Exam 4: Affective Disorders Flashcards
disturbances of mood typically accompanied by sustained, inappropriate expression or pleasure or misery
affective (mood) disorders
what are the 2 types of affective disorders the DSM-5 describes that are characteried by extreme and innaprotpriate exaggeration of mood
major depression
bipolar disorder
recurring episodes of dysphoria and negative thinking
major depression
mood swings from depression to mania over time
bipolar disorder
depression facts
- 5% adults suffer from depression
- women>men
- depression rates tripled over the pandemic ( 1 in 3 in 2021)
- 7-15% of depressed individuals commit suicide
how many people die from suicides each year
> 700,000
2nd leading casue of death in 15-29yrs old
46,000 suicides in US in 2020
75% of ppl in low or middle income countries receive no treatment
reactive depression
state of sadness in response to situations like loss of a loved one
-does not constitute mental illness, unless symptoms are disproportionate to the event or significantly prolonged
clinical depression
characterized by loss of interest in almost everything and inability to experience plessure (adhedonesia)
-most patients feel hopelessness, sadness, worthlessness, guilt, desperation
types of depression (6)
major depressive disorder dysthymia (persistent depressive disorder) postpartum depression psychotic depression seasonal affective disorder bipolar depression
depression symptoms
- loss of interest in almost everything
- anhedonia: cannot exerience pleasure
- feelings of hopelessness, worthlessness, sadness, guilt, desperation
- loss of self-esteem, hopelessness about future
- loss of appetite, insomnia, crying, diminished sex drive, loss of ambition, fatigue, agitation
- digestive disturbances, difficulty breathing, physical pain
- suicidal ideation
frequency of depressive episodes
if untreated can improve in 6-9 months but reoccur throughout lifetime
-frequency and intensity of episodes inc over time
classification of major depressive disorder (MDD)
5 or more of the following symptoms must be present for 2wks or longer and represent a change from normal functioning
- MUST include depresseed mood OR loss of pleasure
- some people can experience MAD wihout “sad/depressed” feeling
depression symptoms-sleep
altered sleep rhythms are one of the most common and persistent symptoms of MDD
- onset of sleep is delayed
- onset of REM sleep occurs earlier
- dec in slow-wave or deep sleep with repeated awakenings during the night
MDD prevalence-gender, age, race
gender: other category
age: 18-24 is the highest
race: unkown race highest then hispanic
dysthymia (persistent depressive disorder)
-mild but long-term form of depression
“down in the dumps” without meeting full criteria of MDD
-symptoms present 2 yrs or more for adults
-onset typically prior to adulthood, but can happen to anyone
common symptoms of MDD and Dysthymia
depressed mood, disturbed sleep, low energy, poor concentration, indecisiveness
symptoms specific to dysthymia, not MDD
no history of mania, no MDD in first 2 yrs
number of checklist symptoms requred for diagnosis of dysthymia
at least 2
postpartum/perinatal depression
major depressive episode that occurs during pregnancy (antenatal depression) or after childbirth (postpartum depression)
- antenatal depression: 20%, PPD 10-15% women in US
- 50-70% go undiagnosed, up to 85% go untreated
symptoms of postpartum/perinatal depression
feelings of extreme sadness, anxiety, guilt, doubt, fatigue apetite changes, physical pain, thoughts of death/suicide/harming baby
interferes with ability to carry out daily tasks
consequences of postpartum depression
offspring at risk for developmental delays, elevated cortisol levels, reduced dopamine and serotonin
seasonal affective disorder
depression characterized by recurrent seasonal pattern
- winter vs summer
- symptoms last 4-5 months
winter pattern SAD can include
oversleeping (hypersomnia)
overeating (carbs)
weight gain
social withdrawal
summer pattern SAD include
troubl sleeping/insomnia poor appetite (weight loss) restlessness/agitation anxiety violent behavior
psychotic depression
MDD/dysthymia accompanied with psychosis
-delusions and hallucinations
affects up t 20% of people with MDD
often leads to hospitalization
inc risk of suicide/accidental death
bipolar disorder disorder
characterized by mood swings from depression to mania over time
what is mania characterized as
periods of great excitement or euphoris delusions, overactivity
types of mania
euphoric mania
dysphoric mania
psychotic mania
hypomania
manic episodes are characterized by
feelings of elation, inc energy, diminished need for sleep, grandiosity, denial, poor decision making
not attributable to drug use
impairs social functioning - may require hospitalization
euphoric mania
“super-human energy”
“feeling great” uncontrollably excited, like you can’t get yor words out fast enough
hypersexual urges
easily distracted or racing thoughts
talking a lot, over friendly, inc activity, sleeping very little, risk taking, excessive spending/drug use
hypomania
not accompanied by severe functional impairment
creative, energetic
reduced sleep needs
dysphoric mania
"agitated depression" mood is terribly depressed feelings of helplessness and worthlessness high energy and agitation anti-depressants worsen dysphoric mania
energized but feel terrible - may be diagnosed as depressed at first instead of bipolar
psychotic mania
15-20% bipolar patients
delusions of grandeur: believe they have special powrs/insight
paranoia (rare)
-belief that others are out to get them
-delusions and paranoia ends with the manic period
comorbidities and depression
anxiety and alcohol dependence
- almost 60%
- comorbidity preditcs severe symptoms and persistent symptoms more difficult to treat
- episodes reoccur throughout life inc frequency and intensity
