Mood Disorders Flashcards by Maddie Bath

Hippocrates

Humoral Theory: Mania caused by warmth and dampness in brain, depression is an excess of black bile

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Romans

Recognized emotional factors in depression

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Cicero

Psychotherapy for melancholia

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Robert Burtons Anatomy of Melancholia

Psychological and social causes of depression

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Emil Kraepelin

Coined term manic depression

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Psychodynamic View

Those who can’t get over grief turn their anger inwards

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Freud and Abraham

Imagined loss: Unconsciously interpret normal events as severe losses which is a catalyst for depression

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Duration of MDD symptoms

Depressed for 2 weeks with 4 additional symptoms

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Cost of MDD

14.4 billion/ year

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Atypical depression

Oversleep, over eat, weight gain, anxiety– most common

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Prevalence of MDD

6% women, 3% men

Lifetime: 12%, 6%

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of Canadians with MDD

1,500,000

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% of people who will experience a second MDD epsiode

50%
70% third
90% 3+

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Average length of MDD episode

6-9 months

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% of MDD people with a comorbid anxiety disorder

50%

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% of MDD die of suicide

15%

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Persistent Deppressive Disorder

Chronic low mood lasting 2 years

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Lifetime prevalence of dysthymia

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Double depression

Dysthymia plus MD episodes

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Mania

Distinct period of elevated, expansive or irritable mood lasting at least one week and accompanied by 3 symptoms

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Hypomania

Less severe form of mania, only 4 days

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Bipolar 1

Mania

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Bipolar II

Hypomania and major depressive episodes

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Mixed State

Manic/hypomanic and depressive symptkms at the same time

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Which bipolar type is harder to diagnose

II- hypomania is harder to detect than mania

Length of manic episodes

2 weeks- 4 months

Bipolar suicide rates

10-15%

Bipolar lifetime prevalence

I- 0.8% | II- 0.5%

MDD gender ratio

2:1 women

Bipolar gender ratio

Bipolar age of onset

Rapid cycling

10-20% of cases

cyclothymia

Continuous periods of hypomanic symptoms and periods of depressive symptoms-- lasts 2 years

Cyclothymia gender ratio

Cyclothymia prevalence

less than 1%

Rapid Cycling specifier

4 or more manic or depressive episodes within a year-- episodes seperated by at least 2 months

SAD

Recurrent depressive episodes tied to the changing seasons

% of MDD with SAD

11%

Prevalence of SAD

2-3%

% of women with modd swings after child birth

70%

% of new mothers with MD or mani episode

10-15%

Mother suicide and infantcide rates

5% suicide | 4% nfantcide

Hormone implcated inpost-partum depression

Progesterone

Psychological level

Temperament, personality, dysfunctional thinking and maladaptive behaviour contribute to mood disorder

2 psychodynamic personality patterns increase risk for depression

Dependant | Self-critical

Dependant

Rely on relationships for sense of identity

Blatt

Personality styles developed in childhood render people vulnerable to depression when they experience a stressor

Beck

Emotional repsonse to as situation is determined by how it is appraised

Schema

Structures in mind containing core beliefs about self, world and future

Negative Feedback Seeking

Actively seek critiscim and negative feedback from others

Reassurance Seeking

Repeatedly seek reassurance of worth and lovability from others

Stress Generation hypothesis

Depressed people generate stressful life events in interpersonla domain and contribute to events due to maladaptve behaviors

Life Stress perspective

Stresful events tax our psychological and physical resources

Chance of first degree relatives of MDD and BP patients to develop disorders

MDD- 2-5x | BP- 7-15x

Heritability estimate for MDD and BP

MDD- 0.36 | BP- 0.75

HTT

Serotonin transporter gene on chromosome 17-- shorter allele in MDD

2 neurotransmitter systems in depression

Catecholamine: Norepinephrine Indoleamine: Serotonin

Origin of serotonin

Raphe nucleui of pons and medulla

Serotonin effects

arousla, mood, anxiety, aggression, eat, sleep, dreams, pain, sex drive, memory

Norepinephrine

Regulates arousal, energy, activity and appetite

Dopamine

pleasure, reward, mood attention, activity

Sleep stages

First 4 are slow wave, 5th is REM

Brain differences in depressed people

Reduced activity in prefrontal cortex, anterior cingulate and basal ganglia

Brain lesions in depression

Left anterior lesions

of CBT depression sessions

16-20

Behavioural experiments

Test negative beliefs in real-life situations to disconfirm them

MBCT

Midfulness-based: Promote awareness of the here and now to reduce ruminative thinking patterns

of IPT sessions

12-16

4 dysfunctions addressed in IPT

Interpersonal disputes Role transitions Grief Interpersonal deficits

Tricyclics

Block reuptake from synpse of norepinephrine-- most effective but many side effcets

MAOI's

Inhibit enzyme that breaks down monoaminergic neurotransmitters so more monoamines are released into synpase

Response rate for antidepressants

50-70%

CANMAT

Guidelines to choose medications for patents

Lithium

Mental illness linked to excess of uric acid-- deactivates enzyme that disrupts circadian clock

% of BP that dont respond to lithium

40%

Anticonvulsants

Increase synthesis of GABA-- inhibitory effect

Severe depression treatment

Meds and IPT

Persistent depression treatment

Meds and CBT

Interpersonal and Social Rhythm therapy

Disruptions in daily routines and conflicts n relationships cause relapses of BP

Treatmnt resistant depression

Failure to achieve remission after 2 trials of meds

Vagnus Nerve Stimulation

Vagnus nerve runs from brain stem to abdomen-- pulse generator surgically implantes and wire attaches to nerve

Deep brain stimulation

Surgically implanted wires and ulse generators in brain regions

Suicide completion gender ratio

3x more men complete suicide

Suicidal Ideation

Thoughts of death and plans of suicide

Suicidal gestures

Behaviours that look like suicide but are clearly not life threatening

Gender ratio for attempted suicide

Women 3x mor likely

Strongest risk factor for suicide

being male

Regions with lowest suicide rates

Catholic countries

Durkheim

Suicide caused by sense of anomie-- feeling rootless and lack of belonging