Chapter 8 Disorders of Mood Flashcards
depression*
a low, sad state marked by significant levels of sadness, lack of energy, low self-worth, guilt, or related symptoms
mania*
a state/episode of euphoria or frenzied activity in which people may have an exaggerated belief that the world is theirs for the taking
depressive disorders*
the group of disorders marked by unipolar depression
unipolar depression*
depression without a history of mania
bipolar depression*
a disorder marked by alternating or intermixed periods of mania and depression
mood problems
= depressive and bipolar disorders
Unipolar Depression: The Depressive Disorders
- severe with long-lasting, physical pain
- may intensify as time continues
How Common is Unipolar Depression?
- 8% adults
- 5% adults = mild forms
- 19% adults = have episode at some point in life
- prevalence rates similar to many other countries
- higher rates among poor
- any age can suffer; most common is 40 years old
- onset = 26 years old
- women = 2x more likely
- 26% women = episode in life
- 12% men = episode in life
- 85% people recover
- 40% have 1 more episode in life after recovery
What are the Symptoms of Depression?
- can be severe or not
- sobbing, indecisiveness, feelings of despair, anger, and worthlessness
Emotional Symptoms
- sad and dejected
- miserable, empty, humiliated
- no sense of humor
- no pleasure (anhedonia)
- anger, anxiety, agitation
Motivational Symptoms
- loss of desire to pursue anything
- suicide = escape
- 6-15% commit suicide
Behavioral Symptoms
- less active and productive
- alone
- bed-ridden
- move and speak slowly
Cognitive Symptoms
- negative self-views
- self-blame
- do not credit themselves for achievements
- vulnerable to suicidal thinking
- confused
- poor intellectual skills
Physical Symptoms
- headaches, indigestion, constipation, dizzy spells, severe pain
- symptoms are usually misdiagnosed as physical illness
- eat and sleep less = fatigued
- some will excessively overeat and oversleep
Diagnosing Unipolar Depression
-major depressive episode = period of 2 weeks or more marked by at least 5 symptoms of depression; may include psychotic symptoms in extreme cases
major depressive disorder*
a severe pattern of depression that is disabling and is not caused by such factors as drugs or a general medical condition
dysthymic disorder*
a mood disorder that is similar to but longer-lasting and less disabling than major depressive disorder
premenstrual dysphoric disorder*
a disorder marked by repeated experiences of significant depression and related symptoms during the week before menstruation
What Causes Unipolar Depression?
- stressful events
- exogenous (reactive) depression= clear cut stressful events
- endogenous depression = response to internal factors
Genetic Factors
- family pedigree: select people with unipolar depression as probands (focus of genetic study)
- 20% relatives depressed fewer than 10% of population
- molecular: tied to chromosomes (abnormality with 5-HTT gene [responsible for serotonin production])
norepinephrine*
a neurotransmitter whose abnormal activity is linked to depression and panic disorder
serotonin*
a neurotransmitter whose abnormal activity is linked to depression, obsessive-compulsive disorder, and eating disorders
Biochemical Factors
- many neurotransmitter interactions = unipolar disorder
- serotonin = neuromodulator (increase/decrease key neurotransmitter activity)
- endocrine system -> adrenal glands -> too much cortisol
- melatonin (released in the dark)
- deficiencies of brain-derived neurotrophic factor (BDNF)
Brain Anatomy and Brain Circuits
- unipolar brain circuit:
- -prefrontal cortex (frontal cortex -> mood, attention, immune function)
- -hippocampus (neurogenesis, messages between it and prefrontal cortex)
- -amygdala (negative memories and emotions -> elevated blood flow when depressed)
- -Brodmann Area 25 (under cingulate cortex -> 5-HTT)
Immune System
- dysregulation (lower functioning of white blood cells/lymphocytes)
- -depression
1. stress = depression
2. depressed people = lower lymphocyte activity and high CRP production
3. more migraines, irritable bowel syndrome, rheutmatoid arthritus, etc.
