M3: Week 12 - Mood disorders Flashcards
_______ is closely associated with depression
Pain
_________ decreases the activity of dopamine neurons that are
important for both motivation and reward (Markovic et al., 2021).
Pain
Many kinds of _________ can cause depression.
stress
TRUE or FALSE
Most of the women who experience depression at those times had previous bouts of depression, and the stress of delivery or menopause triggered a recurrence (Maki et al., 2019).
TRUE
__________ often occurs in women shortly after giving birth, or around the time of menopause, events that put much strain on the body.
Depression
________ events activate the immune system, preparing the body to attack an infection.
Stressful
The immune system releases proteins called ________ that fight infection and conserve energy by reducing activity levels and decreasing appetite (Hodes et al., 2015; Kaplan et al., 2015; Wohleb et al., 2016).
cytokines
Inactivity and loss of appetite are typical symptoms of
___________.
depression
Many of the cytokines released by the immune system produce inflammation, and many people with depression show signs of _____________ (Woelfer et al., 2019).
brain inflammation
_____________ impairs the activity of mitochondria, resulting
in decreased energy, another symptom of depression (Kramer and Bressan, 2018).
Inflammation
One insight into possible biological bases of depression comes from research on ______ that relieve it.
drugs
TRUE or FALSE
Investigators find drugs that seem helpful, and then they try to
understand how the drugs work.
TRUE
_________, the first antidepressant drug, was originally marketed to treat tuberculosis, until physicians noticed that it relieved depression.
Iproniazid
_____________ was originally used as a tranquilizer, until physicians noticed its ability to alleviate schizophrenia.
Chlorpromazine
For decades, researchers evaluated drugs just by _________________.
trial and error
Today, researchers start by testing drugs in ___________ or ___________, in order to use fewer laboratory animals.
test tubes or tissue samples
Antidepressant drugs include:
- tricyclics
- selective seroton
in reuptake inhibitors - monoamine oxidase inhibitors
- atypical
antidepressants.
Blocking ____________
produces drowsiness
Blocking ______________ leads to dry mouth and difficulty urinating
Blocking _________________ causes heart irregularities.
histamine ;
acetylcholine ;
sodium channels
People need to limit their use of __________ drugs to minimize side effects.
tricyclic
attach to the center of just the serotonin transporter protein and lock it into a shape that blocks serotonin from binding to it (Coleman et al., 2016).
Selective serotonin reuptake inhibitors (SSRIs)
produce milder side effects than the tricyclics, but their effectiveness is about the same.
Selective serotonin reuptake inhibitors (SSRIs)
Common SSRIs include:
- fluoxetine (trade name Prozac)
- sertraline (Zoloft)
- fluvoxamine (Luvox)
- citalopram (Cel-exa)
- paroxetine (Paxil or Seroxat)
such as duloxetine (Cymbalta) and venlafaxine (Effexor), block the reuptake of both serotonin and norepinephrine.
Serotonin-norepinephrine reuptake inhibitors (SNRIs)
Antidepressants targeting different neurotransmitters are equally effective (Montgomery et al., 2007; Undurraga and Baldessarini, 2012).
Serotonin-norepinephrine reuptake inhibitors (SNRIs)
Given the variety of symptoms associated with depression, it seems reasonable to try a combination of antidepressant drugs instust one, and many psychiatrists do so, routinely.
Serotonin-norepinephrine reuptake inhibitors (SNRIs)
Researchers have reported that a combination of drugs increases the number of side effects without demonstrably improving the antidepressant response (Stassen et al., 2021).
Serotonin-norepinephrine reuptake inhibitors (SNRIs)
The ____________________ (e.g., phenelzine, trade name Nardil) block monoamine oxidase (MAO), a presynaptic enzyme that breaks catecholamines and serotonin into inactive forms. When MAOIs block this enzyme, the presynaptic terminal has more of its transmitter available for release.
