mental illness - mood disorders Flashcards
Mood Disorders - what? mood? two main forms?
- Mental disorders that have mood disturbance as their predominant feature
- two main forms are depression and bipolar disorders
- Mood: relatively long lasting, nonspecific emotional states (nonspecific = no idea what causes the mood)
Stats - how many suicides canadians? women depression vs men? suicide/total deaths? most common age for depression?
Examples of Mood disorders? (4)
- 4000 Canadians/year commit suicide
- Women are 2x more likely to become depressed than men are
- ¼ of all deaths (Canadians 15 – 24 y.o.) are due to suicide
- Most common age of onset of depression is adolescents
- Examples: Seasonal Affect disorder, Dysthymia, Unipolar depression, Bipolar disorder
Unipolar depression - aka? what? 5?
- aka major depressive disorder
- Severely depressed mood that lasts 2 or more weeks, accompanied by feelings of worthlessness and lack of pleasure, lethargy, and sleep and appetite disturbances
- 8% of Canadians will experience it at some point in their lives
Unipolar depression - changes in affect, thought physical?
- Affect: everything is flat, grey, lifeless
- Thought: people who are depressed pay special attention to negative info, dwell on it, and at the same time greatly downplay coping resources – mistaken cognition
- Physical: aches, pains, stomach problems
Key symptoms of depression? Anhedonia?
- Sadness, feeling worthless & hopeless
- Anhedonia: inability to feel pleasure – stuff that used to make you happy can’t anymore
- Lack of motivation
- Feeling isolated
- Difficulty concentrating – reading a book, following plot of movie, etc
- Bodily symptoms: sleeping too much/too little, eating too much/too little
Unipolar Dep - % canadians? lasts how long? single vs recurrent? median life time risk?
- 8%
o Major depression lasts on average 12 weeks
o Without treatment, 80% will experience at least one recurrence of disorder
o Compared with people with a single episode: recurrent depression has more severe symptoms, higher rates of depression in families, more suicide attempts, higher divorce rates
o Median lifetime risk for depression: 16% but increasing
o Women twice as much as men (maybe because of socioeconomic standing, hormones like estrogen, androgen, progesterone, postpartum depression, maybe more likely to seek help/get diagnosed)
o Women: accept, disclose and ruminate on negative emotions vs. men: deny and self-distract
Uni-Dep - gender and why?
- Women twice as much as men
- maybe because of socioeconomic standing, hormones like estrogen, androgen, progesterone, postpartum depression, maybe more likely to seek help/get diagnosed
- Women: accept, disclose and ruminate on negative emotions vs. men: deny and self-distract
Uni- Dep Biological factors - heritability? parts of brain?
- Biological factors
o Heritability 33% to 45% but vary as a function of severity (more severe = higher concordance rates)
o Might involve diminished activity in left prefrontal and increased activity in right prefrontal cortex
o Stroke patients damaging left PC: higher levels of depression - Psychological factors
o Consistent negative cognitive style – pessimism, low self-worth
o Helplessness theory: individuals prone to depression automatically attribute negative experiences to causes that are internal (their own fault) stable (won’t change) and global (widespread)
o Ex: Bad grade on math test is a sign of low intelligence (internal), will never change (stable) and make them fail all his future endeavors (global)
o Evidence that depressed people’s judgments, memories and attributions are negatively biased (but bias could be a consequence rather than a cause) - Suicide risk and prevention
o Women more likely to attempt, but men more likely to die during suicide attempts
o Suicide rates increase with age, aging white males high risk
o Werther effect: contagion of suicide – contagious, imitation
U-D psychological factors - cognitive style? helplessness theory?
- consistent negative cognitive style – pessimism, low self-worth
- Helplessness theory: individuals prone to depression automatically attribute negative experiences to causes that are internal (their own fault) stable (won’t change) and global (widespread)
Bipolar Depression - what? depressive state?
- Unstable emotional conditioned characterized by cycles of abnormal, persistent high mood (mania) and low mood (depression)
- Depressive phase: often clinically indistinguishable from major depression
BD - mania meaning? symptoms? DSM requirements?
- wild, exuberant, unrealistic activity not justified by environmental events
- erratic thought processes, elated & self-confident but easily angered if challenged, often flip from idea to idea – almost resembles a schizophrenic mind (misdiagnosing possibility)
- has to last at least a week to meet DSM requirements
- Other symptoms: elevated mood, irritable, grandiosity, less sleep, talkative, racing thoughts, distractibility, reckless behaviour, psychotic features like hallucinates/delusions possible
BD - %? manic/depressive timing? recurrence? persistence?
- 1% of Canadians will experience it
- In 2/3 of patients, manic episodes immediately precede or follow depressive episodes
- Recurrent condition: 90% afflicted will suffer from several episodes
- Persistent: lots of relapse and new episodes after recovery
BD - rapid cycling bipolar disorder - %? requirements? gender?
- 10%
- At least four mood episodes (either manic or depressive) every year
- More common in women
- sometimes precipitated by antidepressant drugs
BD biological factors - heritability? genes? neurotransmitters?
- Highest rate of heritability: ID twins 40 to 70% concordance
- Polygenic disorder: interaction from multiple genes
- Low levels of serotonin and norepinephrine might contribute – but doesn’t explain why lithium (unrelated to these neurotransmitters) helps stabilize both depressive and manic symptoms
- Prefrontal cortex & amygdala in particular
BD Psychological factors?
- Stressful life experiences often precede manic and depressive episodes
- Severely stressed patients too longer to recover from an episode
