Mood Disorders Flashcards
Manic Episode
- Abnormal, persistent, elevated, expansive or irritable mood
- Persistently increased goal-directed activity or energy
- Both of these lasting at least one week
- Sufficiently severe to cause marked impairment or require hospitalization
Hypomanic Episode
- All of the same criteria as a manic episode, but shorter duration
- Must last at least 4 days
- Not severe enough to cause hospitalization or marked impairment but observable by others
Bipolar II
Major depression with hypomanic states
Bipolar I
Major depression with full manic states
Cyclothymic Disorder
Symptomology of hypomania and depressed mood without sufficient criteria
Stress and Bipolar
- Stress is shown to be related to the depressive episodes, just as it is in unipolar depression
- Other types of stress, such as those related to striving for success, may precipitate a manic episode
The Swing of Bipolar
- Cycle takes on a life of its own
- Causes exhaustion
- A struggle for those with bipolar disorder is having to give up the energy that comes with mania - the boundless energy, hope, and ability to accomplish so much
Treatments for Bipolar Disorders
- Pharmacotherapy
- Electroconvulsive Therapy
- Transcranial Magnetic Stimulation
- Neurofeedback
For depression specifically: - CBT
- Interpersonal Psychotherapy
Pharmacotherapy for Bipolar Disorders
SSRIs:
- Block reuptake of serotonin
- Fluoxetine (Prozac)
Tricyclic Antidepressants:
- Widely used
- Block reuptake of norepinephrine, other neurotransmitters
Mixed Reuptake Inhibitors and SNRIs:
- Block reuptake of norepinephrine and serotonin
Monoamine Oxidase (MAO) Inhibitors
- Block the enzyme that breaks down norepinephrine
- Must avoid certain foods containing tyramine
Electroconvulsive Therapy (ECT)
- Effective for cases of severe depression, usually as a last resort
- Brief electrical currents, usually unilaterally
- Temporary seizures
- 6-10 outpatient treatments usually required
- Side effects are few, include short-term memory loss
- Uncertain why it works
- Relapse is common
Transcranial Magnetic Stimulation (TMS)
- Noninvasive procedure that uses magnetic fields to stimulate nerve cells in the brain
- Improves depression
- Prefrontal cortex
- Mild or minimal side effects
Neurofeedback
- Type of biofeedback that uses real-time display of brain activity - most commonly EEG - to teach self-regulation of brain function
- Your brain learns without you
- Done on a computer, e.g. the child playing the fish game on the computer
Behavioral Activation
- Type of CBT
- Has to do with getting people up and moving
- Monitoring of daily activities often shows people they’re actually doing a lot more than they realize, or it brings to light how little they’re doing but then we can track it
- Assessment of pleasure and mastery - finding out what the client thinks they did well and what they enjoyed
- Interventions to help ameliorate social skills and other skills
Interpersonal Psychotherapy
- Focuses on problematic interpersonal relationships
- Role conflict: when you’re in conflict in terms of what your role is now and what it was before
- Role disputes: the role you play in your family vs the role you play in your in-laws family
- Addresses problematic interpersonal behaviors
Outcome for Psychological Treatment
- Comparable to medications, but meds may work faster
- Possibly better long term outcomes for psychotherapy
- Combined medication and psychotherapy is modestly more effective
- ECT appears to be somewhat more effective than medication
Depressive Disorders
Five or more of the following symptoms present for two weeks and present a change from previous functioning; at least one of the symptoms is either:
- . *Depressed Mood or
- . *Loss of interest or pleasure
- Significant weight loss when not dieting or weight gain
- Insomnia
- Psychomotor agitation or retardation
- Fatigue or loss of energy
- Feelings of worthlessness or guilt
- Diminished ability to think or concentrate
- Recurrent thoughts of death, suicidal ideation, or suicide attempt or plan
*** There has never been a manic episode or a hypomanic episode
Equifinality
The same outcome resulting from possibly different outcomes
Biological Theories on Depression
Familial and Genetic: some evidence to suggest there is a genetic component
Neurotransmitter systems: serotonin, SSRIs and SNRIs
Immune System: stress hypothesis
Stress Hypothesis
Suggests there is something to do with the immune system and inflammation that is related to depression
Self Referent Encoding Task
- Respondent sees a serious of adjectives on the screen
- Has to rate them as “describes me” or “does not describe me”
- Typically a distractor or filler task
- Respondent is asked to recall as many adjectives as possible
- Depressed people rate more negative adjectives as self-descriptive
- Depressed people recall more negative, self-referent words than other words
Deployment of Attention/Dot Probe
- Assesses where the respondent’s visual attention is
- Two stimuli are presented
- Dot is presented in place of one of the stimuli
- Sometimes dot is presented in the place of a positive word, sometimes a negative word, or no dot
- Where (if anywhere) the person perceives the dot tells us if they were focused on a positive or a negative
- Suggests that people without depression actually have some level of PROTECTIVE attention AWAY from negative stimuli
Psychological Distance Scaling Task
- Task designed to measure interstimulus distance between positive and negative adjectives
- Provides a 2-dimensional representation of a person’s self schema
- Looks like a graph with distributed adjectives
Internal Attributions
Negative outcomes are one’s own fault
Stable Attributions
Believing future negative outcomes will be one’s fault
Global Attribution
Believing negative events will disrupt many life activities