The monoamine oxidase inhibitors (MAOIs)
The ________________ were the earliest antidepressants, but today physicians prescribe them only for patients who did not respond to other antidepressants.
The monoamine oxidase inhibitors (MAOIs)
People taking ___________________ must avoid foods containing tyramine—including cheese, raisins, and many others—because a combination of tyramine and ______ increases blood pressure.
The monoamine oxidase inhibitors (MAOIs) ; MAOIs
- The atypical antidepressants are a miscellaneous category (Horst and Preskorn, 1998).
- One example is __________ (Wellbutrin), which inhibits dopamine reuptake and norepinephrine to some extent.
- The monoamine oxidase inhibitors (MAOIs)
- bupropion
Many people use ___________, a herb, as an antidepressant.
St. John’s wort
It is a nutritional supplement instead of a drug, the U.S. Food and Drug Administration does not regulate it, and its purity varies from one bottle to another.
St. John’s wort
It has the advantage of being less expensive than antidepressant drugs.
St. John’s wort
An advantage or disadvantage, depending on your point of view, is that it is available without prescription.
St. John’s wort
People can get it easily but often take inappropriate amounts.
St. John’s wort
Its effectiveness is reportedly comparable to that of standard antidepressants drug.
St. John’s wort
People generally need to take the drugs for at least _________ before they experience noticeable benefits (Stewart et al., 1998).
2 weeks
_____________ drugs increase levels of serotonin and other transmitters,
Antidepressant
Facilitates neurotrophins
ANTIDEPRESSANTS
Depression is associated with decreased levels of the neurotrophin called ________________________, which is important for synaptic plasticity and learning (Martinowich et al., 2007; Sen et al., 2008).
brain-derived neurotrophic factor (BDNF)
Low ____________, and depression is associated with impaired learning.
brain-derived neurotrophic factor (BDNF)
Standard antidepressants attach to a receptor for _________ and facilitate its release.
BDNF
However, because _______________ do not bind strongly to that receptor, they have to accumulate for weeks to reach a high enough brain concentration to produce a significant effect (Casarotto et al., 2021).
standard antidepressants
A __________ in the receptor for BDNF prevents antidepressants from exerting their effects (Airan et al., 2007).
mutation
Most controlled studies find that antidepressants are at least moderately more effective than __________
placebos
TRUE or FALSE
but even when the advantage over placebos is statistically significant, it is not always strong in a clinical sense (Bschor and Kilarski, 2016; Undurraga and Baldessarini, 2012).
TRUE
Many people respond well to ___________, either because of spontaneous recovery over time or because of the expectation that comes from taking a pill.
placebos
When people take an antidepressant drug and gradually improve, both they and their psychiatrists are likely to attribute the improvement to the pills, even when the improvement may have been a ________________.
placebo effect
_______________ drugs have limited and variable effectiveness. When people take antidepressants, many fail to show a benefit from the first drug they try.
Antidepressant
After a few weeks, the psychiatrist might prescribe a different drug, and then perhaps another one, and so forth, on a ______________ process.
trial-and-error
TRUE or FALSE
Most patients eventually show a favorable response, regardless of whether they switch to a similar drug or a drug of a different type (Keers and Uher, 2012).
TRUE
Many research studies have failed to include adequate _________ groups.
control
TRUE or FALSE
Psychiatrists also sometimes increase the dose, the problem is we don’t know whether the improvement was due to the higher dose or just to the passage of time.
TRUE
______ and other forms of psychotherapy produce benefits that are about equal to the effects of antidepressant drugs.
CBT
Psychotherapy and antidepressants increase ____________ in the same brain areas.
metabolism
“Changing thoughts and changing brain chemistry are the same thing”.
Psychotherapy and antidepressants
Psychotherapy as 2 advantage:
- lack of side effects
- effects are more likely to last.
