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Biological Semester 2 > Mood Disorders > Flashcards

Mood Disorders Flashcards

1
Q

What is the DSM criteria for Major Depressive Disorder (MDD)? (2)

A

At least 5 symptoms for at least 2 weeks

At least 1 symptom of the following has to be one of the 5:
- anhedonia
- sadness

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2
Q

What are the symptoms of MDD? (2-7)

A
  • anhedonia
  • sadness

disturbed sleep
guilt/worthlessness
fatigue
psychomotor retardation
recurrent thoughts of death
learned helplessness
diminished ability to concentrate

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3
Q

What must the symptoms of MDD cause to get diagnosed? (4)

A

significant impairment in daily functioning

not attributable to substances or medical condition

no manic/hypomanic episode

specific severity

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4
Q

What is Persistent depressive disorder (PDD)?

A

less severe, but more chronic form of depression

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5
Q

What is the criteria for pre-menstrual dysphoric disorder (PMDD)? (2)

A

At least 1 of the core symptoms:
- irritability/anger/increased conflict
- hopelessness/self-deprecating thoughts

Plus at least 4 other symptoms

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6
Q

What are the symptoms of PMDD? (2-6)

A
  • irritability/anger/increased conflict
  • hopelessness/self-deprecating thoughts

early awakening
fluctuating weight/appetite
excessive guilt
overwhelmed
lack of energy
hypersomnia/insomnia

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7
Q

What is Prolonged Grief Disorder (PGD)/complicated grief?

A

a condition where grief becomes so severe and persistent that it interferes with a person’s identity and ability to function in daily life

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8
Q

Give the epidemiology of MDD (3)

A

Occurs at any age but uncommon in children

Twice as common in women due to genetic predisposition and fluctuating hormones

Occurs in episodes

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9
Q

Which neurotransmitters act as antidepressants? (3)

A

serotonin
dopamine
norepinephrine

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10
Q

How does dopamine act as an antidepressant?

What are symptoms of dopamine deficiency? (3)

A

motivates us to seek pleasure and reinforcement

  • anhedonia
  • apathy
  • difficulty concentrating
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11
Q

How does serotonin act as an antidepressant?

What are symptoms of serotonin deficiency? (4)

A

mood, sleep, appetite, and digestion regulation

  • sadness
  • anxiety
  • irritability
  • disturbed sleep
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12
Q

How does norepinephrine act as an antidepressant?

What are symptoms of norepinephrine deficiency? (3)

A

plays a role in alertness, focus, and energy levels

  • fatigue/low energy
  • difficulty concentrating
  • problems with sleep and appetite
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13
Q

What is the role of the serotonin transporter protein (SERT)?

A

controls the ability of the axon to reabsorb serotonin after its release

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14
Q

How do stressful events affect people with the 2 short forms of the 5-HTT (serotonin) gene?

Explain why

A

increasing the number of stressful events led to an increase in the probability of depression

since the gene is shorter, it has a shorter DNA sequence, leading to less SERT production - hence reuptake of serotonin is less efficient

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15
Q

Name the 5 categories of antidepressant drugs (TSSMA)

A
  • Tricyclics (dopamine, serotonin, and norepinephrine)
  • Selective serotonin reuptake inhibitors (SSRI’s)
  • Serotonin norepinephrine reuptake inhibitors (SNRI’s)
  • Monoamine oxidase inhibitors (MAOI’s)
  • Atypical antidepressants
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16
Q

Describe how tricyclics, SSRI’s and SNRI’s work (2)

A
  1. block transport proteins that reabsorb serotonin/dopamine/norepinephrine into the the presynaptic neuron
  2. therefore the neurotransmitters remain in the synaptic cleft, where they continue stimulating the postsynaptic neuron
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17
Q

Describe how MAOI’s work

A

Monoamine oxidase are enzymes that break down serotonin into inactive forms, hence MAOI’s block monoamine oxide

18
Q

Give 2 examples of atypical antidepressants and how they work (2)

A

Bupropion - inhibits dopamine and norepinephrine reuptake

Agomelatine - works as an agonist (facilitator) at melatonin receptors

19
Q

What herbal medication is used as an antidepressant, but is not regulated by the FDA?

