6A: Mood Disorder Depression

Question 1

Limbic system

Answer 1

a collection of brain regions that controls mood and attitude, is involved in storage of highly charged emotional memories, and controls appetite and sleep cycles

Question 2

Depression

Answer 2

is a set of neuropsychiatric disorders characterized by symptoms including
a pervasive low mood, low self-esteem, changes in sleep (insomnia/hypersomnia), weight loss/gain, anhedonia/loss of pleasure, thoughts of death, fatigue & loss of energy,
psychomotor agitation/retardation, feelings of worthlessness and guilt, lack of concentration, and sometimes delusions/hallucination (psychotic depression)

Question 3

Anhedonia

Answer 3

the inability to experience pleasure or interest in formerly pleasurable or satisfying activities

Question 4

Psychomotor agitation

Answer 4

is a series of unintentional and purposeless motions that stem from mental tension and anxiety of an individual. This includes pacing around a room, wringing one’s hands, uncontrolled tongue movements, pulling off clothing and putting it back on other similar actions.

Question 5

Psychomotor retardation

Answer 5

is a visible slowing of physical activity such as movement and speech

Question 6

Major depressive disorder

Answer 6

having 5 or more depressive symptoms that last without remission for at least two weeks. Usually this disorder is characterized by a loss of pleasure in most or all activities, psychomotor retardation, weight loss, guilt, and insomia.

Question 7

melancholic depression

Answer 7

the most ‘classic’ type of depression- with a low mood, insomnia, loss of appetite/weight loss, anhedonia

Question 8

Atypical depression

Answer 8

a type of depression with mood reactivity, paradoxical anhedonia despite apparent positivity, significant weight gain or increased appetite from comfort eating, hypersomnia, leaden paralysis, and a significant social impairment from hypersensitivity to perceived interpersonal rejection.

Question 9

Dysthymia

Answer 9

a less severe, but long lasting depression that lasts for at least two years

Question 10

Adjustment disorder with depressed mood

Answer 10

mood disturbances appearing as a psychological response to an identifiable event or stressor or where resulting emotional or behavioral symptoms are significant but do not meet the criteria for a major depressive episode

Question 11

Catatonic depression

Answer 11

a rare and severe form of major depression involving disturbances of motor behavior and other symptoms. The patient is mute, immobile or exhibits purposeless or even bizarre movements

Question 12

Postpartum depression

Answer 12

intense, sustained and sometimes disabling depression experienced by women within three months after giving birth that can last as long as three months. Likely due to sudden withdrawal of placental hormones at birth.
Postpartum psychosis (= postpartum mania) is also possible.

Question 13

Premenstrual dysphoric disorder (PMDD)

Answer 13

– severe, debilitating PMS with abnormal
response to normal hormonal levels. Symptoms can be any combination of depression symptoms and typically start about 1 week prior to the onset of menstruation but abruptly end when menstruation begins. Treatment: may include low-dose anti-depressants taken only during the week of symptoms.

Question 14

Seasonal affective disorder (SAD)

Answer 14

depressive disorder related to circadian rhythms in which depressive episodes come on in autumn or winter and resolve in spring. In winter time, patients experience intense hunger, weight gain, hypersomnia, and lower mood in the evening. Treatment: light therapy (phototherapy) to increase daylight exposure time

Question 15

Biological causes of depression

Answer 15

monoamine neurotransmitter, hormonal changes (postpartum, PMDD), circadian rhythm changes (SAD), stress responses from increased cortisol

Question 16

Monoamine hypothesis

Answer 16

an early hypothesis about a biological basis for
depression based on the observation medications that affect the monoamine
neurotransmitters dopamine, norepinephrine, and serotonin may have
psychological side effects affecting mood

Question 17

Specific monoamine hypothesis

Answer 17

the theory that depression results from presynaptic and/or post-synaptic changes in noradrenergic (norepinephrine) and/or
serotonergic (5-HT) pathways

Question 18

Psychosocial causes of depression

Answer 18

positive correlation between stressful life events and onset of depression

Question 19

Cognitive model

Answer 19

a model of depression that states that depressed patients hold
pessimistic views of themselves, the world, and the future with recurrent patterns
of depressive thinking, resulting in disordered information processing (led to
cognitive behavioral therapy)

Question 20

Learned hopelessness theory

Answer 20

a model of depression that states that the patient loses hope that life will get better, possibly based on early life experiences, and
they believe that negative experiences are due to stable, global reasons

Question 21

Psychotherapy (treatments of depression)
Cognitive behavioral therapy (CBT)