Most people relapse into ___________ sooner after antidepressant drug treatment than after psychotherapy.
depression
The advantage of antidepressant drugs is _____________.
convenience
People receiving both treatments show more ________________ than people receiving either one alone.
rapid improvement
electrically induced seizure.
Electroconvulsive Therapy (ECT)
Quick result, most patients awaken calmly without remembering it. But usually not long-lasting.
Electroconvulsive Therapy (ECT)
Proved to be ineffective for most cases of schizophrenia but able to relieve depression in many cases.
Electroconvulsive Therapy (ECT)
Misuse during the 1950s earned it a bad reputation.
Electroconvulsive Therapy (ECT)
1970s, use for severely depressed patients who did not respond to the drugs, given only with informed consent or if a court order required it. Patients with high risk for suicide.
Electroconvulsive Therapy (ECT)
Every other day for about 2 weeks. To prevent relapse, patient periodically returns for treatment
patients are given ____________ or _________ to minimize discomfort and injury.
muscle relaxant or anethetics
Common effect on memory impairment that usually last only a few months not forever.
Electroconvulsive Therapy (ECT)
Limiting the shock to the right hemispheres reduces the _____________.
memory loss
ALTERNATIVES TO MEDICATION
Exercise and Sleep
simplest, least expensive
- Exercise and Sleep
- Alter sleep schedule going to bed earlier than usual.
___________ improves positive mood.
walking
___________ increases blood flow to the brain and increases the supply of nutrition to the brain.
exercise
Most people with ____________ enter REM earlier than average and awaken early as if they had just moved a couple time zones west. By going to bed earlier, they get a normal amount of sleep with normal timing of REM.
depression
This procedure
usually relieves
depression quickly and its benefits last for a week or more (Riemann et al., 1999).
Alter sleep schedule going to bed earlier than usual.
eventually, the _____________ shifts again, as if the person had traveled west again.
circadian rhythm
Depression can be ________ or ________.
unipolar or bipolar
People with __________ vary between normality and depression.
unipolar depression
People with _______________ alternate between depression and its opposite, mania.
bipolar disorder
_________ is characterized by restless activity, excitement, excessive self-confidence, rambling speech, and loss of inhibitions.
Mania
People with full-fledged manic episodes have ___________________.
bipolar I disorder
Those with only mild, hypomanic episodes have ___________________.
bipolar II disorder
Bipolar disorder usually has its onset in the ___________ or ______.
teenage years or early 20s
Brain’s increase in glucose use during _______ and its decrease during _________ (Baxter et al., 1985).
mania ; depression
TRUE or FALSE
Twin studies have demonstrated high heritability for bipolar
disorder.
TRUE
At least _____ common genetic variants are linked to bipolar
disorder, although no common variant has a large effect.
30
Some of the genes linked to bipolar disorder also show a slightly positive correlation with creative accomplishments in ______, _____, ________, or ________ (Power et al., 2015).
acting, art, music, or writing
A history of _____________________ also increases the risk of bipolar disorder (McIntyre et al., 2020).
childhood maltreatment
The first successful treatment for bipolar disorder, and still the most common one, is _____________.
lithium salts
Cade mixed _________ (a component of urine) with a lithium salt to help it dissolve and then gave the solution to patients.
uric acid
Lithium’s benefits were discovered accidentally by an Australian investigator, __________, who believed uric acid might relieve mania and depression.
J. F. Cade
TRUE or FALSE
It was indeed helpful, but investigators soon discovered
that lithium was the effective agent, not uric acid.
TRUE
_________ stabilizes mood, preventing a relapse into either mania or depression.
Lithium
The dose must be regulated carefully, as a low dose is ___________, and a high dose is _______.
ineffective ; toxic
Bipolar disorder is associated with overactivity of ___________, leading to hyperactivity of many neurons.
mitochondria
A likely hypothesis for the effectiveness of lithium is that it reduces ____________ (Kato, 2019).
hyperactivity
Other drugs are the
_________________ and ____________, which also reduce overexcitation.
anticonvulsants valproate and carbamazepine
Patients with bipolar disorder frequently have poor ______________ during manic phases, depressed phases, and even when their mood is normal (Altena et al., 2016).
sleep quality
Getting consistent, adequate _________ helps stabilize mood and decrease the risk of a new episode (Harvey et al., 2009).
sleep
IDENTIFICATION:
are a broad umbrella term used for conditions
in which disturbance of mood is the central feature.
