12.1 Mood disorders

Question 1

what are the core symptoms of depressive disorders?

Answer 1

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

Question 2

what is an adjustment reaction?

Answer 2

• 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

Question 3

what is hypomania and mania?

Answer 3

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

Question 4

what is bipolar disorder?

Answer 4

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

Question 5

what physical disorders can cause mood disorders?

Answer 5

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

Question 6

how can alcohol and drug misuse lead to the development of depressive episodes?

Answer 6

drugs = the comedown can affect you, especially the ones that induce a feeling of happiness and wellbeing

alcohol = hangover is rough

Question 7

what are the main functions of the limbic system?

Answer 7

emotion
motivation
memory

Question 8

what are the functions of the frontal lobe?

Answer 8

motor function
language (Broca's area)
executive functions
attention
memory
mood
social and moral reasoning

Question 9

what systems do brain circuits play a roll in?

Answer 9

• cognitive processes
• sympathetic output
• parasympathetic output
• motor systems

Question 10

what are the important receptors in mood disorders?

Answer 10

serotonin
noradrenaline
dopamine (mania and psychosis)
GABA (for anxiety)

Question 11

what are the two main symptoms of psychosis?

Answer 11

hallucinations

delusions

Question 12

what is the role of norepinephrine receptors in the brain?

Answer 12

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

Question 13

how does AMPT affect the brain?

Answer 13

AMPT inhibits tyrosine to L dopa

result = sleep, anger, calmness, depressive symptoms

Question 14

Name 3 anti depressants. When would you prescribe them?

Answer 14

NARI
Tricyclic anti depressants (TCA)
SNRI’s

don’t give to mildly depressant or bipolar. Only severely depressed

Question 15

what is the role of 5HT (serotonin) in the brain?

Answer 15

sleep
impulse control
appetite
mood

Question 16

where is serotonin made?

Answer 16

brainstem (raphe nuclei) and transported to cortical areas and limbic system

Question 17

why would you implicate 5HT (serotonin) in depression?

Answer 17

• 5HIAA depletion in CSF (a metabolite of serotonin) in patients with depression
• Tryptophan depletion (a precursor for serotonin) causes depression
• PET studies

Question 18

what can cause clinical depression in terms of

• predisposing
• perpetuating (maintaining)
• precipitating

Answer 18

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

Question 19

what is the kuber ross model and what are the stages?

Answer 19

the 5 stages of grief

they are

• denial
• anger
• bargaining
• depression
• acceptance

Question 20

what is the peak onset of depression?

Answer 20

30/40 years old

Question 21

what are some epidemiological factors for mania?

Answer 21

mean age of onset = 19

monozygous twins = high concordance rate

Question 22

what childhood experiences can cause depression?

Answer 22

• quality of attachment
• quality of parental relationships
• loss of parent
• bullying

Question 23

why are women more likely to suffer from an affective disorder?

Answer 23

• 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

Question 24

what are some social stressors that can be perpetuating causes of depression?

Answer 24

• social economic status
• unemployment
• financial hardship
• isolation from family and friend

Question 25

what medications can be used for depression?

Answer 25

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!!!!

Question 26

how would you treat bipolar mania and bipolar depression?

Answer 26

AVOID ANTIDEPRESSANTS

use mood stabilisers e.g lithium, sodium valproate, carbamazepine, lamotrigene

use antipsychotics e.g quetiapine, aripiprazole, olanzapine