Chapter 7: Mood Disorders Flashcards

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1
Q

Symptoms of depression

A
  • Feelings of sadness, hopelessness, passivity, sleep and eating disturbances lasting for two weeks or more.
  • Experiences five or more emotional, cognitive, motivational and somatic symptoms and one of the symptoms must be depressed mood or loss of interest or pleasure.
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2
Q

Define “Episodic Depression”

A

Lasts for less than two years and has a clear beginning, which distinguishes it from previously nondepressed functioning.

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3
Q

Define “Chronic depression”

A

A.k.a., Dysthymia, is less severe than major depression. With dysthymia, the depression symptoms can linger for a long period of time, often two years or longer. Those who suffer from dysthymia can also experience periods of major depression

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4
Q

Symptoms of melancholia

A

Severity in…

  • Loss of pleasure from all activities
  • Numbing
  • General lack of reaction to pleasurable events
  • Worse in the morning
  • Early morning awakening
  • Lethargia
  • Weight loss
  • Guilt
  • Slow speech
  • Slow movement
  • Lack of reaction to environmental change during episode
  • Somatic symptoms
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5
Q

Who is most susceptible to depression?

A
  • Those born after 1970, live in a prosperous nation and are female.
  • Women twice as likely as men to get depression
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6
Q

Mood symptoms of depression

A

Comorbid with anxiety disorders
Loss of interest in bigger things (job or child-rearing), progressing to smaller things (food, sex).
64% lose enjoyment of other people

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7
Q

What percentage of Americans are depressed?

A

1/20

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8
Q

Cognitive Symptoms of depression

A

-Thinks of self in a very negative light
-Believes they are cause of own failures
Pessimistic about future

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9
Q

Motivational Symptoms of depression

A
  • Ambivalence

- Trouble getting up in the morning or getting started

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10
Q

Physical symptoms of depression

A
  • Loss of sex drive, appetite, weight
  • Somatic symptoms
  • Higher rate of physical illness
  • Especially true of melancholia
  • Depression is often symptom of cancer, heart disease and infectious illness
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11
Q

What are the theories behind the sex differences of depression?

A
  • Women more likely to admit depression than men in Western society
  • Women: Passivity and crying
  • Men: Anger or indifference
  • Women experience premenstrual dysphoric disorder: spontaneous sadness, anger, tensity, depression, apathy, overwhelmed, difficulty concentrating, appetite changes, sensitivity to rejection, sleep changes
  • Women carrying depressive gene are more likely to become depressed whereas men are more likely to become alcoholics
  • Differences of dealing with adversity: men inclined to more action and less thought and women ruminate more
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12
Q

What women are least likely to get depressed?

A

Those with…

  • Intimate relationship with significant other
  • Part or full time job
  • Fewer than three children
  • Religious commitment
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13
Q

Why do those who are depressed more prone to getting sick?

A

Hypothalamic-pituitary-adrenal axis: Greatly increased levels of cortisol in blood and cerebrospinal fluid.

  • Cortisol increases delivery of glucose to the bloodstream to enable defensive action against a stressor.
  • However, it also shuts down wound-healing and the deactivation of germs by the immune system
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14
Q

Which brain regions are suspected to cause depression?

A

Right-Frontal Lobe

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15
Q

Explain the Psychodynamic Approach of Depression

A

-Anger against the self, dependence on others for self esteem and helplessness at achieving one’s goals causes depression

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16
Q

Biological: Drug Treatment for Depression

A

Tricyclic antidepressants
-Monoamine oxidase inhibitors:
inhibit monoamine oxidase, thereby increasing norepinephrine
-Selective serotonin reuptake inhibitors:
inhibit the reuptake of serotonin
60-70% success rate in patients with mild depression
Reduces the chances of relapse

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17
Q

Biological: Electroconvulsive Shock Therapy for Depression

A
Electro-convulsive shock therapy
Discovered in 1938
80% improvement
Side-effects are high and many
Amnesia, high recurrence, motivational changes, cognitive deficits on learning and memory
Inexpensive
No known reasons as to why it works.
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18
Q

Psychological Treatment for Therapy: Cognitive Therapy

A
  • Changes the way the depressed patient thinks
  • This is not to create an inflated sense of optimism but rather get the patient into thinking the way normal people do by…
  • Detecting automatic thoughts, reality-testing said thoughts, reattribution training and changing depressogenic (depression-causing) assumptions
19
Q

What are some hormonal explanations in regards to depression?

A

-Hypothyroidism
-Low levels of testosteron
-HPA Axis:
Greatly increased levels of cortisol in blood and cerebrospinal fluid

20
Q

What is the “Theory of Learned Helplessness” in regards to treating depression

A

Change “internal, stable, global” to “external, unstable and specific.”

21
Q

What is the etiology of depression?

A
  • .6-1.1% experience bipolarity at some point in their life.
  • Appears between ages of 20 and 30
  • First attack occurs before the age of 50 mostly.
  • Episode can last several days to several months
  • Frequency and intensity of episodes tends to worsen
  • Not many episodes appear twenty years after first onset
22
Q

Explain “flexible optimism” in its treatment of depression. Name the pros, cons and considerations.

A

Pros

  • People with optimism tend to do better than pessimists.
  • Teaches people to curtail catastrophic thinking.

Cons

  • However, pessimism can keep people from seeing things as they really are.
  • Might help enable them from taking responsibility and blaming it on others.
  • Sometimes better not to dispute such thoughts

Considerations

  • Therefore, should only choose optimism when it will lead to less depression, more achievement or better health.
  • If the cost of failure is high, optimism is the wrong strategy.
23
Q

Prevalence of Bipolar Depression

A

.6-1.1% at some point in everyone’s life.