Mood Disorder
IDENTIFICATION:
conditions that affect a person’s emotional state and how one interacts with the world.
Mood Disorder
ENUMERATION:
Two of the best-known mood disorder
- Major Depressive Disorder
- Bipolar Disorder
IDENTIFICATION:
This is what we often hear referred to as major depression or clinical depression.
Major Depressive Disorder (MDD)
IDENTIFICATION:
involves periods of extreme sadness, hopelessness, or emptiness accompanied by a variety of physical, cognitive, and emotional symptoms.
Major Depressive Disorder (MDD)
IDENTIFICATION:
This disorder was formerly called manic depression
Bipolar I Disorder
TRUE OR FALSE:
During manic episodes, people with bipolar I also regularly engage in risky activities that can result in negative consequences for themselves and/or others.
TRUE
IDENTIFICATION:
It is characterized by euphoric and/or irritable moods and increased energy or activity.
Mania
IDENTIFICATION:
Diagnosis requires a minimum two-year history of many episodes that resemble hypomania and major depression, but none of which meet the criteria for these conditions.
Cyclothymic Disorder
TRUE OR FALSE:
To be diagnosed with Bipolar I, a person must have had at least:
- one episode of current or past hypomania (a less severe from of mania)
- one episode of current or past major depression but no history of any manic episodes
FALSE; to be diagnosed with Bipolar II
IDENTIFICATION:
This describes a person who is experiencing symptoms of bipolar disorder because of alcohol, drugs, or medication.
Substance/Medication-Induced Bipolar Disorder
IDENTIFICATION:
This diagnosis is used when a person experiences a depressive disorder due to alcohol, drugs, or medication.
Substance/Medication-Induced Depressive Disorder
IDENTIFICATION:
This depressive disorder was added to the DSM-5 for children 6 to 18 years of age who exhibit persistent irritability and anger and frequent episodes of extreme
temper outbursts without any significant provocation.
Disruptive Mood Dysregulation Disorder
IDENTIFICATION:
This diagnosis is meant to include both chronic major depressive disorder (that has lasted for two or more years) and what was previously known as dysthymic disorder or dysthymia, a lower- grade form of depression.
Persistent Depressive Disorder
IDENTIFICATION:
This diagnosis is based on the presence of one or more specific symptoms in the week before the onset of menstruation, followed by the resolution of these symptoms after onset.
Premenstrual Dysphoric Disorder
IDENTIFICATION:
a person displays symptoms characteristic of a mood disorder, but they don’t meet the criteria for a doctor to diagnose them with a depressive or bipolar disorder (including unspecified bipolar disorder or unspecified depressive disorder).
Unspecified Mood Disorder
ENUMERATION:
What are the symptoms of Premenstrual Dysphoric Disorder
- Mood Swings
- Irritability or anger
- Depressed mood or Hopelessness
- Anxiety or Tension
IDENTIFICATION:
are a type of major depression that occurs at a specific time of the year, usually during the fall and winter months when there is less natural sunlight.
Seasonal Affective Disorders (SAD)
IDENTIFICATION:
It is sometimes called “winter depression” or “winter blues.”
Seasonal Affective Disorders (SAD)
ENUMERATION:
What are the scientific basis for SAD?
- Disruption to the body’s circadian rhythms
- Changes in Serotonin and Melatonin Levels
- Influence of Genetics
IDENTIFICATION:
Research has shown that ______ ________, which mimics natural sunlight, can help regulate these biological factors and improve symptoms of SAD.
