life.

PREDICTING SUICIDE

·         People who commit suicide tend to signal their intentions, often quite explicitly, such as by telling others about their suicidal thoughts. In fact, most people who commit suicide make contact beforehand with a health-care provider (Luoma, Martin, & Pearson, 2002).

·         The prediction of suicide is not an exact science, even for experienced professionals. Many observable factors, such as hopelessness, do seem to be connected with suicide, but we cannot accurately predict when a hopeless person will attempt suicide, if at all.

SUICIDE PREVENTATION

·         Draw the person out

·         Be sympathetic

·         Suggest that means other than suicide can be discovered to work out the person’s problem, even if they are not apparent at that time.

·         Ask how the person expects to commit suicide.

·         Propose that the person accompany you to consult a professional right away.

·         Don’t say something like “You’re talking crazy.”

Definisi Gangguan Emosi

-

 

Diiktirafkan sebagai satu situasi yang menunjukkan satu atau lebih karasterisitik oleh

murid-murid. Kamus dewan bahasa dan pustaka telah memberi maksud kepada

gangguan emosi sebagai gangguan emosi adalah akibat konflik yang tidak dapat

diselesaikan dan dicirikan dengan keresahan sama ada melalui pertuturan atau

perlakuan tertentu.

-

 

Gangguan emosi juga boleh ditakrifkan sebagai kelakuan menunjukkan ciri suka

menyendiri dan mempunyai emosi yang tidak stabil.

-

 

Antara gangguan personaliti yang berlaku ialah antisocial, ketidakmampuan untuk

belajar yang tidak dapat dijelaskan oleh factor-faktor intelektua, kesihatan juga menjadi

definisi untuk gangguan emosi.

-

 

Secara ringkasnya, gangguan emosi boleh dikatakan bahawa gangguan yang diterima

oleh seseorang murid yang menyebabkan emosi murid tersebut tidak stabil.