13) Depression

Question 1

What’s Major Depression?

Answer 1

• Major depression is the most commonly diagnosed mood disorder.
• females are 2x as likely to suffer from depression than males are

Question 2

When does Major Depression emerge?

Answer 2

At any age, but it’s most common around puberty
Typical age of onset:
- 20-30 years old
- 10% of those diagnosed are 55+ years old when they have their first episode.
- 25% 18-29 have already experiences major depressive disorder, an increase

Question 3

What’s the length of a depressive episode?

Answer 3

It can vary between 2 weeks - 2 years minimum. However, the residual symptoms strongly predict the later relapse

Question 4

Phenomenology & Diagnostic Features:

Anhedonia

Answer 4

The loss of interest in activities that you previously enjoyed doing.

Question 5

Phenomenology & Diagnostic Features:

Psychomotor Retardation

Answer 5

An Individuals difficulty to perform tasks - it becomes something that take up an enormous amount of time and energy
(ie. getting out of bed)

Question 6

Phenomenology & Diagnostic Features:

Decreased Cognitive Abilities

Answer 6

Many find it hard to concentrate & Make decisions.

When this symptoms appear in the elderly it is mistakes sometimes with pseudodementia

Question 7

Phenomenology & Diagnostic Features:

Change In Appetite

Answer 7

It can either increase or decrease food consumption. Those who tend to eat more generally eats more carbohydrate based foods.

Question 8

Phenomenology & Diagnostic Features:

Sleep Disturbances

Answer 8

it can either increase or decrease like sleep.

Question 9

Phenomenology & Diagnostic Features:

Feeling of Worthlessness or Guilt

Answer 9

People find that everyday occurrences as evidence of personal defects

Question 10

Phenomenology & Diagnostic Features:

Thoughts of Death, Suicidal Ideation, or Suicide Attempts

Answer 10

May have transient thoughts of suicide with or without specific plan, or thoughts of just not waking up in the morning.

Question 11

Exogenous Depression

Answer 11

Natural reaction to bad things happening, and it is normal, perfectly healthy.

Question 12

Endogenous Depression

Answer 12

exaggerated reaction to bad events, or negative reaction to non harmful, non offensive events.
“Comes from within”.
They feel as though they lives are worse than it actually is

Question 13

Based on the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition), What is the key element of Major depression?

Answer 13

That is should cause clinically significant distress or impairment.

Question 14

Monoamine Hypothesis

Answer 14

Depression is the results form the dysfunction to the monoamine neurotransmitter system. That there is not enough monoamine neurotransmitters in the body

Question 15

Glucocorticoid Hypothesis

Answer 15

Depression is the result from over-activity of the HPA axis (Hypothalamic–pituitary–adrenal axis)

Question 16

Cytokine hypothesis

Answer 16

Depression results form over activity of cytokines & other immune signallers

Question 17

Monoamine Neurotransmitters

Answer 17

1) Serotonin
2) Dopamine
3) Epinephrine
4) Norepinephrine

Question 18

Tricyclic Antidepressants
&
Monoamine Oxidase Inhibitors (MOAIs)

Answer 18

The first drugs to specifically target the symptoms of depression.

Question 19

Tricyclics

Answer 19

the mechanism is still unknown, but it does inhibit the monoamine reuptake neurotransmitters

Question 20

Monoamine Oxidase Inhibitors

Answer 20

work by inhibiting monoamine oxidase from breaking down monoamine neurotransmitters like serotonin in the synaptic cleft

Question 21

What’s the overall affect of Tyicyclics and MAOIs in the body?

Answer 21

They both increase the amount of monoamine neurotransmitters in the synaptic cleft

Question 22

Side Effects of Tricyclics

Answer 22

Drowsiness, Blurry vision, digestive troubles

Question 23

Side Effects of MAOI’s

Answer 23

They interfere with digestive metabolism of teaming (amino acid). The excess of tryzmine in the body causes hypertensive crisis.

“Cheese Effect”

Question 24

Selective Serotonin Reuptake Inhibitors (SSRIs)

Answer 24

They selectively inhibit serotonin reuptake transporters, & by inhibiting monoamine oxidase form breaking it down. This ultimately leads to an increase in serotonin levels in the synapse

Question 25

Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)

Answer 25

these medications also inhibit norepinephrine reuptake transporters & monoamine oxidase.

Question 26

What’s the purpose of these antidepressants?

Answer 26

Increase the monoamine neurotransmitters in the synapse

Question 27

What are some of the reasons why Monoamine hypothesis can’t be the whole story?

Answer 27

1) serotonin depletion does not cause depression in healthy individuals
2) Antidepressants take a few week to affect symptoms of depression. Strange, because their effects of neurobiology are immediate.
3) Not everyone is helped by conventional antidepressants ( about 50% of the people are)

Question 28

Hypercotisolemia

Answer 28

elevated levels of cortisol in the blood, even during non stressful times

Question 29

What’s damaged due to Major Depression?

Answer 29

Hippocampus is damaged because of it

Question 30

What’s Neurogenesis &

What is it blocked by?

Answer 30

process that creates new neurons, and it is blocked by Cortisol and certain cytokines like (L-1)

Question 31

What can explain hippocampal shrinkage seen in depression?

Answer 31

Long-term decrease in hippocampal neurogenesis
&
could also explain the cognitive problems that comes with depression.