24
Q

Drug treatment of bipolar disorder and its side-effects

A

Lithium Carbonate
-Makes people with mania lethargic
-Ended severe manic attacks
-Discovered by John Cade in 1949
effective treatment for both the mania and depression of bipolarity.
-80% of patients who take it will show full or partial alleviation in symptoms when administered.
-Lots of side effects on the heart and kidney
-Physically damaging if overdose
-Especially risky for bipolar patients who need to take it and are already unreliable at taking drugs consistently

Anticonvulsant Drugs: benzodiazepines, GABA analogs

25
Q

Cycling of Bipolarity

A

Cycling:

  • Lots of self-medicating with alcohol
  • The more severe the mania, the more frequent the alcohol
  • Between 20-50% of people with it experience social and occupational impairment
  • In most cases, hospitalization is required
  • Suicide is a constant threat
  • Rate of success of suicide tends to be higher in people with bipolarity than people with just unipolar depression
  • 15% with bipolarity tend to end their life.
26
Q

Cognitive theories of bipolarity

A
  • Mania and depression coexist to cancel each other out when one becomes too overwhelming
  • Some believe mania to be a mask for depression
27
Q

Egoistic Suicide

A

Reflects a prolonged sense of not belonging, of not being integrated in a community, an experience, of not having a tether, an absence that can give rise to meaninglessness, apathy, melancholy, and depression.
-The result of a weakening of the bonds that normally integrate individuals into the collectivity

28
Q

Cultural Differences with Suicide

A

1.Religion has no influence over those who commit or attempt suicide.

  1. More common in industrialized countries
    a. Russia and Hungary have the highest suicide rates in the world
    i. Triple that of the U.S.
    ii. USSR Russia had double what it has today
  2. Communities with strong religious foundations have low rates
    a. Mexico and Egypt have the lowest suicide rates
  3. In past thirty-five years, suicide rate in college students has more than tripled
    a. 28 per 100,000 compared to 12 per 100,000 in general population

5.Raises considerably in men between middle and old age

29
Q

Anomic Suicide

A

Precipitated by a shattering break in an individual’s relationship to his society; the loss of a job, economic depression and even sudden wealth

30
Q

Altruistic suicide

A

For the sake of the group or society

31
Q

Surcease Suicide

A

To give up

32
Q

Prevention of Suicide

A

a. To have the final word in an argument
b. Revenge on a rejecting lover
c. To ruin the life of another

33
Q

Biological Explanations of Depression

A

1) Biological: genes, brain development, neurotransmitters (serotonin, norepinephrine, dopamine deficiences)

34
Q

Hormonal Explanations of Depression

A

2) Hormonal: estrogen, hypothyroidism, low testosterone levels, hypothalamic-pituitary-adrenal axis creating a surplus of cortisol

35
Q

Neurological Explanations of Depression

A

3) Neurodevelopment: less activity in the right and frontal lobe and smaller hippocampi (especially true in women)

36
Q

Psychodynamic Explanations of Depression

A

4) Psychodynamic: Anger against the self, dependence on others for self esteem and helplessness at achieving one’s goals causes depression

37
Q

Beck’s Cognitive Theories of Depression: The Cognitive Triad

A

The Cognitive Triad
-Negative thoughts about the self
-Patient thinks they are worthless, defective and inadequate
-Unpleasant experiences = personal worthlessness
-Belief that they will never attain happiness
-Ongoing experience
-Small obstacles seen as impassable barriers
-Drawn to negative interpretations of experiences
the future
-Negative things are happening now, thus will continue to happen

38
Q

Beck’s Cognitive Theories of Depression: Errors in Logic

A

Errors in Logic
-Arbitrary Interference:
Refers to drawing a conclusion when there is little to no evidence to support it
-Selective abstraction:
Draws wrong conclusions from an event.
-Overgeneralization:
Drawing global conclusions about worth, ability, or performance on the basis of a single fact.
-Magnification and minimization:
Small events are magnified and large good events are minimized.
-Personalization:
Incorrectly taking responsibility for bad events in the world.

39
Q

Beck’s Cognitive Theories of Depression: Helplessness

A

Learned helplessness, hopelessness.

40
Q

How many people a year commit/attempt suicide, how many people are alive that have attempted it and how many who have attempted it will succeed in doing so later on?

A
  • 25,000 people kill themselves every year
  • 30,000 attempted and completed suicides in 1996
  • As many as ten times attempted suicides than completed ones.
  • 5 million people in the U.S. who have survived suicide
  • 10% of those who have attempted will succeed in the next ten years.
41
Q

What % of suicides are committed by people with depression, and how much more likely are they to do it over the normal population?

A
  • 80% of suicidal patients are depressed

- 25 times more likely to commit suicide than general population

42
Q

What are other comorbidities with suicide?

A

-20% are comprised of alcoholics, schizophrenics and homicidal individuals.

43
Q

How do men and women compare in suicide statistics?

A
  • Women most at risk.
  • Three times more likely than men to try and commit suicide.
  • However, men are more successful
  • Men are more likely to use definitive ways of killing themselves than women.
  • Guns, jumping off a building for men
  • Slitting wrists, overdosing for women
  • Men are more likely to kill themselves because of failure at work
  • Women are likely to kill themselves over depression or failure in interpersonal relationships.