Chapter 6: Mood Disorders and Suicide

Question 1

mood disorders

Answer 1

a group of disorders involving severe and enduring disturbances in emotionality ranging from elation to severe depression

Question 2

Major depressive episode

Answer 2

extremely depressed mood and/or loss of pleasure

lasts most of the day, nearly every day for at least two weeks

anhedonia

at least 4 additional physical or cognitive symptoms: indecisiveness, feeling worthless, fatigue, appetite change, restlessness, sleep disturbance, etc.

The duration of these episodes, if untreated, is approximately 4 to 9 months.

Question 3

anhedonia (not too important to know this)

Answer 3

loss of energy and inability to engage in pleasurable actives or have any fun

Question 4

Manic

Answer 4

abnormally exaggerated elation, joy, or euphoria.

Become extremely active, require little sleep, and may develop grandiose plans, believing they can accomplish anything–that’s where it gets dangerous

Duration: 1 week, but untreated it’s 3 to 4 months

Rarely happens on it’s own (e.g. bipolar)

Question 5

Hypomanic episode

Answer 5

less severe version of mania

does NOT cause impairment

lasts 4 days

The episode itself isn’t problematic, but its presence does contribute to the definition of several mood disorders

Question 6

Individuals who experience either depression or mania are said to suffer from a _______ ______ ________, because their mood remains at one “pole” of the usual depression-mania continuum.

Answer 6

unipolar mood disorder

Question 7

mixed features (textbook)

Answer 7

term for experiencing depressive symptoms during a manic or hypomanic episode, or experiencing manic symptoms during a depressive episode

requires specifying whether a predominantly manic or predominantly depressive episode is present, and then nothing if enough symptoms of the opposite polarity are present to meet the mixed features criteria.

Question 8

Major depressive disorder

Answer 8

one or more depressive episodes and the absence of manic or hypomanic episodes before or during the disorder

can have one episode but that’s incredibly rare

usually recurring episodes separated by at least 2 months (recurrent)

unipolar depression is often a chronic condition that waxes and wanes over time but seldom disappears

duration of episodes is 4 to 5 months

7 out of 10 cases are female

Question 9

Persistant depressive disorder

Answer 9

duration at least two years of depressive symptoms, during which the patient cannot be symptom free for more than 2 months at a time

symptoms can persist unchanged over long periods (20 years or more)

may include periods o more severe major depressive symptoms

Question 10

double depression

Answer 10

severe mood disorder typified by major depressive episodes superimposed over a background of persistent depressive disorder

Question 11

Premenstrual dysphoric disorder

Answer 11

significant depressive symptoms occurring the menses period

lots of controversy on this topic, overall it’s decided to be a mood disorder and not a physical disorder

Question 12

Disruptive mood dysregulation disorder

Answer 12

children being diagnosed as this

kids being misdiagnosed at bipolar when it really should be this

symptoms: severe temper outbursts occurring frequently, chronic irritability, aggression, hyperarousal, and temper tantrums (not limited to one episode) that occur three or more times per week for at least one year.

these children show no evidence of periods of elevated mood (mania), which is required for bipolar disorder

this is more common than bipolar disorder, but it’s still relatively new so that’s why we haven’t heard of it

Question 13

Bipolar I Disorder

Answer 13

Alternations between full manic episodes and major depressive episodes (delusions can be apart of bipolar)

Onset: 15-18 years old, beginning acutely (more sudden)

Can begin in childhood

Tends to be chronic

Suicide is a common consequence, often end of manic episode (textbook says during depression episodes…)

Times of normal functioning, then six weeks of manic or depression episode, then normal, then six weeks of manic or depression, etc.

Lithium is the medicine that’s helps

Question 14

Bipolar II Disorder

Answer 14

Alternations between major depressive and hypomanic episodes

Onset: 19-22 years

Can begin in childhood

10% to 25% of cases progress to full bipolar I disorder

Tends to be chronic

Bipolar II is an overall more depressive state with hypomanic episodes (more depressed version of bipolar I)

Question 15

Cyclothymic Disorder

Answer 15

alternating between periods of mild depressive symptoms and mild hypomanic symptoms

these mood states may persist for long periods (the periods may last years with very few moments of normal or euthymic)

Onset: 12 to 14

More common in females

Chronic

1/3 to 1/2 develop full-blown bipolar

Question 16

What is the worldwide lifetime prevalence for major depression?

Answer 16

16%, 6% have experienced major depression in last year

Question 17

What are the sex differences in the prevalence of mood disorders? (depression, bipolar)

Answer 17

Females are twice as likely to have major depression

Females and males are equally likely to have bipolar disorder

Question 18

The rate in relatives with mood disorders is consistently about ___ ___ ___ times greater than in relatives of controls who idon’thave mood disorders.

Answer 18

2 to 3

Question 19

Twin studies

Answer 19

From twin studies we know that mood disorders can have a genetic component. A study shows that an identical twin is two to three times more likely to present with a mood disorder than maternal twins if the first twin has a mood disorder.

Question 20

What does serotonin regulate?

Answer 20

norepinephrine and dopamine

Question 21

______ is strongly related to mood disorders. Poorer response to treatment, longer time before remission.

Answer 21

Stress

Question 22

What are the three attributes in learned helplessness?

Answer 22

1) Internal: negative outcome’s are one’s own fault
2) stable: even after a negative event passes, they still think all future things to go wrong will be my fault
3) global: believing negative events will disrupt many life activities (e.g. someone begins to believe events are out of their control, and the bad situations are all their fault)

Question 23

What are the two types of cognitive errors?

Answer 23

1) arbitrary inference: overemphasize the negative aspects of a mixed situation
2) overgeneralization: negatives apply to all situations

Question 24

What is the best treatment for depression?

Answer 24

Be active. That includes physical activity, being around people you enjoy, doing activities you enjoy, etc. Medication is good for a time-limited case where depression is happening one time (mourning, postpartum depression).

Question 25

Monoamine Oxidase (MAO) Inhibitors

Answer 25

This antidepressant blocks the enzyme MAO that breaks down such neurotransmitters as norepinephrine and serotonin. Because they are not broken down, the neurotransmitters pool in the synapse, leading to a down-regulation.

It’s dangerous in combination with certain foods: beer, red wine, cheese, and cold medicine. Because of the dangers, it is usually only prescribed when other antidepressants are not effective.

Question 26

Lithium

Answer 26

lithium carbonate = a common salt

treatment of choice for bipolar disorder

considered a mood stabilizer because it treats depressive and manic symptoms

effective 50% of the time

why lithium works remains unclear

Question 27

Electroconvulsive Therapy (ECT)

Answer 27

an electrical current is applied to the brain to cause a seizure that acts as a reboot which makes depression go away. Can take several ECT shocks over time.

There is short-term memory loss which is usually restored. Some patients suffer long-term memory loss.

This is only available in a few hospitals. Not a common pick this one.

Question 28

What has longer-lasting effectiveness in depression than medication?

Answer 28

cognitive-behavioral therapy and interpersonal psychotherapy