Depressive and Bipolar disorders- exam 2 Flashcards
what is unipolar depression
Major depressive disorder
- at least 2 weeks of depressed mood or loss of interest, withdrawl from family and friends
- changes in weight, appetite, or sleep
- difficulty thinking, concentrating, or making descisions
- recurrent thoughts of suicide or death
- discouraged, sad, hopeless
- lack of energy, loss of interest
- causes major distress or impairment
- recurrent (2 or more episodes)
- no mania
what are the 4 ‘building blocks’ of mood disorders
- major depressive episode
- manic episode
- hypomanic episode
- mixed episode
what are the signs/symptoms/DSM-5 criteria for a major depressive episode/disorder
5 or more of the following symtpoms present for the same 2 week period and are different from regular functioning; at least one symtpom is either depressed mood or loss of interest/pleasure
1. depressed mood most of the day almost every day
2. markedly diminished interest of pleasure in all, or almost all, activiteis most of the day nearly every day
3. significant weight loss when not dieting or weight gain, decrease or increase in appetite
4. insomnia or hypersomnia nearly every day
5. pyschomotor agitation nearly everyday
6. fatigue or loss of energy nearly every day
7. feelings of worthlessness or excessive or inappropriate guilt
8. diminished ability to think or concentrate, or indecisive
9. recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or specific plan
What does MDD and MDE stand for
MDD- major depressive disorder
MDE- major depressive episode
What are the ‘specifiers’ of MDE
- anxious distress
- mixed features
- melancholic features
- psuchotic features
- catatonic features
- atypical features
- seasonal pattern
- peripartum onset
What is SAD, what is a ‘special’ treatment for it, and what factors contritbute (besides time of year)
Seasonal Affective Disorder
can be treated with light therapy
what is peripartum depression
onset of major depressive episode during pregnancy or in the 4 weeks following delivery
what is persistent depressive disorder/dysthymic disorder
- chronic lesser version of depression. At least 2 years of generalized depressed mood and other symptoms but not as sever as depression
- around 10% will go on to a major depressiv episode
what is the percentage of females v. males with depression
higher rates in adult females than males
- females: 8.7%
- males: 5.3%
what is linked to depression in females
multifacatorial
females tend to experience more external risk factors such as hisotry of family conflict and abuse, depression prior to and during puberty
what is the most common age range of adults with depression
most common in ages 18-25 (around 13% of young adults meet the criteria)
lowest in age goups over 65 but rise among people over 85
people with depression experience episodes that last ____ weeks in a mild episode of ____ weeks when symptoms are severe. People diagnosed with depression lose ____ days of work per year due to their symptoms
14-17 weeks per mild episode or 23 weeks when sevee and lose 27 days of work
what is bipolar disorder
depressive symtpoms alternate with mania
what are the signs and symptoms of bipolar disorder
Manic episode:
- abnormal and persistently elevated mood for at least one week
- causes major distress or imparment PLUS 3 of the following: inflated self esteem or generosity, decreased need for sleep, pressured speech, flights of ideas, distractability or increased involvment in goal related activities, excessive pleasurable activities with no concern for consequences.
Major depressive episode
what is a manic episode and what is a hypomanic episode
Manic episode:
- abnormal and persistently elevated mood for at least one week
- causes major distress or imparment PLUS 3 of the following: inflated self esteem or generosity, decreased need for sleep, pressured speech, flights of ideas, distractability or increased involvment in goal related activities, excessive pleasurable activities with no concern for consequences.
Hypomanic episode:
does not meet full criteria for a manic episode
- change in mood and behavior that is less extreme than mania
- at least 4 days of abnormally elevated mood
- not sever enough to cause marked impairment in social or occupation functioning
is there a genetic component to bipolar disorder, which type?
- strong genetic influence around 4%-24% of people with a first degree relative with be diagnosed
what is the difference between bipolar I and bipolar II
bipolar 1: Manic episodes with some major depressive episodes
bipolar 2: major depressive episodes with hypomanic episode
what is cyclothymic disorder
chronic and less severe version of bipolar. Frequent period of depressed mood and periods of hypomania (without full blown bipolar) must last at least 2 years
what is ‘mixed’
- rapidly alternating modds. At least one week where BOTH manic and depressive episodes happen nearly every day. Not due to substance use or ECT
Disruptive Mood Dysregulation Disorder is seen in what age group ( and has been perhaps mis-diagnosed as ____)
severe anc chronic irritability, persistently negative mood, and severe temper outbursts among children and adolscents who previosuly would be misdiagnosed as having bipolar.
can’t be diagnosed to children under 6 or over 18
what is anaclitic depression
excessive interpersonal concerns, including feelings of loneliness, weakness, helplessness and abandonment fears.
what neurotransmitters are associated with mood disorders
serotonin, norepinepherine, dopamine
what are three different neurotransmitter abnormalities attributable to depression
- synthesis of serotonin and norepinephrine may be abnormal
- there may be abnormalities in the genes regulating seotonin and norepinepherine transport
- receptors for serotonin and norepinepherine may malfunction
What is used to treat drug resistant depression
ECT
Which medications have been given a black box warning for children
Celexa, Luvox, Paxil, Prozac, Zoloft, Effexor, Remeron, Serzone, Wllbutrin (all anti-depresents)
What is suicidal ideation
want/thoughts to commit suicide
what are some behaviors that indicate suicidal intent
what risk factors/predictors are associated with suicide
- diagnosable mental disorder
- past suicidal thoughts or actions
- stressful/traumatic life events
- physical illness
- impulsivity
- low serotonin
what are some protective factors?
- intervention programs (immediate risk)
- prevention programs (general public) - education
- ## removing all access to guns
suicide is the 2nd leading cause of death in what age group?
10-14
suicide prevention
- public info
- SSRIs
- DBT
- suicide hotlines
what to do if someone you know is suicidal
- take them seriosuly
- get help, call therapist, hotline, emergency services
- express concern
- pay attention to everything the person does or says
- ask direct questions about if there is a plan and what it is
- acknowledge their feelings
- reassure them
- dont promise confidentiality
- make sure all means of self-harm are not available
- do not leave them alone until in the hands of a professional
- take care of yourself
be able to describe the normal workings of synaptic transmission. Know in general how drugs may interact with this process to increase or decrease function in a neurotransmitter system. Know where the drugs work in the diagram