A

St Johns Wort

20
Q

In what cases are antidepressants ineffective?
What is the alternative treatment?

A

ineffective for people who suffered abuse, neglect, or trauma during early childhood

treatment: psychotherapy

21
Q

What amino acid is required for an increase in serotonin levels?

A

Tryptophan - precursor to serotonin

22
Q

What neurotrophin do people with depression have lower than average?

A

Brain derived neurotrophic factor (BDNF)

23
Q

What are neurotrophins?

A

proteins released at the synapse which aid in the survival, growth, and connections of neurons

24
Q

If depressed people do not lack neurotransmitters, why do they still need antidepressants?

A

prolonged use of antidepressants increase BDNF production - which is needed to facilitate new learning to build new synapses

25
Q

What are the non-chemical treatments for severe depression? (2)

A

Electroconvulsive therapy (ECT)
Transcranial magnetic stimulation

26
Q

Explain how ECT works (3)

A

electrically induced seizure

applied everyday for 2 weeks

accompanied with drug treatment, psychotherapy, and periodic ECT after initial treatment

27
Q

What are the benefits of ECT? (2)

A

increases proliferation of new neurons in hippocampus

alters gene expression in hippocampus and prefrontal cortex

28
Q

How does transcranial magnetic stimulation work?

A

an intense magnetic field is applied to the scalp to stimulate neurons to fire action potentials

29
Q

What is bipolar disorder?
Name the 3 types

A

alternating states of depression and mania

3 types:
- bipolar 1 disorder
- bipolar 2 disorder
- cyclothymia

30
Q

Describe bipolar 1 disorder (3)

A

at least 1 manic or mixed episode

mixed episode = depression combined with agitation, anxiety, insomnia, and racing thoughts

combination of high energy and low mood = high risk of suicide

31
Q

Describe bipolar 2 disorder (2)

A

episodes of hypomania and depression

NOT full blown manic episodes

32
Q

Describe cyclothymia (2)

A

cyclical mood swings with less severe symptoms

hypomania and mild depression

33
Q

Name the common symptoms of mania (7)

A
  • unusually high or extremely irritable
  • grandiose beliefs in one’s ability
  • little sleep but high energy
  • talking rapidly about racing thoughts - normal person can’t keep up
  • high distractibility and inability to concentrate
  • impulsive/reckless
  • delusions and hallucinations (severe cases)
34
Q

Describe depression in bipolar people (5)

A
  • more likely to involve irritability, guilt, unpredictable mood swings, and restlessness
  • move and speak slowly
  • excessive sleep
  • weight gain
  • psychotic depression (lost contact with reality)
35
Q

What brain differences appear in bipolar people? (3)

A
  • imbalances in dopamine, norepinephrine, serotonin
  • too much activity in limbic area
  • too little activity in frontal lobes
36
Q

What are the treatments for bipolar disorder? (2)

A

Lithium
Anticonvulsant drugs

37
Q

How do lithium and anticonvulsant drugs work? (2)

A
  • Decrease activity of dopamine (only lithium) and glutamate (both)
  • Increase activity of GABA
38
Q

What is the biology of seasonal affective disorder (SAD)? (2)

A

high levels of SERT –> low serotonin
overproduction of melatonin

39
Q

Why does winter induce SAD? (2)

A

winter –> low sunlight –> high levels of SERT –> low serotonin –> SAD

winter –> darkness –> stimulates pineal gland to produce melatonin –> high levels of melatonin –> SAD

40
Q

What is the treatment for SAD?
How does it work (2)

A

Light therapy (bright light)

  • stimulates serotonin synapses
  • regulates melatonin secretion

Biological Semester 2 (8 decks)

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