Mood disorders (depression and bipolar disorder) Flashcards
Depression and bipolar
What % of the worldwide population will experience a severe depressive episode at some point in their lives?
15%
What is the recovery % for depression without treatment ?
85% recovery without treatment but 40% will have at least one further episode
What are some symptoms of unipolar depression?
- thinks little of themselves
- poor memory
- feelings of misery, emptiness and humiliation
- appetite and sleep disturbance
- 7-5% commit suicide compared to 1% of non-depressed people
What are five types of symptoms ?
- emotional symptoms
- motivational symptoms
- behavioural symptoms
- cognitive symptoms
- physical symptoms
symptoms can be psychotic in extreme cases and can include hallucinations and delusions
Explain major depressive disorder
major episode but no history of mania
explain dysthymic disorder
at least two years of depression but less disabling
explain premenstrual dysphoric disorder
depressive symptoms during the week before menstruation
explain disruptive mood regulation disorder
depression and severe outburst of anger
How can stress cause depression?
Stressful life events can trigger depression - depression then causes more stress as every day tasks become even more of a struggle to complete
What are the 3 biological models of unipolar depression?
genetic factors
biochemical factors
endocrine system/ hormone release
Briefly explain the genetic model for depression
Twin studies demonstrate a strong genetic component of depressive disorder , there may even be specific genes that cause depression.
Briefly explain the biochemical model of depression
Abnormal levels of neurotransmitters such as serotonin and norepinephrine are associated with depression. Treatments confirm the role of NT role - a complicated interaction is at work .
Briefly explain the endocrine system / hormone release model of unipolar depression
Abnormal levels of cortisol - the stress hormone and abnormal melatonin secretion which regulates sleep patterns
What are the two main techniques to treat depression?
antidepressant drugs and brain stimulation
How do antidepressants treat depression?
MAO inhibitors cause a rise in norepinephrine activity . Tricyclics are another drug used but if a patient suddenly stops taking them relapse is likely to occur within a year . Maintenance therapy is required to avoid this . Tricyclics affect re-uptake mechanisms by blocking them.
Name the three second generation antidepressants
Prozac, Zoloft, Lexapro
What are the 4 types of brain stimulation treatment for depression?
Vagus nerve stimulation
Transcranial magnetic stiumualtion
Deep brain stimulation
ECT (very controversial, causes brain to seizure)
What is the psychodynamic model of depression ?
There is a link between depression and grief , depression may be triggered by a major loss
What is the psychodynamic treatment for depression?
Therapy is only occasionally helpful as patients may be too weary , short term methods are better
Explain the behavioural model of depression
Depression is due to changes in rewards or punishment people receive leading them to perform fewer and fewer constructive behaviours - social rewards holds high importance
What is the behavioural treatment for depression?
Patients are reintroduced to activities and events which improve their social skills, cognitive and behavioural treatments are combined (CBT)
What is the cognitive model of depression?
There are two key explanations =
1. learned helplessness = people become depressed when they think they can’t help themselves
2. negative thinking = internal attributions that are global and stable lead to greater feelings of helplessness and possible depression
What is Beck’s negative triad as a cognitive explanation of depression
1)negative view of the self
2) negative view of the world
3) negative view of the future
What is the cognitive treatment of depression?
Cognitive therapy for approximately 20 sessions =
there are four phases of therapy
1) increasing activities and elevating mood
2) challenging automatic thoughts
3) identifying negative thinking and biases
4) changing primary attitudes
What does the sociocultural model of unipolar depression believe to depression to be influenced by?
influenced by the social context that surrounds people
What is the family social perspective view of depression? (sociocultural model)
Depression is tied to the unavailability of social support . For example, divorced people have higher depression rates than married or widowed people
What is the common treatment for depression due to having unavailable social support?
Interpersonal therapy , couple therapy also known as (behavioural martial therapy)
Explain the multicultural perspective, one part of the social cultural model of depression
There is a strong link between gender and depression, women are more likely to be diagnosed with unipolar . depression than men.There is also a link between cultural background and depression.
What are the theories behind why women are more likely to be diagnosed for depression than men?
- Both sexes are equally prone to depression but clinicians fail to diagnose men as often
- hormones
- life stress theory : w more stress than m (invisible workload)
- body dissatisfaction in western society has taught women to be slender from birth - an unattainable goal
- lack of control theory - w feel less control than men in their lives
What is the association between cultural background and depression?
There are shared symptoms of depression which are constant across all countries but some vary from country to country.
What is the key experience of bipolar?
Characterised by experiencing the lows of depression and the highs of mania
What does bipolar I involve?
Full manic and major depressive episodes . Most experience an alternation of episodes whereas others have mixed episodes.
What does bipolar II involve?
