Mood Disorders Flashcards
What are the two categories of mood disorders
Bipolar Disorders and Unipolar Disorders
Common symptoms of depressive disorders
- Dysphoria
- Anhedonia
- Psychomotor retardation
- Psychomotor agitation
- Fatigue
- Worthlessness/Guilt
- Trouble Concentrating
- Changes in sleep and appetite
- sometimes psychotic symptoms
Dysphoria
Intense feelings of sadness
Anhedonia
Having no interest in things one previously found pleasure in
Psychomotor retardation
Physically slowed appearance
Psychomotor Agitation
Physical agitation
- fidgeting, difficulty sitting still
Major Depressive Episode
Period of two or more weeks marked by at least 5 symptoms including sad mood and/or loss of pleasure
Major Depressive Episode
Presence of at least one episode
- Can’t have history of mania or a shift in life that can explain mood
- once you experience one episode you are more likely to experience more
- Episode on average lasts 2 weeks to 9 months (will resolve on own)
Prolonged Greif Disorder
Impairment for more than 6 months pertaining to greif
Prevalence of MDD
Estimated 10% across cultures
- More common in woman than men across all cultures
- Less common in people of color
MDD with seasonal pattern
- Two years of experiencing and fully recovering from episodes
- For most, starts in fall/winter and resolves in spring
- Cannot be explained by psychosocial events, such as seasonal unemployment
Persistent Depressive Disorder
- Depressed mood for most of the day, most days, for at least 2 years
- Less intense symptoms
- Symptoms do not cease for more than 2 months at a time
- Worse functional consequences than MDD (more commonly comorbid with anxiety and substance use disorder)
Biological Approach to theories of depression
Heritability
- Females: 36-44%
- Males: 18-24%
Monoamines
- Serotonin, norepinephrine, dopamine
- Less about how much of each and more about the interaction between them
Brain Differences
- Neural plasticity: ability for nervous system to modify itself in response to experience and injury
- Differences in anterior cingulate, prefrontal cortex, amygdala, hippocampus
Differences in prefrontal cortex with depression
Decreased grey matter
- Specifically on left side
Differences in Amygdala with depression
Increase in size and activity
Differences in Hippocampus with depression
Decrease in size and activity
Behavioural Approach for theories of depression
More likely to have chronic life stressors
-96% have acute critical life event 6 months before
- Can contribute to anhedonia
- reduced positive reinforcement
Learned helplessness
- Uncontrollable negative events can cause feelings of helplessness
- Loss of motivation, reduction in efforts to change environment
Learned helplessness Dog study
1) placed in hammock
- not able to move
- received shocks
2) Placed on grid floor with one safe side and one shock side
- Hammock dogs stay on same side (don’t avoid shocks)
Learned helplessness Tail suspension test
- Without learned helplessness try to get out of tail suspension
- With learned helplessness don’t try and get out
Psychological flexibility
Ability to adapt and adjust behaviours in response to situational demands
Pakenham study on psychological flexibility
Investigated the role of psychological flexibility on mental health during lockdowns in COVID19 pandemic
- RESULTS: increased flexibility = decreased depression during pandemic
Attribution-Helplessness Theory
When people view events as beyond their control, they ask themselves why this is so
- Internal + global + stable
- Helpless to prevent future negative outcomes
Cognitive approach to theories of depression
HOPELESSNESS DEPRESSION
NEGATIVE COGNITIVE TRIAD
RUNINATIVE RESPONSE STYLES THEORY
Alloy et al. study on hopeless and optimistic attributional styles
- First year students with hopeless and optimistic attributional styles interviewed every 6 weeks for 2 years
- No depression history + hopeless more likely to develop MDD
- Depression history +hopeless more likely to relapse
Hopelessness depression
Cognitive theory
- Pessimistic attributions for important life events
- No way to cope with consequences
Negative Cognitive triad
Cognitive approach
- negative views of themselves, the world, the future
Ruminative Response Styles Theory
- Some focus on how they feel when upset (but do not do anything about causes)
- Depressed people more likely to dwell on negative stimuli, experience difficulty disengaging, remember more negative stimuli, recall vague memories than concrete
Mania
Persistently elevated mood that causes psychological dysfunction
Manic Episode
Elevated, expansive, or irritable mood lasting at least one week
- In addition at least 3 other symptoms
What is the core criterion for bipolar disoders
Emotional disturbance involving alternation of manic and depressive episodes
Symptoms of manic episodes
- Inflated self-esteem
- Increased goal-directed activity
- Racing thoughts
- Decreased impulse control
- Agitation
- Decreased need for sleep
- Emotional, expansive or irritable mood
Euthymia
- Stable mood state
- No mania or depression
Mixed Episodes
- Full criteria met or mania
- 3 depressive symptoms
- Every day for 1 week or longer
Bipolar 1 disorder
- Manic episodes that last at least 7 days
- Experience periods of euthymia
- can have mixed episodes
- Some peoples depression is as bad as MDD
Bipolar 2 Disoder
- Less severe episodes of mania known as hypomania (lasts at least 4 days)
- no psychotic episodes
- don’t meet full criteria for mania but need to meet full criteria for depressive episode
Cyclothymic Disorders
Chronic mood instability without extreme mood episodes
- Hypomania and depression but not meeting episodic criteria
- Increased risk of later developing bipolar 1 or 2
- Most common but no commonly diagnosed because it may seem like depression
Prevalence and onset of bipolar disorder
- 2.6% lifetime prevalence in Canada
- No consistent differences between ethnic groups or cultures
- late adolescence, early adulthood onset (20-25)
- No significant gender differences
Bipolar disorder comorbidity
More likely to abuse substances
- impairs control over disorder, medication adherence, functioning
Biological approach to theories of bipolar disorders
- Heritability = 79-93%
- Some structural and functional brain differences
- Dysregulation in dopamine system (High = reward seeking , Low = insensitivity to reward)
Psychosocial contributors to bipolar disorders
More reward sensitive
Episodes can be triggered by:
- Family discord
- Goal-striving
- Changes in bodily rhythms
- Changes in social climate
