Mood Disorders (Case Study #2) Flashcards
Describe the epidemiology of mood disorders:
- Occurs in nearly 20% of the general population
- Higher rates of depression in women (21%) compared to men (13%)
- Bipolar onset in mid to late 20’s, whereas depression onset in mid 30’s
- Depression more likely in lower socioeconomic groups, and bipolar more likely in higher socioeconomic groups
What is serotonin?
A neurotransmitter that controls our mood and energy levels. When levels are low, can result in depression and anxiety, and when low, can result in manic and insomnia symptoms.
What is dopamine?
A neurotransmitter in the brain.
Low results in Parkinson’s, and high results in psychosis. This is why anti-psychotics that target dopamine can cause Parkinson’s-like symptoms.
What is the connection between mood and medical conditions?
- Has several co-morbidities that increase risk of developing mood disorders (substance abuse, cognitive disorders, schizophrenia, pain symptoms, heart disease, cancer, traumatic injuries, altered thyroid, etc.)
- Can occur in response to stress, illness and medications
- Secondary medical concerns can occur as a result of depression (fibromyalgia, IBS)
What are the symptoms of major depressive disorder?
- Requires at least five of these symptoms, every day, for at least two weeks or more
- Mood depressed, sad, empty, numb
- Anhedonia (no longer experiencing joy from previous activities that brought joy)
- Sadness, crying, numbness, disinterest, disconnect
- Anxiety, irritability or anger
- Loneliness, helplessness or hopelessness
- Flat/constricted affect, minimal expression
What is the difference between depression and adjustment disorder?
- Symptoms can be similar
- Depression has slow, insidious onset, whereas adjustment disorder is more acute, short-lived and intense, and in response to a specific stressor
What is Dysthymic Disorder?
- Chronic, low-level depression
- Symptoms must be present for two years or more
- Cannot have had any diagnosis of bipolar disorder in the past
- Depressed mood, poor appetite or overeating, insomnia/hypersomnia, low energy/fatigue, low self-esteem, poor concentration, difficulty making decisions, feelings of hopelessness (i.e. trouble with day-to-day executive functioning)
- Symptoms may be present for so long that it becomes central to their personality
- Requires a break in thinking patterns, so more likely to recover with counseling, behavioural therapy, etc.
What are common drugs used to treat depression?
- Tricyclic anti-depressants (TCA’s)
- Monoamine Oxidase Inhibitors (MAOI’s)
- Selective Serotonin Reuptake Inhibitor’s (SSRI’s)
- Atypical anti-depressants
What are some of the symptoms serotonin syndrome, a serious adverse effect of anti-depressants?
- Confusion
- Increased BP
- Spiked fever
- Muscle twitching/rigidity/tremors
- Altered orientation
- No tests or treatments! All that can be done is treat symptoms (anti-hypertensives) and stop treatment
What are the symptoms of mania?
- Symptoms must be present for at least one week
- Mood abnormally elevated, expansive or irritable
- Inflated self-esteem
- Decreased need for sleep
- More than usual talkativeness
- Racing thoughts
- Distractibility
- Increase in goal-directed activity
- Excessive involvement in pleasurable and risky activities
What is hypomania?
- Elevated mood without the decreased functioning
- Extremely happy and agreeable
- Ease with social conversation
- Humorous
- Productive
What is the key differences between hypomania and mania?
- Hypomanic patients have better insight and judgement into their symptoms compared to pure mania
- Hypomania do not have delusions or significant changes in thought patterns, whereas patients with mania can be delusional and/or experience hallucinations
- Mania is an emergency situation requiring hospitalization, whereas hypomania can be managed in community
What is Bipolar I Disorder?
Experiences both major depressive episodes that alternates with manic episodes
What is Bipolar II Disorder?
Presence of at least one depressive episode and one hypomanic episode
What is Cyclothymic Disoder?
Chronic mood disturbance of at least 2 years (switches every few months), symptoms are less severe or intense than they would be in other diagnoses