Answer 21

an empirically tested and widely used
type of psychotherapy for treating depression, in which patients typically meet in
groups and are taught to alter their recurrent patterns of depressive thinking so
that they can restore normal information processing

Question 22

TOD Medicine: Monoamine oxidase inhibitors (MAOIs)

Answer 22

antidepressant medication that
results in a general increase in monoamine neurotransmitters (serotonin,
norepinephrine, dopamine), but carries dietary risks

Question 23

Tricyclic antidepressants

Answer 23

antidepressant medications used to treat depression named for the three-ring chemical structure; works on serotonin and
norepinephrine

Question 24

Selective serotonin reuptake inhibitors (SSRIs) -

Answer 24

an antidepressant drug that
acts by blocking the reuptake of serotonin so that more serotonin is available to
act on receptors in the brain

Question 25

Noradrenergic serotonergic reuptake inhibitors (NSRI)

Answer 25

an antidepressant drug that acts similarly to SSRIs, but affects both serotonin and norepinephrine (norepinephrine is also called noradrenaline and is the neurotransmitter of the noradrenergic pathway).

Question 26

Stimulation:
Electroconvulsive shock therapy (ECT)

Answer 26

electric shock therapy used to treat
severe cases of depression that have not be effectively treated by other means;
basically a grand mal seizure is induced in a sedate patient to ‘jumpstart’ or
‘reboot’ the brain. Patients will lose memory of the hours/day of the ECT and
may have some fatigue.

Question 27

Transcranial magnetic stimulation

Answer 27

depression therapy done by inducing an
electrical current in the brain, but can only affect brain regions on the surface of
the brain

Question 28

Deep brain stimulation (DBS)

Answer 28

therapy used to treat severe depression where
electrodes are implanted into the basal ganglia, as in Parkinson’s disease, and
stimulate the basal ganglia at a particular frequency (exact frequency set for each
patient individually)

Question 29

Bipolar disorder
MANIA

Answer 29

– a psychological state characterized by irritability, anger or rage, delusions,
grandiose ideas and plans, hypersensitivity, hypersexuality, hyper-religiousity,
hyperactivity, impulsiveness, racing thoughts, pressured speech (pressure to keep talking,
rapid speech), and a decreased need for sleep

Question 30

Bipolar disorder
HYPOMANIA

Answer 30

• is a mood state characterized by persistent disinhibition and euphoric mood
  but generally less severe than full mania. Characteristic behaviors are being extremely energetic, talkative with a flight of creative ideas, and confident. While hypomanic
  behavior often generates productivity and excitement, it is considered to be a precursor to
  mania, which can put the subjects at great risk of harm.

Question 31

Bipolar Disorder I

Answer 31

episodes of severe depression alternate with mania

Question 32

Bipolar disorder II

Answer 32

episodes of severe depression alternate with hypomania

Question 33

Cyclothymia

Answer 33

dysthymia alternates with hypomania

Question 34

Mixed affective disorder

Answer 34

a disorder characterized by combined manic and depressive symptoms, including agitation, impulsiveness, anxiety, restlessness, aggressiveness, irritability, rage, confusion, fatigue, insomnia, morbid and/or suicidal ideation, panic, paranoia, persecutory delusions, pressured speech, and racing thoughts. Rather than experiencing periods of depression that alternate with periods of mania (as well as with normal mood periods), patients with mixed affective disorder experience manic and depressive symptoms all at the same time.

Question 35

causes of bipolar disorder
genetics

Answer 35

Genetic link plus environmental disorder – possibly related to anxiety/depression
spectrum disorders

Question 36

causes of bipolar disorder

Answer 36

Uncontrolled changes in hormonal pathways
Hypothalamus-pituitary-adrenal axis - major part of the neuroendocrine system
that controls reactions to stress and regulates many body processes, including
mood and emotion; may be abnormal in anxiety and depressive disorders

Question 37

treatments of bipolar disorder
psychotherapy

Answer 37

Cognitive behavioral therapy (CBT)

Question 38

treatments of bipolar disorder
medication

Answer 38

mood stabilizers used to prevent mania

Question 39

Lithium

Answer 39

the element lithium is used to treat bipolar disorder together with anti-depressants. It acts as a mood stabilizer (preventing mania), but
must be carefully managed because it is toxic.

Question 40

Anticonvulsants (anti-seizure medications)

Answer 40

generally lower neural activity
brain-wide.

Question 41

Antidepressants

Answer 41

but ONLY with a mood stabilizer (to stop mania)

Question 42

Antipsychotic medication

Answer 42

for manic agitation; usually act to directly or
indirectly lower dopamine