Major Depression Flashcards
What is the difference between a dualist and monist (materialist) view?
dualist - brain and mind are discrete entities
monist - brain an dmind are the same entitiy (preferred today)
True or false: people with MDD experience depression on a continuum ranging from elated to sadness to depression.
false - the experience is that depression is an entirely different beast
What is Beck’s triad of cognitive changes for MDD?
hopelessness, helplessness, and worthlessness
What are the two primary psychiatric depressive disorder?
major depressive disorder
dysthymic disorder
what are the three types of secondary depressive disorders?
- due to general med condition
- substance-induced
- seasonally-mediated
The secondary depressive disorders that are due to a general med condition (NOT neurological) will present with what type of symptoms?
more of the neurovegetative symptoms: fatigue, lethargy, lack of motivation, sometimes sadness
What are some examples of gen medical conditions that can cause a secondary depression?
Nutritional deficiencies (B12, folate, vit D) Anemia Hypothyroidism Adrenal insufficiency brain injury
What are two neurological conditions that can be associated with a secondary depression? With what symptoms?
parkinson’s disease and stroke
they get a full depressive syndrome
What are some drugs that can induce a secondary depression?
alcohol and cannabis (through CNS depressant effects)
cocaine, amphetamine, MDMA (through NT depletion)
Describe how the season can mediate a depressive disorder?
- shortened photo-period
- less light reaches retina
- disrupts circadian rhythm
- neurovegetative changes
- depressive mental state
What gene is especially shown to be a genetic vulnerability for MDD?
serotonin transporter linked promoter region polymorphism
Does the long or short polymorphism of the 5HTTLPR give the vulnerability? Why?
the short promoter - there’s less space for the transcrption machinery to bind, so they get less expression of the serotonin transporter gene
For a diagnosis of MDD, you need at least 2 weeks of either….
low mood or anhedonia (plus other symptoms
What is the lifetime prevalence of MDD?
16.5% (more so in women)
What is the average age of onset for MDD?
32
How do you treat a secondary depression if it’s from a general med condition vs a neurological condition?
general med = just fix the medical problem and the dep will go away
neurological = treat like a MDD
How do you treat a seoncdary depressive disorder that is substance-induced?
abstinence from substance and maybe an antidepressant
How do you treat seasonally mediated secondary depressive disorder?
phototherapy: 10,000 lux for 30 minutes daily
What are the three general arms of treatment for MDD?
lifestyle changes
psychotherapies
somatic treatments
What surprising finding on brain imaging occured after an exercise program in MDD?
it actually reversed hippocampal atrophy (plus releases endorphins)
What are three general types of psychotherapies you can use for MDD? Which is most effective?
cognitive behavioral therapy (most effective)
psychodynaomic psychotherapy
interpersonal therapy
What are the three general types of somatic treatments for MDD?
psychosurgery
neuromodulation
medications
What psychosurgery is still done occasionally for MDD?
anterior cingulotomy (cuts the communication between the dorsolateral prefrontal cortex and the basal ganglia/limbic structures. we don’t know why it works
What are the 3 types of neuromodulation treatments for MDD?
- electroconvulsive therapy
- transcranial magentic stimulation of the dorsolateral PFC
- Deep brain stimulation
