Lecture 25: Depression/Developmental Disorders

Question 1

Major affective disorders

Answer 1

• Two main types: Bipolar and MDD (major depressive disorder)
• Bipolar: alternating mania & depression
– Euphoria not justified by situation, full of own importance, very active, long periods w/o sleep, working fervently
• MDD: depression w/o mania
– Little energy; sometimes torpid other times restless; anhedonia; sleep disturbances
• Increased risk of death by suicide

Question 2

Depressive disorders

Answer 2

• MDD: severe negative mood, anhedonia
– affects 6-7% of Americans in given 12-month period; women 2x more likely than men
– little energy, sometimes torpid but other times restless, sleep disturbances
• Dysthymia: form of depression not severe enough to be diagnosed as major depression
– affects 2-3% of population
– lasts from 2-20+ years, although typical duration is 5-10 yrs
– B/c depressed mood is so long lasting, some psychologists consider it a personality disorder

Question 3

Situational components

Answer 3

Life stressors are a factor in many cases of depression
Link to depression is especially likely in face of multiple negative events
– Patients w/ depression often have experienced negative life events during the year before onset of depression
How an individual reacts to stress is important (hardiness: commitment, control, challenge)
Interpersonal relationships important role in depression

Question 4

Cognitive components

Answer 4

Beck hypothesized people w/ depression think negatively about themselves, their future, their situations - cognitive triad
Second cognitive model of depression based on learned helplessness
– people see themselves as unable to have effect on events in their lives
– attribute negative events to stable and global rather than situation, temporary, specific events -> feel hopeless about making positive changes

Question 5

Heritability: MDD

Answer 5

Heritable: 10X more likely if they have affected relatives
Monozygotic twins 69%, dizygotic 13%
Genetic? No gene emerges; one example:
– Retinoid-related orphan receptor alpha (RORA gene)
– Control of circadian rhythms
– Also associated w/ PTSD, ASD, ADHD

Question 6

Biological basis of depression?

Answer 6

Brain structure & function
Neurotransmitter systems targeted by anti-depressant meds
Non-pharmacological treatment?

Question 7

The depressed brain

Answer 7

Hyperactive: subgenual ACC, amygdala
Hypoactive: PFC

Question 8

WTF is the subgenual ACC?

Answer 8

Part of network involved in mood regulation
– connected with amygdala, hippocampus, NAC
Overactive in depressed patients
Improvement associated w/ decreased activation in subgenual ACC & increased PFC activation

Question 9

Treatment: MDD

Answer 9

Antidepressants
Behavioral therapy
ECT
TMS
DBS
Phototherapy for SAD
Men less likely to seek help & more likely to self-medicate