6A: Mood Disorder Depression Flashcards
Limbic system
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
Depression
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)
Anhedonia
the inability to experience pleasure or interest in formerly pleasurable or satisfying activities
Psychomotor agitation
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.
Psychomotor retardation
is a visible slowing of physical activity such as movement and speech
Major depressive disorder
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.
melancholic depression
the most ‘classic’ type of depression- with a low mood, insomnia, loss of appetite/weight loss, anhedonia
Atypical depression
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.
Dysthymia
a less severe, but long lasting depression that lasts for at least two years
Adjustment disorder with depressed mood
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
Catatonic depression
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
Postpartum depression
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.
Premenstrual dysphoric disorder (PMDD)
– 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.
Seasonal affective disorder (SAD)
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
Biological causes of depression
monoamine neurotransmitter, hormonal changes (postpartum, PMDD), circadian rhythm changes (SAD), stress responses from increased cortisol
Monoamine hypothesis
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
Specific monoamine hypothesis
the theory that depression results from presynaptic and/or post-synaptic changes in noradrenergic (norepinephrine) and/or
serotonergic (5-HT) pathways
Psychosocial causes of depression
positive correlation between stressful life events and onset of depression
Cognitive model
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)
Learned hopelessness theory
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
Psychotherapy (treatments of depression)
Cognitive behavioral therapy (CBT)
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
TOD Medicine: Monoamine oxidase inhibitors (MAOIs)
antidepressant medication that
results in a general increase in monoamine neurotransmitters (serotonin,
norepinephrine, dopamine), but carries dietary risks
Tricyclic antidepressants
antidepressant medications used to treat depression named for the three-ring chemical structure; works on serotonin and
norepinephrine
Selective serotonin reuptake inhibitors (SSRIs) -
an antidepressant drug that
acts by blocking the reuptake of serotonin so that more serotonin is available to
act on receptors in the brain
Noradrenergic serotonergic reuptake inhibitors (NSRI)
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).
Stimulation:
Electroconvulsive shock therapy (ECT)
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.
Transcranial magnetic stimulation
depression therapy done by inducing an
electrical current in the brain, but can only affect brain regions on the surface of
the brain
Deep brain stimulation (DBS)
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)
Bipolar disorder
MANIA
– 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
Bipolar disorder
HYPOMANIA
- 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.
Bipolar Disorder I
episodes of severe depression alternate with mania
Bipolar disorder II
episodes of severe depression alternate with hypomania
Cyclothymia
dysthymia alternates with hypomania
Mixed affective disorder
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.
causes of bipolar disorder
genetics
Genetic link plus environmental disorder – possibly related to anxiety/depression
spectrum disorders
causes of bipolar disorder
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
treatments of bipolar disorder
psychotherapy
Cognitive behavioral therapy (CBT)
treatments of bipolar disorder
medication
mood stabilizers used to prevent mania
Lithium
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.
Anticonvulsants (anti-seizure medications)
generally lower neural activity
brain-wide.
Antidepressants
but ONLY with a mood stabilizer (to stop mania)
Antipsychotic medication
for manic agitation; usually act to directly or
indirectly lower dopamine
