Chapter 6: Mood Disorders and Suicide Flashcards
mood disorders
a group of disorders involving severe and enduring disturbances in emotionality ranging from elation to severe depression
Major depressive episode
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.
anhedonia (not too important to know this)
loss of energy and inability to engage in pleasurable actives or have any fun
Manic
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)
Hypomanic episode
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
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.
unipolar mood disorder
mixed features (textbook)
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.
Major depressive disorder
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
Persistant depressive disorder
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
double depression
severe mood disorder typified by major depressive episodes superimposed over a background of persistent depressive disorder
Premenstrual dysphoric disorder
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
Disruptive mood dysregulation disorder
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
Bipolar I Disorder
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
Bipolar II Disorder
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)
Cyclothymic Disorder
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
What is the worldwide lifetime prevalence for major depression?
16%, 6% have experienced major depression in last year
What are the sex differences in the prevalence of mood disorders? (depression, bipolar)
Females are twice as likely to have major depression
Females and males are equally likely to have bipolar disorder
The rate in relatives with mood disorders is consistently about ___ ___ ___ times greater than in relatives of controls who idon’thave mood disorders.
2 to 3
Twin studies
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.
What does serotonin regulate?
norepinephrine and dopamine
______ is strongly related to mood disorders. Poorer response to treatment, longer time before remission.
Stress
What are the three attributes in learned helplessness?
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)
What are the two types of cognitive errors?
1) arbitrary inference: overemphasize the negative aspects of a mixed situation
2) overgeneralization: negatives apply to all situations
What is the best treatment for depression?
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).
Monoamine Oxidase (MAO) Inhibitors
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.
Lithium
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
Electroconvulsive Therapy (ECT)
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.
What has longer-lasting effectiveness in depression than medication?
cognitive-behavioral therapy and interpersonal psychotherapy