Light Therapy
IDENTIFICATION:
Also known as Depressive Disorder; it involves a depressed mood or loss of pleasure or interest in activities for long periods of time.
Depression
TRUE OR FALSE:
Depression is the same from regular mood changes and feelings about everyday life.
FALSE; it is different
TRUE OR FALSE:
Globally, an estimated 5% of adults suffer from depresison.
TRUE
TRUE OR FALSE:
Depression is about 50% more common among women than men.
TRUE
IDENTIFICATION:
Approximately, ____ million people in the world have depression.
280
TRUE OR FALSE:
Worldwide, more than 10% of pregnant women and women who have just given birth experience depression.
TRUE
TRUE OR FALSE:
More than 500,000 people die due to suicide every year.
FALSE; more than 700,000 people
(TW!) TRUE OR FALSE:
Suicide is the fourth leading cause of death in 15-29 year olds
TRUE
IDENTIFICATION:
These people have a high probability of relatives with circulatory problems
People with late-onset depression (especially after age 45 to 50)
IDENTIFICATION:
These people have a high probability of having other relatives with psychiatric problems, not always depression.
People with early-onset depression (before age 30)
TRUE OR FALSE:
Researchers identified seven genetic variants linked specifically to early-onset depression
FALSE; they only identified four genetic variants
TRUE OR FALSE:
Humanistic psychologists have proposed the hypothesis that depression could be an adaptation to conserve energy after a defeat.
FALSE; it was Evolutionary Psychologists
TRUE OR FALSE:
Depression often occurs in women shortly after giving birth, or around the time of menopause, events that put much strain on the body.
TRUE
IDENTIFICATION:
The immune system releases proteins called _________ that fight an infection and conserve energy by reducing activitylevels and decreasing appetite
Cytokines
IDENTIFICATION:
It impairs the activity of mitochondria, resulting in decreased energy, another symptom of depression
Inflammation
IDENTIFICATION:
________ and ____ ____ ___________ are typical symptoms of depression.
Inactivity and Loss of Appetite
IDENTIFICATION:
It is the first antidepressant drug, and was originally marketed to treat tuberculosis, until physicians noticed that it relieved depression.
Iproniazid
TRUE OR FALSE:
Many of the cytokines released by the immune system produce inflammation, and many people with depression show signs of brain inflammation
TRUE
IDENTIFICATION:
It was originally used as a tranquilizer, until physicians noticed its ability to alleviate schizoprenia
Chlorpromazine
TRUE OR FALSE:
For decades, researchers evaluated drugs by trial and error
TRUE
IDENTIFICATION:
It operates by blocking the transporter proteins that reabsorb serotonin, dopamine, and norepinephrine into the presynaptic neuron after their release.
Tricyclics
TRUE OR FALSE:
Today, researchers start by testing drugs in test tubes or
tissue samples, in order to use fewer laboratory animals.
TRUE
TRUE OR FALSE:
Tricyclics also block histamine receptors, acetylcholine
receptors, and certain sodium channels
TRUE
IDENTIFICATION:
Blocking acetylcholine leads to ______ and ___________ __________
Dry mouth and Difficulty Urinating
IDENTIFICATION:
Blocking Histamine produces ________
Drowsiness
IDENTIFICATION:
Blocking sodium channels causes _____ ________?
Heart Irregularities
TRUE OR FALSE:
To receive a diagnosis of depression, symptoms must cause the individual clinically significant distress or impairment in social, occupational, or other impairment areas of functioning.
TRUE
TRUE OR FALSE:
Some medical conditions can cause symptoms of bipolar disorder
TRUE
TRUE OR FALSE:
Predisposition can make depression more likely, events in the environment are the immediate triggers
TRUE
TRUE OR FALSE:
Researchers have identified at least 17 common genetic variants linked to depression
TRUE
IDENTIFICATION:
As with ________ _________, heritability is higher for early-onset depression than for depression later in life.
Substance Abuse
