Depression

Question 1

Give 7 examples of mental health conditions

Answer 1

1. depression
2. bipolar disorder
3. eating disorders (anorexia nervosa/bulimia)
4. borderline personality disorder
5. schizophrenia
6. anxiety
7. obsessive compulsive disorder
8. phobias

Question 2

Give 5 symptoms of depression:

Answer 2

1. consistent low mood
2. lack of energy
3. lack of enjoyment in normal activities
4. poor concentration
5. altered sleeping habits
6. loss/gain of weight
7. irritability
8. guilt
9. worthlessness
10. thoughts of harming oneself/suicide

Question 3

How long must depressive symptoms persist for before a formal diagnosis can be made?

Answer 3

two weeks

Question 4

Name the four overlapping domains of depressive symptoms and give 3 examples of symptoms which exist in each domain:

Answer 4

1. mood changes: low mood, feelings of guilt, excessive irritability
2. cognitive impairment: poor attention span, decreased motivation, short term memory deficits
3. motor deficits: motor slowing, restlessness, agitation
4. circadian dysregulation: low energy, poor sleeping habits, weight loss/gain

Question 5

Give the 5 risk factors for depression

Answer 5

gender: women are more likely to develop depression than men
childhood experience: those who have experienced trauma during childhood are more likely to develop depression (e.g. poor relationship with parents, abuse, divorce)
personality types: those who have a neurotic personality are less able to process and cope with stressful situations leading to depression
major life changes: stress, bereavements, trauma. Other factors such as lack of social support, financial pressures or loneliness may further increase the risks of developing depression
certain physical illnesses: such as hypo/hyperthyroidism, diabetes.

Question 6

What is the basic premise of the neurochemical dysregulation theory of depression?

Answer 6

Depression is caused due to reduced numbers of neurotransmitters in the brain.

Question 7

Which neurotransmitters are thought to be lacking in the neurochemical dysregulation theory of depression?

Answer 7

Serotonin, noradrenaline and dopamine

Question 8

What category of neurotransmitter do serotonin, noradrenaline and dopamine fall into?

Answer 8

Monoamines

Question 9

What are the three major classes of antidepressant drugs?

Answer 9

SSRI’s (selective serotonin reuptake inhibitors), MAOI’s (monoamine oxidase inhibitors) and tricyclic antidepressants.

Question 10

Which neuroendocrine pathway is responsible for the secretion of cortisol?

Answer 10

The hypothalamic pituitory adrenal axis (HPA axis)

Question 11

What does the amygdala release in response to fear stimuli?

Answer 11

Corticotrophin releasing factor

Question 12

Where is the amygdala located?

Answer 12

In the limbic system

Question 13

What does corticotrophin releasing factor release from the amygdala stimulate the hypothalamus to release?

Answer 13

Further corticotrophin releasing factor

Question 14

What does corticotrophin releasing factor released from the amygdala and the hypothalamus stimulate the pituitary gland to release?

Answer 14

Adrenocorticotrophic hormone (ACTH)

Question 15

Where does adrenocorticotrophic hormone travel in the bloodstream to?

Answer 15

The adrenal cortex

Question 16

What does adrenocorticotrophic hormone release in the adrenal cortex?

Answer 16

Cortisol

Question 17

What is the effect of cortisol on the body?

Answer 17

It enables the body to deal with stressful situations effectively

Question 18

Via a negative feedback system, increased cortisol levels act on glucocorticoid receptors in the hypothalamus- what does this achieve?

Answer 18

Binding of glucocorticoid receptors inhibits the release of corticotrophin releasing factor and adrenocorticotrophic hormone from the hypothalamus, reducing the release of cortisol.

Question 19

What is the link between childhood trauma and

cortisol/corticotrophin releasing factor receptors in the brain?

Answer 19

Those children who experienced trauma in childhood are likely to have less corticotrophin releasing factor and cortisol receptors in the brain due to prolonged exposure to cortisol during childhood. This means they are less able to cope well with stress in adulthood leading to depression.

Question 20

How do cortisol levels effect serotonin levels?

Answer 20

Increased cortisol results in reduced serotonin.

Question 21

How do increased cortisol levels effect cytokine levels?

Answer 21

Cortisol causes an imbalance in inflammatory cytokines in the brain. This further causes excess production of corticotrophin releasing factor within the hypothalamus.

Question 22

How does an imbalance of inflammatory cytokines and further excess production of corticotrophin releasing factor effect the hippocampus?

Answer 22

It causes the hippocampus to develop degenerative changes causing it to become dysfunctional resulting in inappropriate and often excessive emotional responses.

Question 23

How does increased levels of cortisol effect brain development?

Answer 23

High cortisol levels inhibit neurogenesis within the brain i.e. the building of new neural networks and the repair of old neural networks. This can lead to areas of the brain which are undersized or malfunctioned.

Question 24

Which two areas of the brain secrete neurotransmitters?

Answer 24

The raphe nuclei (secretes serotonin) and the locus coerulus (secretes noradrenaline)

Question 25

What is the function of an axon within a neuron?

Answer 25

To pass on an electrical impulse (action potential) to another neuron allowing them to communicate with one another.

Question 26

Which three brain structures make up the limbic system?

Answer 26

The hippocampus, the hypothalamus and the amygdala

Question 27

Serotonin is released from the raphe nuclei into the: (7 places)

Answer 27

The brainstem, the cortex, the limbic system, the hypothalamus, the basal ganglia, the cerebellum and the spinal cord.

Question 28

Which mono amine transporter proteintransports serotonin from the synaptic cleft to the presynaptic neuron?

Answer 28

SERT - serotonin transporter

Question 29

Noradrenaline is released from the locus coerulus into the: (5 places)

Answer 29

Hypothalamus, temporal lobe, cortex, cerebellum and the spinal cord

Question 30

The locus coerulus noradrenaline system affects which processes?

Answer 30

Attention and concentration as well as sleep disturbances and arousal disturbances

Question 31

What if the affect of dopamine in the brain?

Answer 31

Affects the sleep/wake cycle and is important in goal directed behaviours and reward based learning