Hypomanic episodes that alternate with major depressive episodes
What are the emotional symptoms of bipolar?
Active powerful emotions
What are the motivations; symptoms of bipolar?
Need for constant excitement and involvement in companionship
What are the behavioural symptoms of bipolar?
very active, move quickly, talk loudly or rapidly
cognitive symptoms of bipolar?
poor judgement or planning
physical symptoms of bipolar?
high energy level, often the presence of little or no rest
How common is bipolar?
Between 1% and 2.6% of all adults in the world suffer from a bipolar disorder at any given time. Equally common in women and men. More common in low income than hight . Onset occurs between ages of 15 and 44 years
How is a full manic episode characterised?
Abnormally high or irritable mood, for at least one week, increased activity activity or energy and at least three other symptoms of mania. In extreme cases symptoms are psychotic.
What is a cyclothymic disorder?
Numerous hypomanic episodes and mild depression. Affects at least 0.4% of the population.
what can low serotonin and low norepinephrine lead to?
depression
What can low serotonin and high norepinephrine lead to?
mania
What role may ions play in the development of bipolar?
Ions may be improperly transported through cells of individuals with bipolar disorder. Some theorists believe that irregularities in the transports of these ions may cause ions to fire too easily (mania) or resist firing (depression)
What role may genetics play in the development of bipolar?
A biological predisposition to bipolar may be inherited . Family lineage supports this theory. 40% likelihood identical twins.
How does lithium and other mood stabilisers improve symptoms of bipolar?
Lithium has been shown to improve symptoms =
- 60% of mania patients improve
- Helps prevent symptoms from developing
- Mood stabilisers help those with bipolar overcome depressive episodes
How does adjunctive psychotherapy improve bipolar ?
Drugs may not always be sufficient , 30% of patients don’t respond successfully yo medical treatment. Therapy is used to focus on medication management, social skills, and relationships issues. Furthermore, psychotherapy helps reduce hospitalisation, improves social functioning and increases clients’ ability to obtain and hold down a job.
What are symptoms of unipolar depression?
Feeling miserable , empty or humiliated , poor memory, headaches, indigestion, dizziness , pain 7-15% commit suicide
What are the tips of symptoms of depression?
Emotional
Motivational
behavioural
Cognitive symptoms
Physical symptoms
What are some emotional symptoms of depression?
Experiencing little pleasure
What are some motivational symptoms of depression ?
Lacking drive, initiative , spontaneity
What are some behavioural symptoms of depression?
Less active, less production
What are some cognitive symptoms of depressions?
Negative views of themselves , pessimistic
What are some physical symptoms of depression?
Headaches, dizzy spells, general pain
What does a major depressive episode involve?
A period of two or more weeks marked by. five or more symptoms of depression - depression can be psychotic in extreme cases and can involve hallucinations and delusions
What % of relatives of depressives have depression themselves?
20%n comapred to 10% of general population
MZ concordance rate for depression
46%
DZ concordance rate for depression
20%
What is vagus nerve stimulation?
Stimulating vagus nerve through the use of a pulse generator implanted under the skin of the chest. This has provided significant relief to as many as 40% of those with treatment resistant depression/
What is transcranial magnetic stimulation?
Has been found to reduce depression when administered daily for 2 to 4 weeks
What is deep brain stimulation?
By theorising that there is a ‘depression switch’ in the brain , researcher have experimented with electrode implantation in the brain’s Brodmann Area 25
What is Electroconvulsive therapy (ECT)?
One of the most controversial forms of treatment - consists of targeted electrical stimulation to cause a brain seizure .
What are the limitations of psychodynamic treatments for unipolar depression?
Depressed clients may be too passive or weary to participate in subtle therapy discussions fully . They may also become discouraged and end treatment early when treatment is unable to provide quick relief
Name some support for the learned helpless model
There has been significant research support for this model. Human subjects who undergo helpless training score higher on depression surveys
Animal subjects lose interest in sex and social activities
Describe Seligman’s theory of learned helplessness theory with lab dogs
Dogs subjected to uncontrollable shock were placed in a shuttle box . Even when presented with an opportunity to escape , dogs that experiences the shocks made no attempt to leave. It was theories that the dogs had learned to be helpless to do anything to change their negative situations.
What are some automatic thoughts depressed people may have?
A steady train of unpleasant thoughts that suggests inadequacy and hopelessness.
What are the two kinds of sociacultural views ?
The family social perspective
The multicultural perspective
What are the emotional symptoms of bipolar ?
Active, powerful emotions in search of outlet
What are the motivational symptoms of bipolar?
Need for constant excitement, involvement , companionship
What is the ‘‘permissive theory ‘’ about mood disorders?
Low serotonin may ‘‘may open the door’’ to a mood disorder and permit norepinephrine activity to define the particular form the disorder will take
