Disorders Pt. 3 Flashcards
DSM-5 Criteria: (Major Depressive Disorder)
- Depressed mood or irritable (most of the day, nearly every day)
- Decreased interest/pleasure (in most activities, most of each day)
- Weight change or change in appetite
- Change in sleep: insomnia or hypersomnia
- Change in activity: psychomotor agitation or retardation
- Fatigue or loss of energy
- Guilt/worthlessness: feelings of worthlessness or excessive or inappropriate guilt
- Concentration: Diminished ability to think or concentrate, or more indecisiveness
- Suicidality: Thoughts of death or suicide, or has a suicide plan
Activity in Amygdala & PFC
High activity especially in subgenual ACC (anterior cingulate cortex)
How Depression Alters Sleep
- Stage 3 of slow-wave sleep is reduced
- Patients enter REM sleep very quickly with an increase of REM sleep in the first half of the night
Learned Helplessness
Experience of many negative events outside of a person’s (perceived or actual) control
- General feelings of helplessness
*Does not explain how everyone develops depression
Animal Model of Depression
- Learned helplessness procedure can create depressed-like animals:
- Stressful experience –> animals
“give up” in other negative
contexts
- Stressful experience –> animals
Study: “Relationship Between mPFC Activity and Learned Helplessness Outcome”
Findings:
- Rates who were resilient after
stress…weakened synaptic strength
in mPFC
- Rates who were helpless after
stress…heightened synaptic
strength in mPFC
- Chemical enhancement of mPFC
neurons…resilience–>helplessness!
Depression Treatment
- Antidepressant drugs (monoamine hypothesis): increase availability of dopamine, norepinephrine, & serotonin
- MAO-Is, tricyclics, SSRIs, SNRIs
- Psychotherapy: lower relapse rates with CBT than SSRIs
- Shock/stimulate the brain (ECT, rTMS, DBS); quick relief (days instead of weeks), but frequent relapse
Problems with SSRIs
- Long lag time (often weeks) between treatment and reduction of symptoms
- Not everyone responds to SSRIs
- Some SSRIs benefits are attributed to placebo effect
- Increased risk of suicide in children and adolescents using SSRIs
Bipolar Disorder
- Affects ~ 2.6% of the population
- Characterized by alternating cycles of:
- Depression
- Mania
- Increased energy &
productivity
- Talkativeness
- Grandiose thinking
- Hallucinations, delusions
- Cycles may happen rarely, with long periods of stable mood between, or switch rapidly, with no stable period between cycles
- Onset occurs during late adolescence/early childhood
Creativity & Risk for Bipolar Disorder
- Clusters of genes associated with
creativity increases the risk of
developing bipolar disorder - Risk factors for developing bipolar
disorder predicts greater creativity
Causes of Bipolar Disorder
- Etiology is not well understood
- Onset likely results from genetic
disposition and environmental
factors
- Onset likely results from genetic
- Severity of symptoms related to
abnormal HPA axis function - Enlarged ventricles and reduced
cortical volume likely results from
untreated repeat manic episodes
Medications: Treatment for BPD
- Lithium Carbonate
- Specifically decreases manic episodes; stabilizes mood
- Anticonvulsants
- Used alone or with lithium; decreases symptoms
- Atypical antipsychotics
- May decrease the effects of mania
Psychotherapy: Treatment for BPD
- Cognitive-behavior therapy (CBT)
