[8.28] Depression and Anxiety Flashcards
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Behavioural symptoms
- mood depression / pessimism
- changes in motor function
- physiological symptoms (sleep, appetite, concentration)
causes of clinical depression
- biological (hormonal/chemical imbalance)
- medications (antivirals, corticosteroids)
- genetics
- major life events (loss, serious illness, abuse, substance abuse)
neurochemical changes in depression? which chemicals are involved?
- monoamine concentrations
- dopamine
- noradrenaline
- 5-HT
(and all their metabolites) –> involved in excitatory pathways
describe the limbic pathways involved
aka forebrain - contains? how connected?
contains: hypothalamus, hippocampus, amygdala, olfactory bulb, septum and parts of the thalamus (< subcortical structures) and cerebral cortex
involved in? motivation, emotion, learning and memory
describe 5-HT levels in depression
- reduced 5-HT (or rather metabolite 5-HIAA) in CSF
5-hydroxyindoleacetic acid
past classifications of depression (and why they no longer stand)
- endogenous VS reactive (by cause: stuff happens to ppl all the time, alot of grey area)
- psychotic VS neurotic (type)
- major VS minor (severity)
current classification of depression; based on which characteristics?
- unipolar VS bipolar
uni: predominant mood is depressed
bi: episodes of manic symptoms following periods of depression (basically alot of mood swings); also delusions, hallucinations
*based on: *
- duration
- number of symptoms
- cause of symptoms
- dysthmia (chronic depression - 2 years)
- atypical/severe depression (hallucinations/delusions + psychological and physical symptoms)
what is a depressive episode?
more than 5/9 symptoms + for 2 weeks or longer + significant distress and/or decline in functioning:
**- intense sadness and/or loss of interest
**
- insomnia/hypersomnia
- psychomotor agitation or retardation
- weight/appetite changes
- loss of energy
- difficulty concentrating/making decisions
- worthlessness/guilt
- suicidal ideation or behaviour
describe the 4 stages to develop clinical depression
- non-pathological (sad)
- syndromal depression (at least 2 but the duration and severity does not match minor/major)
- minor depressive disorder (2-4)
- major depressive disorder (>5)
non-generic depression (list types)
- post-partum depression (blues is diff from dep: dep caused by history of anxiety, stress during pregnancy, unplanned preg, alcohol abuse/illegal substances/smoking
- PMDD (> severe than PMS)
- seasonal affective disorder (SAD) due to lack of sunlight (vit D)
pmdd: pre-menstrual dysphoric disorder
clinical symptoms of anxiety
- physical sensations: palpitations, nausea, chest pains and/or SOB (caused by incr HR, BP, blood flow; decr immune/digestive fn)
- emotional: negative emotions, fear, apprehension, worry
- behavioural: voluntary/involuntary escapism and avoidance
types of anxiety
- GAD (common, chronic; unspecific, inarticulable)
- results in persistent muscle tension and autonomic fear reactions –> vasoconstrictory symptoms eg. headaches, heart palpitations, dizziness, insomnia) - general/social phobia (strong irrational fear/avoidance; specific stimulus / social = overwhelming anxiety and XS self-consciousness)
- panic disorder (brief, intense; episodic)
- results in trembling and shaking, dizziness, difficulty breathing; anxiety between episodes - OCD (senseless obsessions and compulsions)
- 1/5: checking, contamination, hoarding, intrusive thoughts, eating (bulimia, anorexia, binge)
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neurochemical theories of anxiety (what worsens it?)
- hyper-activity of NA [from locus coeruleus into thalamus, cortex, hypothalamus, autonomoic response]
- hypo-activity of GABA [into cortex]
- hypo-activity of 5-HT [from dorsal raphe nucleus into basal ganglia, cortex, amygdala]
- 5-HT also acts as a vasoconstrictor –> blood flow effects
means of anxiety diagnosis
diagnosis and statistical manual of mental disorders (DMS)-II
- GAD is specifically characterised apart from other anxiety disorders
