Mood Disorders

Question 1

Depression

Answer 1

• Characterized by low arousal, low positive affect, and/or high negative affect
  → negative mood, negative attitude, pessimistic, back feelings about ourselves over an extended period of time
• typically has motivational, behavioural, cognitive, and physical symptoms in addition to a depressed mood
  → motivation: lack of motivation to perform one’s usual activities (decreased behaviour)
  → cognitive: negative self-view, sense of hopelessness/helplessness, pessimism, “automatic thoughts” (embedded negative thoughts), self-critical, negative self-competency
  → physical: pain, headaches and other mild symptoms; sleep and appetite disturbances
• diagnosis depends on symptoms, duration of their presence/absence, and lack of certain other symptoms (mania)
• depression subtypes:
  → post-partum depression
  → seasonal affective disorder

Question 2

Psychodynamic model

Answer 2

• Argues that depression represented a subjective loss of self caused by an objective loss of something we identify with
  → we identify ourselves with this “thing” (person, object, circumstance), when we lose that “thing” we lose ourselves

Question 3

Existentialist model

Answer 3

• Argues that depression is a loss of meaning in life
  → lack meaningful sense of self and motivation to do things
• form of treatment → volunteer work (find meaning)

Question 4

Cognitive-behavioural model

Answer 4

• Depression creates a feedback loop where the consequences of self-criticism, pessimism etc. enhance processes (generates consequences and reinforces them)
• based on beliefs and judgements of a situation, not the situation itself
• behavioural activation
  → introducing patients to constructive and rewarding activities (volunteer work)
  → achievements generate positive mood which undercut negative thoughts
• cognitive therapy:
  → depression is caused by negative thinking, not negative feelings
  → feelings/experiences are not inherently good or bad (what matters is what we do with them)
  → psychological condition is due to our beliefs/judgements about a situation, not the situation itself

Question 5

Neurobiological model

Answer 5

• Depression is a result of neurological and biological dysfunction
• genetic factors: people are much more likely to have depression if a relative has it
• neurochemical factors: association between depression and neurotransmitter activity (serotonin, norepinephrine, glutamate etc.)
• monoamine oxidase inhibitors: inhibit production of monoamine oxidase enzymes (which break down serotonin, dopamine, norepinephrine) which causes neurotransmitters to break down more slowly
• trcylics and 2nd generation antidepressants: inhibit the reuptake of certain neurotransmitters, which increases availability within the synapses
• neural stimulation: electroconvulsive therapy, transcranial magnetic stimulation
• ketamine: anaesthetic drug that increases the availability of glutamate (excitatory neurotransmitter)

Question 6

Bipolar disorder

Answer 6

• Depression plus mania
• mania: extreme and prolonged increase in affect and arousal
  → euphoria, irritability, extreme desire for excitement/attention/socialization
  → cognitive symptoms include poor judgement lack of planning, grandiose thinking, optimism
  → behaviour: hyperactivity, little sleep, rapid speech
  → may cause psychosis if severe

Question 7

Bipolar l disorder

Answer 7

• At least one episode of mania + major depression
• classic bipolar disorder

Question 8

Bipolar II disorder

Answer 8

• At least one episode of hypomania + major depression
  → hypomania: less severe form of mania which does not significantly impair functioning
• often misdiagnosed with major depressive disorder
  → mistaken as irrational response to events (feeling good because good things are happening or just your personality)

Question 9

Cyclothymia

Answer 9

• Hypomania + mild depression

Question 10

Mixed episode

Answer 10

• When symptoms of mania and depression overlap
• can have high positive and negative affect at the same time (confusing and disruptive)

Question 11

Rapid cycling

Answer 11

• When patients experience several cycles of mania and depression within a year

Question 12

Diagnosing bipolar disorder

Answer 12

• Hypomania is easily mistaken for personality or attributed to rational causes
• manic/hypomanic episodes tend to be shorter and less frequent than depressive episodes
• people with bipolar disorder are more likely to use substances, to which thinking/behaviour is mistakenly attributed
• people with bipolar disorder are often misdiagnosed with major depressive disorder
  → treatment with anti-depressants seems to induce hypomania (exacerbate the disorder)

Question 13

Treatment

Answer 13

• Pharmaceutical drugs are the primary treatment
  → mood stabilizers (lithium)
  → anti-psychotic medication are first prescribed (risperidone, olanzapine, haloperidol)
  → anti-seizure medication (lamotrigine, carbamazepine)
• psychotherapy or family therapy to manage stress, identify episodes, and maintain health/lifestyle
• medications are usually more effective at treating manic/hypomanic symptoms than depressive symptoms