Lecture 6: Mood Disorders Flashcards
What is mania?
Characteristics by intense and unrealistic feelings of excitement and euphoria or irritability
What is unipolar depressive disorder?
A person experiences only depressive episodes
What is bipolar disorder?
A person experiences both depressive and manic episodes
What is a depressive episode?
When a person is markedly depressed or loses interest in formerly pleasurable activities for at least 2 weeks
What is a manic episode?
Markedly elevated, expansive or irritable mood for at least 7 days
What is a hypomanic episode?
Abnormally elevated, expansive or irritable mood for at least 4 days; the person must also have at least 3 other symptoms similar to those involved in mania
How is the rate of unipolar depression related to SES?
Inversely related
What is the diagnosis baseline of Major Depressive Episode?
5+ of the following symptoms, present for >2 weeks (most of the day nearly every day), causing impairment/distress, must include (1) or (2)
1. Low mood
2. Loss of interest or pleasure
3. >5% loss of body weight or decrease/increase appetite nearly everyday
4. Sleep disturbance
5. Agitation or feelings of being slowed down
6. Loss of energy
7. Feelings of worthlessness, low self-esteem, tendency to feel guilty
8. Loss of ability to concentrate
9. Thoughts of death/suicide
Relapse vs Recurrence
Relapse happens when symptoms return quickly after treatment, meaning the person hasn’t fully recovered. Recurrence is when a person has been well for a long time but then develops a new episode of depression later on.
What is another name for Persistent Depressive Disorder?
Dysthymia
2 requisites for Persistent Depressive Disorder diagnosis
- Depressed mood for most of the day, for more days than note, for at least 2 years
- Never been without symptoms for more than 2 months at a time
What is double depression?
Moderately depressed on a chronic basis but undergo increased problems from time to time, during which the person also meets the criteria fro a major depressive episode
What is premenstrual dysphoric disorder?
When a woman faces at least five symptoms in the final week before the onset of menses, start to improve within a few days after the onset of menses, and become minimal or absent in the week post-menses
What are 3 causal biological factors in unipolar mood disorders?
- Genetics
- Neurochemical and neurobiological factors
- Sleep and other biological rhythms
Independent vs Dependent Life Events
Independent life events are events that happen on their own, like a sudden loss. Dependent life events occur as a result of one’s behaviour.
What is neuroticism/negative affectivity?
A personality trait that makes a person more sensitive to negative stimuli or emotions.
What is early adversity as a diathesis?
Experiencing difficulties or challenges early in life can make someone more vulnerable to depression later in life.
What is the behavioural theory of unipolar mood disorder?
Depression may occur when a person’s actions no longer lead to positive reinforcement (reward or pleasure) or when there is an increase in negative reinforcement (more unpleasant experiences or punishments). But not proven by research yet.
What is Beck’s Cognitive Theory?
- Beck believed that negative thoughts (cognitive symptoms) are often the first signs of depression and can cause mood symptoms, rather than mood problems causing negative thinking.
- Depression is linked to rigid, extreme and unhelpful believes about oneself, the world or the future (Negative Cognitive Triad)
- When these negative beliefs are triggered by a stressed or depressed mood, they lead to automatic negative thoughts, which reinforce the depression
What is rumination?
Rumination is when someone repeatedly and passively focuses on their negative thoughts or problems. People who have a negative thinking style are more likely to ruminate and develop depression because they dwell on distressing thoughts rather than taking action to resolve them.
What are the 5 elements of Beck’s Unified Model of Depression?
- Early Experiences
- Genetic Risk
- Biological Stress Reactivity
- Information Processing Biases
- Negative Cognitive Triad
What is cyclothymic disorder?
The repeated experience of hypomanic symptoms for a period of at least 2 years
What is a mixed episode in Bipolar I disorder?
Symptoms of both manic and major depressive episodes for at least 1 week, either intermixed or alternating rapidly every few days
Difference between Bipolar I and Bipolar II
Bipolar I has full mania, Bipolar II has hypomania (less intense). Bipolar II typically has worse depression than Bipolar I.
5 causal factors in bipolar disorder
- Genetic Influences
- Neurochemical Factors
- Hormonal Factors
- Neuroanatomical Factors
- Sleep and other biological rhythms
What was the evolution of antidepressants?
1950s - MAOIs (monoamine oxidase inhibitors)
1960s - TCAs (tricyclic antidepressants)
Now - SSRIs (selective serotonin re-uptake inhibitors)
How long do antidepressants take before working?
3-5 weeks
How many percent of patients do not respond to the first drug prescribed?
Around 50%
How is a relapse caused?
Stopping the medication when symptoms have improved
What is lithium commonly used to treat?
Bipolar Disorder. For people that don’t respond well to lithium, can use anticonvulsants (drug used to treat seizures)
For whom is electroconvulsive therapy used for?
Patients who are severely depressed and may be at an immediate risk of suicide
What is Transcranial Magnetic Stimulation??
Uses magnetic pulses to stimulate specific areas of the brain. More effective than antidepressants, with fewer side effects compared to ECT.
What is deep brain stimulation?
Used for people with severe depression who haven’t responded to other treatments. Involves implanting an electrode in the brain and using an electrical current to stimulate specific areas of the brain.
What is bright light therapy?
Used for seasonal affective disorder (depression related to changes in seasons, usually in winter), but shown to be effective for nonseasonal depression as well. Uses light to regulate mood.
What is CBT work?
Focuses on current problems and helps people identify and evaluate their negative thoughts and dysfunctional beliefs. Teaches people how to challenge and change these negative thought patterns.
What is Behavioural Activation Treatment?
A newer treatment that focuses on increasing positive activities.
What is interpersonal therapy?
Focuses on current relationship issues, helping people understand and change unhealthy interaction patterns.
Is there a genetic link when it comes to suicide?
The concordance rate for suicide is about three times higher in identical twins compared to fraternal twins, suggesting a genetic link.
What is the serotonin function in relation to suicide?
Suicide victims often have changes in serotonin function, with reduced serotonin activity, which may be linked to depression and suicidal behaviour.
What is executive function impairments with regard to suicide?
People who attempt suicide show significant impairments in executive function (such as decision-making, planning and impulse control).