Psychodynamic View
- death (loss of loved one) = depression
- -oral stage (merge identities with lost loved one) -> introjection (typically temporary)
- –if introjection is not temporary = depression
symbolic/imagined loss*
loss of a valued object, that is unconsciously interpreted as the loss of a loved one
anaclitic depression*
a pattern of depressed behavior found among very young children that is caused by separation from one’s mother
Behavioral View
- rewards and punishments = unipolar depression
- -rewards dwindle so do constructive behaviors
- -rewards/no rewards = no depression/depression
- social rewards = no depression
Cognitive View
- theories of negative thinking and learned helplessness
- negative thinking:
- -maladaptive attitudes (general worth = tasks performed, failures = depression)
- -cognitive triad (experiences, themselves, futures and negative thinking = depression)
- -errors in thinking (negative conclusions based on little evidence = depression)
- -automatic thoughts (steady train of unpleasant thoughts = unipolar depression)
cognitive triad*
3 forms of negative thinking b Aaron Beck = depression; triad = experiences, themselves, their future
automatic thoughts*
numerous unpleasant thoughts = depression, anxiety, other forms of psychological dysfunction
learned helplessness*
perception, based on past experiences, that one has no control over one’s reinforcements, that they are responsible for helplessness
Sociocultural Views
- family-social perspective: role played by interpersonal factors in development of depression
- multicultural perspective: ties depression to factors such as gender, race, economic status
Family-Social Perspective
- depressed persons:
- -display weak social skills
- –cause people to avoid them = decrease in social rewards
- -unavailablility of social support
- separated/divorced = 3x more likely
- high correlation between level of marital conflict and degree of sadness:
- -.37 men
- -.42 women
- -.66 clinically depressed
- unsatisfying relationship = 3x more likely
- isolation/without intimacy = depression
Multicultural Perspective
(1) links between gender and depression
(2) ties between cultural and ethnic background and depression
Gender and Depression
- women = 2x more likely, younger, more frequent, longer-lasting
- artifact theory: women and men both equally likely but clinicians fail to diagnose men (men hide it better so women are “more likely”)
- hormone explanation: hormone changes = depressed women
- life stress theory: women experience more stress
- body dissatisfaction explanation: women taught to seek low body weight and slender body shape
- lack of control theory: learned helplessness, feel less in control than men
- rumination theory: focus on one’s feelings when depressed and consider repeatedly the causes and consequences of the depression
Cultural Background and Depression
- hispanic and african americans = 50% more likely than whites
- 54% whites = treatment
- 34% hispanics = treatment
- 40% africans = treatment
Bipolar Disorders
- lows (depression) and highs (mania)
- mania = dramatic and inappropriate risings in mood
- -move quick, talk loud and rapidly
- -poor judgement
Diagnosing Bipolar Disorders
- full manic episode = 1 week of symptoms (high/irritable mood, increased activity)
- DSM-V = 2 kinds of bipolar
- 1-2.6% adults = bipolar
- 4% adults = 1 bipolar disorder in life
- bipolar I = more common
- bipolar I and II equally likely in men and women
- onset = 15-44 years old
- eventually goes away then recurs later
bipolar I disorder*
a type of bipolar disorder marked by full manic and major depressive episodes
bipolar II disorder*
a type of bipolar disorder marked by mildly manic (hypomanic) and major depressive episodes; 4 or more episodes in a year = rapid cycling
What Causes Bipolar Disorders?
- biological:
- -neurotransmitter activity
- -ion activity
- -brain structure
- -genetic factors
Neurotransmitters
- mania linked to low serotonin (just like depression)
- study: manic patients given reserpine (blood pressure drug) to lower norepinephrine activity
Ion Activity
- messages between neurons
- relays messages within neurons
- Na+ (ends of neuron membrane) –> at rest
- receiving = Na+ taken in by pores opening
- electrical activity travels down neuron
- -neuron fires
- after firing, K+ flows from inside neuron to outside
- returns to resting state
Brain Structure
- basal ganglia and cerebellum = smaller
- lower volumes of gray matter in brain
- dorsal raphe nucleus, striatum, amygdala, hippocampus, and prefrontal cortex = abnormal
Genetic Factors (Bipolar I & II)
- inherit biological predispositions
- identical twins = 40% chance developing same disorder
- fraternal twins and close relatives = 5-10% chance developing same disorder
- general linkage:
- -larger families
- –observe pattern of disorder distribution
- -genetically transmitted family trait (genetic marker)
- -linked to X chromosome
