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Caroline Woodham/Photographer's Choice/Getty Images

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While his bride awaited him, Abraham Lincoln was suffering from a depressive episode that was so severe he was unable to proceed with the wedding until several days later.

UPI-Bettmann/Corbis

Figure 6.1 Cross-cultural data on the onset of major depressive disorder (MDD). (From “The Changing Rate of Major Depression: Cross-National Comparisons,” by the Cross-National Collaborative Group, 1992, Journal of the American Medical Association, 268, 3098-3105. Copyright © 1992 by the American Medical Association. Reprinted by permission.)

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Queen Victoria remained in such deep mourning for her husband, Prince Albert, that she was unable to perform as monarch for several years after his death.

Hulton-Deutsch Collection/Corbis

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Most seasonal affective disorders involve depression in winter, when the light is low and the days are short.

Rob Howard/Corbis

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Among adolescents, severe major depressive disorder occurs mostly in girls.

Royalty-Free/Corbis

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Depression among the elderly is a serious problem that can be difficult to diagnose because the symptoms are often similar to those of physical illness or dementia.

Matthew McVay/Stock Boston

Figure 6.2 Co-occurrence of types of mood disorders in twins for unipolar (UPD) and bipolar (BPD) affective disorder (AD). (From “The Heritability of Bipolar Affective Disorderand the Genetic Relationship to Unipolar Depression” by P. McGuffin, F. Rijsdijk, M. Andrew, P. Sham, R. Katz, and A. Cardno, Archives of General Psychiatry, 60, 497-502. Copyright © 2003 by the American Medical Association. Adapted with permission.)

Figure 6.3 Context and meaning in life stress situations. (From “Life Events and Measurement,” by G. W. Brown. In G. W. Brown and T. O. Harris, Eds., Life events and illness, 1989. Copyright © 1989 by Guilford Press. Reprinted by permission.)

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According to the learned helplessness theory of depression, people become depressed when they believe they have no control over the stress in their lives.

Jon Feingersh/Corbis

Figure 6.4 Beck's cognitive triad for depression.

Figure 6.5 n Lifetime international rate per 100 people for major depression. (From “Depression in Women: Implications for Health Care Research,” by M. M. Weissman and M. Olfson, 1995, Science, 269. Copyright © 1995 American Association for the Advancement of Science. Reprinted with permission.)

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Of the impoverished people in the United States, three-quarters are women and children.

Tony Freeman/PhotoEdit, Inc.

Figure 6.6 An integrative model of mood disorders.

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Of the synthetic drugs for depression, fluoxetine (Prozac, left), is the most widely used; the common groundcover hypericum (St. John's wort, right) is being tested as an effective natural treatment.

Scott Camazine/Photo Researchers, Inc.

Patrick Johns/Corbis

Figure 6.7 Data on relapse after treatment for depression. (From “Differential Relapse Following Cognitive Therapy and Pharmacotherapy for Depression,” by M. D. Evans, S. D. Hollon, R. J. DeRubeis, J. M. Piasecki, W. M. Grove, M. J. Garvey, and V. B. Tuason, 1992, Archives of General Psychiatry, 49, 802-808. Copyright © 1992 by the American Medical Association. Reprinted by permission.)

Figure 6.8 Survival (nonrelapse/nonrecurrence) curves comparing relapse/recurrence with major depression for treatment as usual and mindfulness-based cognitive therapy in patients with three or more previous episodes of major depression. CT = cognitive therapy. (From Teasdale et al., 2000.)

Figure 6.9 Survival curves for bipolar patients assigned to family-focused treatment (FFT) and medication or crisis management (CM) and medication (intent-to-treat analysis, N = 101). Comparison of the curves revealed that patients undergoing FFT had longer survival intervals without experiencing disease relapse than patients undergoing CM (Wilcoxon X 21 = 8.71, P = 0.003). (From “A Randomized Study of Family-Focused Psychoeducation and Pharmacotherapy in the Outpatient Management of Bipolar Disorder,” by D. J. Miklowitz,E. L. George, J. A. Richards, T. L. Simoneau, and R. L. Suddath, Archives of General Psychiatry, 60, 604-912. Copyright © 2003 American Medical Association. Adapted with permission.)

Figure 6.10 United States suicide rates for Caucasians and non-Caucasians by age group, sexes combined. (Data from the National Center for Health Statistics, Vital Statistics of the United States, 2001.) (Centers for Disease Control and Prevention, National Center for Health Statistics, 2003, Deaths: Final data for 2001.)

Figure 6.11 Suicide rates per 100,000 in population for total population and for 15- to 19-year-olds. (Data from the National Center for Health Statistics, Vital Statistics of the United States.) (Centers for Disease Control and Prevention, National Center for Health Statistics, 2003, Deaths: final data for 2001.)

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Individuals, usually volunteers, are highly trained to help desperate people thinking of harming themselves on suicide hotlines.

© Joel Gordon

Figure 6.12 Threshold model for suicidal behavior. (From “Clinical Assessment and Treatment of Youth Suicide,” by S. J. Blumenthal andD. J. Kupfer, 1988, Journal of Youth and Adolescence, 17, 1-24. Copyright © 1988 by Plenum Publishing Corporation. Reprinted with kind permission of Springer Science and Business Media.)

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