Mood Disorders Flashcards
Dysthymic disorder
Depressed mood for most of the day more days than not for at least two years
Symptoms do not remit for more than 2 months at a time
Major depressive disorder
Five or more symptoms present during the same two week period nearly every day: depressed mood, ahedonia, significant change in weight, insomnia, hypersomnia, fatigue, psychomotor agitation, recurrent thoughts of death
Double depression
Suffering from dysthymia and MDD at the same time, means a poorer prognosis
Term will likely become obsolete
Depressive disorders stats
8% severe, 5% mild in a given year 19% of adults will experience in a lifetime Women 2x more likely Onset risk increases with age 6-15% commit suicide
Dysthymia mean duration
5 years, could be as many as 20-30
Manic episode
A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally increased goal-directed activity or energy lasting at least 1 week
Marked impairment
Hypomanic episode
Same as manic except symptoms only present for four days and is not severe enough to cause marked impairment or problems in functioning
Mixed episode
MDD and a sub clinical mania or hypomania
Bipolar I
Presence or history of one or more major depressive episodes, criteria have been met for at least one MANIC episode
Bipolar II
Criteria met for at least one major depressive episode and one HYPOMANIC episode
Cyclothymic disorder
For at least two years there have even numerous period a with hypomanic and depressive symptoms that do not meet criteria for either episode
Bipolar I and II stats
1-2.6% at any given time
Equal among men and women, more common in low income
Onset 15-18 (I) and 19-22 (II)
High rate of suicide
Cyclothymia stats
0.4% at any given time
Onset between 12-14
May develop into bipolar I or II
Rapid Cycling
Transitioning between mania and depression four or more times in a year
Mood disorders in older adults
High rates, characterized by health anxiety sleep difficulties and agitation, symptoms often confused with progressive dementia, 50% with Alzheimer’s have comorbid depression
Biological causes of mood disorders
Genes (women twice as likely to be influenced by genes), neuroanatomy, neurotransmitters
Neuroanatomy and unipolar depression
Reduced blood flow to prefrontal cortex, small hippocampus, lack of production of new neurons, elevated activation of the amygdala
Neuroanatomy in bipolar disorders
Small cerebellum and basal ganglia, structural abnormalities in amygdaloid hippocampus and prefrontal cortex
Neurotransmitters in unipolar depression
Low levels of serotonin and norepinephrine
Neurotransmitters in bipolar disorder
High levels of norepinephrine and low levels of serotonin
Psychological causes of mood disorder
Life stress, negative thinking styles, learned helplessness, overgeneralization, depressive cognitive triad (negative thinking about self, world, future)
SSRIs
Most common class of antidepressants, work to block reputable of serotonin, many side effects
Mixed reuptake inhibitors
Relatively new class of drugs, work to block the reuptake of multiple neurotransmitters, fewer side effects
Tricyclics
Oldest class of antidepressant, unclear how they work, down-regulate norepinephrine, lethal of overdosed, significant side effects
MAOIs
Block the MAO enzyme which breaks down neurotransmitters, rarely used only as a last resort
Effectiveness of SSRIs
50% it works for
20-30% achieve remission
30-40% don’t respond at all
Bipolar medications
Mood stabilizers like lithium carbonate or anticonvulsants for those who don’t respond
Has potentially severe side effects
50% response rate
Electroconvulsive therapy
Electric shock is administered to the brain to produce seizures, relatively safe and effective, may cause memory loss and confusion
Cognitive Behavioral therapy
Highly structured therapy with the goal of recognizing, identifying, and interrupting negative thinking patterns that cause maladaptive behaviors
Aaron Beck
