Depression Flashcards
What are the main symptoms of depression?
Low mood
Lack of energy
Lack of interest and enjoyment
What are some other symptoms of depression?
Loss of appetite
Weight loss
Insomnia
Depressive thoughts
What is the minimum of duration of symptoms for depression?
Every day for 2 weeks
What is a normal adjustment reaction?
State of emotional distress following experience of a traumatic event
How does depression differ from a normal adjustment reaction?
Symptoms develop gradually, continuous, chronic
Lack of interest Low energy Insomnia, particular early morning waking Loss of appetite, weight loss Low self-esteem, feelings of guilt
What structures of the brain are involved in depression?
Frontal lobe
Basal ganglia
Limbic system
What are the main functions of the limbic system?
Emotion
Motivation
Memory
Behaviour
What part of the frontal lobe is most significant in depression?
Prefrontal area
How is the frontal lobe affected in depression?
Hypoperfused
Dysfunctional
What are the functions of the basal ganglia that are relevant to depression?
Cognition
Emotion
Behaviour
How are the frontal lobes, basal ganglia and limbic system affected as a whole unit in depression?
Dysfunctional circuits between these brain areas
Affects cognition, motor systems
What are the two neurotransmitters involved in depression? Which is more important?
Noradrenaline
Serotonin - more important
Where is noradrenaline made in the brain?
Locus coeruleus in the brainstem pons and medulla
What happens to noradrenaline after it is made in the locus coeruleus in the brainstem?
Transported to the cortex and limbic system and cerbellum
When is noradrenaline made in the brain?
Locus coeruleus is active when are awake and inactive during sleep
What increases noradrenaline production in the brain?
Stress
Amphetamines
What are the functions of noradrenaline in the brain?
Mood - restlessness and anxiety
Behaviour - arousal and alertness
Memory
Which adrenergic receptor in the brain plays a role in mood and behaviour?
Alpha receptors
What is the evidence that noradrenaline is involved in depression?
AMPT inhibits tyrosine being converted into L-DOPA which reduces noradrenaline, causes an increase in depressive symptoms
Serotonin noradrenaline reuptake inhibitors are effective anti-depressants
Tricyclic anti-depressants are effective anti-depressants, some of these are SNRIs
What are the functions of serotonin in the brain?
Appetite
Sleep
Mood
Where is serotonin produced in the brain?
Raphe nuclei int he brainstem
What happens to serotonin after it is produced in the Raphe nuclei in the brainstem?
Transported to cortex and limbic system
What is the evidence that serotonin is involved in depression?
Tryptophan depletion causes depression
5HIAA depletion with depression
Selective serotonin reuptake inhibitors are effective anti-depressants
Tricyclic anti-depressants are effective, some of these are SNRIs
How does 5HIAA relate to serotonin?
Metabolite of serotonin
What is the monoamine hypothesis for depression?
Depletion of serotonin and noradrenaline in the CNS is the pathophysiology of depression
How does tryptophan relate to serotonin?
Precursor of serotonin
What are the types of causes of depression? What do they each mean?
Predisposing, these make depression more likely
Precipitating, these trigger depression
Perpetuating, these maintain depression
What are some examples of predisposing factors of depression?
Genetics - 50%
Female gender
What is an example of a gene that may be involved in causing depression?
Serotonin transporter gene
What are some examples of precipitating factors of depression?
Personality difficulties
Physical disorders
Alcohol, drug misuse
What particular type of physical disorders may cause depression?
Chronic diseases
How is depression treated?
Anti-depressant
Psychotherapy, CBT
Encouragement of hobbies
What types of depression are anti-depressants effective at treating?
Moderate or severe depression, not mild
How can alcohol misuse cause depression?
Alcohol crosses the blood-brain barrier
What type of anti-depressant is usually used to treat depression?
Selective serotonin reuptake inhibitors
