Major Depressive Disorder Flashcards
What are the symptoms of major depressive disorder?
- affective: sadness, helplessness, loneliness
- motivational: difficulties with task initiation, impaired performance, difficulty making decisions
- cognitive: low self esteem, self blame, inability to hope
- psychological: loss of appetite, fatigue, personal health problems
What are the prevalence rates of depression?
- 5-12% of men, 10-25% of women
- 25% do not seek help
- most treated by GPs, only about 10% referred to psychiatric services
- 1.5-5 times greater among 1st degree relatives than general population
Understand that the serotonin system regulates norepinephrine and dopamine activity and low levels of serotonin lead to mood deregulation
Learn the top card
How does MAO inhibitors work at the synapse?
Inhibits the breakdown of monoamine neurotransmitters in the synaptic cleft
How does tricyclics work at the synapse?
Blocks the reuptake of monoamines into the presynaptic cell
How does selective serotonin reuptake inhibitors (SSRIs) work at the synapse?
Blocks serotonin reuptake
Understand the link between cortisol level and depression
High levels of cortisol (stress) hormone is related to depression
Understand that depression is also associated with elevated CRH
Elevated CRH is associated with depressive symptoms, antidepressants and ECT can lower it
Understand the implications of the finding that early life stress in animal models can lead to permanent changes in the level of CRH (and therefore cortisol)
There can be a permanent increase in CRH level among rats who were maternally deprived as new borns. This can set life long depression
Understand the logic of the serotonin depletion experiments that allow us to get a handle on how serotonin levels affect depression
- have been used to see whether change in neurotransmitter level is a cause or effect of depression
- lowering serotonin levels does not induce depression in all people
- serotonin levels can be reduced artificially by introducing an agent that depletes tryptophan
- lower serotonin levels can be a causal agent in depression
What is the red route into the anxiety-alcohol-depression vicious cycle?
- anxiety is the entry point
- to reduce anxiety is tot numb oneself with alcohol
- large amounts of alcohol has a depressive effect on the nervous system
- impacts motivation and productivity
- the body develops a tolerance to alcohol so more alcohol is necessary for the same numbing effect
What is the green route into the anxiety-alcohol-depression vicious cycle?
- alcohol is the entry point
- late amounts of alcohol starts to depress the nervous system
- once depressed the person starts to become anxious as well
- this increases the need and attachment to heavy drink to dampen anxiety
What is the blue route into the anxiety-alcohol-depression vicious cycle?
- depression is the entry point
- depression can bring under performance which elevates anxiety levels
- alcohol is then chosen as a self medication which succeeds in deepening depression
What are the effects of chronic stress on the HPA axis?
- acute or chronic stress can damage the hippocampus
- early life elevation of CRH level due to stress can permanently alter the timing of the stress response
What is Beck’s triad?
- trying to change how individuals think
- cognitive triad shows a pattern of thinking where they assume personal defectiveness, negatively interpret events and they have no hope for the future
- patterns of reasoning: my work is not valued, nobody likes me
What is arbitrary inference?
Drawing a negative conclusion without a tight argument
What is selective abstraction?
Picking up something negative and then broadening it into a more general principle
What is over-generalisation?
Again, going from negative instances to broad negative views
What is negative magnification?
Highlighting or over-estimating the importance of the negative aspects of experience
What is personalisation?
Unwarranted levels of holding the self-responsible for negative things
Understand the mechanism by which certain learning events can lead to global learned helplessness
Don’t know
Understand the logic of seligman’s shock experiment.
- 3 conditions: inescapable shock, escapade shock and no shock
- the dogs in the escapade shock and no shock condition run out of the cage when given the shock
- the inescapable shock dogs stayed in the cage and took the shock even though the door was open
What are the different types of explanatory styles from reports about patients’ styles of thinking?
- internal and external attributions
- stable explanations
- global causes
- internal-stable-global explanation
- external-unstable-specific explanatory style
What is internal and external attributions?
- internal: blames the self
- external: finds causes outside the self
