Exam 2 - Mood Disorders (Depression) Flashcards
Mood Disorders
Depression & Bipolar Disorders
Depressive Disorders
- Major Depressive Disorder (MDD)
- Persistent Depressive Disorder (PDD)
Components of Depression
Emotional
Cognitive
Somatic
Behavioral
Components of Depression: Emotional
- Sad mood
- Anhedonia: loss of interest or pleasure in usual activity
Anhedonia
The loss of interest or pleasure in usual activity
Components of Depression: Cognitive
- Trouble concentrating
- Trouble making decisions
- Thoughts of death/hopelessness
- Guilt
Components of Depression: Somatic
- Fatigue/ heavy feeling
- Changes in appetite (not eating, or excessive eating)
- Changes in sleep
Components of Depression: Behavioral
Psychomotor Retardation:
- Very slow movement or talking or processing (seen less in out-patient, more in in-patient)
Psychomotor Agitation:
- Increased movement or mental activity
Major Depressive Disorder:
DSM-5 Diagnostic Criteria
- 5+ symptoms present for at least 2 weeks:
- Must Include: Sad Mood and/or Anhedonia)
- Symptoms affect most of the day almost every day
- 2+ weeks
- Symptoms cause significant impairment/ distress (in daily life)
Persistent Depressive Disorder:
DSM-5 Diagnostic Criteria
Old name: Dysthymia
** PPD = Chronic condition**
Diagnostic Criteria:
- Depressed mood more days than not for 2+ years
- Additional 2+ other symptoms
Does not qualify if there a break in symptoms is 2+ months
Depression:
Course and frequency
Average Onset Age: early 30s
- (decreased over last 50 years)
Course: ~50% recover within 6 months
COVID: depression rates rose dramatically among children/teens
Depression:
Prevalence (+ Disability Rates)
Prevalence:
- ~16–20% of population experiences depression
- women = 2x more likely be diagnosed w depression
- differences in gender rates peak during adolescence)
Disability Rates:
- Depression =10% of disability worldwide
Depression:
Etiology (causes)
Social Factors:
- stressful life events
Psychological Factors:
- Cognitive theories (ie: The Attribution Theory)
Biological Factors:
- Heritability + Role of Neurotransmitters
Depression - Etiology (causes)
Social Factors
Stressful life events (ie: poverty)
predict Depressive Disorders
- 42-67% of people report a stressful life event in year prior to depression diagnosis:
Depression: Etiology (causes)
Psychological Factors
(Attributions Theory)
Attributions Theory: depression can be caused or worsened by how people explain negative events and how they either attribute outcomes to internal or external causes.
Attribution Style:
-
Internal, Stable, Global (Higher Depression Risk)
- Internal: I failed bc I’m not smart enough
- Stable: I’m not going to be able to keep a job or do well in school
- Global: I’ll fail at everything I do in the future
-
External, Unstable, Specific (Lower Depression Risk)
- External: This was beyond my control
- Unstable: This job was just too demanding for me right now
- Specific: My next job will be a better fit for me
Depression - Etiology (causes)
Biological Factors
heritability + brain (Neurotransmitters)
Heritability: ~50%
Neurotransmitters:
- Involved: Serotonin, Dopamine, Norepinephrine, and GABA
- Variety of symptoms suggest involvement of different neurotransmitters
-
Serotonin = Leading Theory
- low levels of serotonin cause depression
- Research = Mixed (serotonin: likely not the only cause, but a reaction)
Depression - Etiology (Causes)
Cognitive Theories of Depression
Cognitive Theory: The way we think about events influences how react to them.
- Automatic Negative Thoughts (about self & environment) play a central role in the development and duration of depression
Depression:
Relevant Brain Structures
Dorsolateral Prefrontal Cortex
Ventromedial Prefrontal Cortex
Anterior Cingulate Cortex
Amygdala
Depression - Relevant Brain Structures:
Dorsolateral Prefrontal Cortex
Function: Planning and executive functioning
Pattern: Decreased activity in some studies
Depression - Relevant Brain Structures:
Ventromedial Prefrontal Cortex
Function: Regulating emotion
Pattern: Increased activity in some studies
Depression - Relevant Brain Structures:
Anterior Cingulate Cortex
Function: motivation, emotion regulation
Pattern: Decreased activity
Depression:
Depression Treatment Types:
Talk Therapy + Medications
Depression - Relevant Brain Structures:
Amygdala
Function: emotional salience
Pattern: Increased activity in response to threat/negative stimuli
Depression - Treatment Types:
Talk Therapy
1. Cognitive Behavioral Therapy:
-
Behavioral Activation: Increased engagement with positive/pleasant activities (ex: exercise)
- Engage in positive activities → Experience more pleasure → Improve depressed mood
- Thoughts: Identify Cognitive Distortions + feelings (ex: Catastrophizing)
2. Mindfulness-Based Cognitive Therapy:
- Incorporating Mindfulness Techniques into a Cognitive Domain.
- Goal: Thoughts are not facts (observe don’t act)
- Very useful in reducing relapse of depression
Depression: Treatment Types
Medication
- SSRIs → Selective Serotonin Reuptake Inhibitors
- SNRIs → Serotonin and Norepinephrine Reuptake Inhibitors
- Electroconvulsive Therapy (ECT)
-
Transcranial-Magnetic Stimulation (TMS)
- Applies a magnetic pulse to brain
- For treatment-resistant depression
-
Ketamine
- Theory: Suppresses neurotransmitter activity & alters activation patterns & connectivity
- Limited long-term research (Be Cautious)
- Seems to require higher doses
- Exercise / Physical Activity
Depression: Treatment
Combinations & Comparisons of Treatments
Therapy + Medication:
*Combining the two is better than either alone by 10% – 20%
* Medications quicker, therapy longer-lasting effects
Cognitive Behavioral Therapy (alone):
- As effective as medication for severe depression
- CBT = more effective than medication at preventing relapse
