Exam 2: Mood and Depressive Disorders Flashcards
BPD 1
Full-blown maina w/ episodes of major depression
Onset age= 18 y/o
BPD 2
At least 1 hypomania and 1 depressive episode
Age onset= 20 y/o
Rapid-Cycling BPD
4+ severe mood disturbances in 1 year
Mixed state BPD
Simultaneous mania & depression
Cyclothymic Disorder
Fluctuations that alternative btw. hypomanic and depressive symptoms
BPD Developmental Factors
Kids- rate diagnosis increasing overtime, may cycle more rapidly, irritability, temper tantrums –> push for Disruptive Mood Dysregulation D/O to not overdiagnose children
Major Depressive Disorder (MDD)
Persistent sad/low mood
-Children may present with irritability or hostility
Atypical Depression
Temporary boost in mood in response to positive events
Persistant Depressive Disorder (Dysthymia)
Chronic state of depression that is milder than MDD, but persists longer
-Symptoms last 2+ yrs
Disruptive Mood Dysregulation Disorder
Severe recurrent temper tantrums out of proportion in intensity/duration to situations.
-Ages 6-18 y/o
(may get another diagnosis when age out)
-Made to decrease rate BPD diagnosis in kids
-Must occur in more than one context
-New to DSM 5
-Alternative to BPD diagnosis for kids
Criticisms for BPD diagnosis in kids: Most children that meet criteria also meet criteria for other disorders (e.g., conduct disorders), poor reliability, might misdiagnose and be developmental issue
Peri-pardum Depression
“Baby Blues”
Major depressive episode during, before, or after pregnancy
-onset (ex: post-partum) is specifier
-Similar to MDD
-May feel overwhelmed, emptiness, disconnect from child, guilt don’t feel overwhelming love for child after delivery
Result–>Associated w/ tempermental, behavioral, social, emotional, cognitive, and physical health difficulties in their kids
Premenstrual Dysphoric Disorder (PMDD)
More extreme PMS,
Mood symptoms that include deep saddness, dispair, anxiety, anger/irritability, panic
-Symptoms persistent, not cyclical
-Changes in sleep, appetite, and labido may also occur
Epidemiology/Sex of Mood/Depressive Disorders
MDD most common disorder in the US
-Depression rates 2x high for women
-Women at higher risk:
low SES, less educated, unemployed
Sex difference explanations:
-Hormones
-Bodily changes during puberty
Cultural Influences on Depressive Disorders
Ethnic identity and religion can act as protective factors
-Culture may affect presentation and diagnosis
Developmental Factors Depressive Disorders
Mean age onset MDD = 26 y/o
-Children/Young individuals may not have the words to describe emotions, so harder to diagnose earlier
-Childhood- boys and girls equally as likely to have depression
-Onset of puberty, sex differences emerge
Depressive Disorder Comorbidities
72% comorbidity
Co-occurs with:
Anxiety d/o
Substance Use Disorder (SUD)
Impulse control d/o
-Depression most common comorbid disorder in eating disorder (eating d/o increases suseptibility)
Suicidal ideation
Thoughts of death
Active suicidal ideation
Includes details on a plan like when, where, and how
Passive suicidal ideation
Wish to be dead with no active planning component
Parasuicides
Acts that cause harm (like superficial self-harm or ODs on non-lethal meds) but do not lead to death
Suicide victims
Males slightly more likely to commit suicide
Adolescent risks: MDD, BPD, previous attempts, drifting (feeling disconnected from work, home, family)
-Immediate events: relationship breakup, interpersonal problems, financial difficulties
Suicidal ideation and attempts higher in children and adolescence
90% children who die by suicide have a psych disorder
Risk Factors in suicide
Previous attempts
Family history
Psychiatric illnesses
Biological factors (serotonergic system dysfunction)
Etiology: Biological Perspective of BPD and MDD
-Genetic and family studies suggest heritability
-Neuroimaging studies –> brain abnormalities affecting emotional response/decision regulation, etc.
-Environmental factors: Stress, loss, grief, work problems
-Sensitivity to environment can influence genetic predisposition
Etiology: Psychological Perspective of BPD and MDD
Psychodynamic theory
-Depression form of “anger turned inwards”
-Occurs after real/imagined loss
-Mania and depression are interlinked b/c mania is a defense to intolerable feelings of depression
Attachment theory
-Disruptions in attatchment leads to vulnerability to depression
Etiology BPD MDD
Behavioral theories –> withdrawal of reinforcement for healthy behavior
Treatment of BPD
Primary treatment medication
CBT
-effectiveness inconsistent in those w/ BPD
-responsiveness to reason may be impacted by mania
Treatment of Depressive Disorders
-CBT
-Behavioral activation component (increase engagement in pleasurable activities to increase positive reinforcement)
-Interpersonal Psychotherapy
Biological treatments:
Antidepressants
Light therapy, ECT
