12.1 Mood disorders Flashcards
what are the core symptoms of depressive disorders?
for 2 weeks continually, experience
- low mood
- lack of energy
- lack of enjoyment and interest
- depressive thoughts
- biological symptoms e.g lack of appetite, poor diet and libido
- in some severe cases might have psychotic symptoms e.g might believe they are responsible for tragic events
what is an adjustment reaction?
- symptoms develop suddenly after an event
- symptoms fluctuate
- time limited
- preoccupation with event
- energy not low
- no particular pattern to sleep disturbance
- reduced or increased appetite
- feelings of anger and frustration more typical
what is hypomania and mania?
hypomania = a milder form of mania
the opposite of depression
consist of
- elevated mood
- increased
- pressure of speech (speaking fast)
- reduced sleep
- flight of ideas
- normal social inhibitions are lost e.g lots of sex n drugs
- attention cannot be sustained
- self esteem is inflated, often grandiose
- may have psychotic symptoms
- only require symptoms for 1 week
what is bipolar disorder?
2 episodes of a mood disorder, at least one of which is mania or hypomania
types
bipolar 1 - episodes of mania = most severe with psychotic symptoms
bipolar 2 - hypomania = no psychotic symptoms but episodes of depression. Harder to diagnose
what physical disorders can cause mood disorders?
physical disorders
- hormone disorders e.g thyroid dysfunction
- vitamin deficiencies such as B12
- heart and lung diseases
- blood vessels not functioning well
- kidney disease
- liver disease
how can alcohol and drug misuse lead to the development of depressive episodes?
drugs = the comedown can affect you, especially the ones that induce a feeling of happiness and wellbeing
alcohol = hangover is rough
what are the main functions of the limbic system?
emotion
motivation
memory
what are the functions of the frontal lobe?
motor function language (Broca's area) executive functions attention memory mood social and moral reasoning
what systems do brain circuits play a roll in?
- cognitive processes
- sympathetic output
- parasympathetic output
- motor systems
what are the important receptors in mood disorders?
serotonin
noradrenaline
dopamine (mania and psychosis)
GABA (for anxiety)
what are the two main symptoms of psychosis?
hallucinations
delusions
what is the role of norepinephrine receptors in the brain?
mood
role in arousal and attention
memory functions
receptors are a1 a2 b1 and b1
a1 and 2 thought to play a role in arousal and attention
how does AMPT affect the brain?
AMPT inhibits tyrosine to L dopa
result = sleep, anger, calmness, depressive symptoms
Name 3 anti depressants. When would you prescribe them?
NARI
Tricyclic anti depressants (TCA)
SNRI’s
don’t give to mildly depressant or bipolar. Only severely depressed
what is the role of 5HT (serotonin) in the brain?
sleep
impulse control
appetite
mood
where is serotonin made?
brainstem (raphe nuclei) and transported to cortical areas and limbic system
why would you implicate 5HT (serotonin) in depression?
- 5HIAA depletion in CSF (a metabolite of serotonin) in patients with depression
- Tryptophan depletion (a precursor for serotonin) causes depression
- PET studies
what can cause clinical depression in terms of
- predisposing
- perpetuating (maintaining)
- precipitating
predisposing = genetics, childhood experience, female gender
perpetuating (maintaining) = stressful job, studies, relationship difficulties, substance misuse, financial strain, housing, unemployment
precipitating factors = life events often related to losses e.g a loved one, loss of health and break up of relationships
what is the kuber ross model and what are the stages?
the 5 stages of grief
they are
- denial
- anger
- bargaining
- depression
- acceptance
what is the peak onset of depression?
30/40 years old
what are some epidemiological factors for mania?
mean age of onset = 19
monozygous twins = high concordance rate
what childhood experiences can cause depression?
- quality of attachment
- quality of parental relationships
- loss of parent
- bullying
why are women more likely to suffer from an affective disorder?
- social and occupational role e.g childcare = stressful and often falls to women, number of depressive episodes relates to number of children
- men more likely to distract themselves from depressive mood
- women are more willing then man to admit to being depressed
what are some social stressors that can be perpetuating causes of depression?
- social economic status
- unemployment
- financial hardship
- isolation from family and friend
what medications can be used for depression?
antidepressants
- SSRI’s e.g sertraline, citalopram, fluoxetine
- SNRIs (serotonin and NA reuptake inhibitors)
- tricyclic antidepressants
also use mood stabilisers
e.g lithium and sodium valproate, carbamazepine, lamotrigene
ALSO COGNITIVE BEHAVIOURAL THERAPY!!!!
how would you treat bipolar mania and bipolar depression?
AVOID ANTIDEPRESSANTS
use mood stabilisers e.g lithium, sodium valproate, carbamazepine, lamotrigene
use antipsychotics e.g quetiapine, aripiprazole, olanzapine
