Session 12 - Lecture 1 - Mood Disorders Flashcards
2 - Lecture Synopsis
- Symptoms of Depression and bipolar disorder leading to diagnosis,
- Brain structures Involved in Mood disorders
- Neurotransmitters involved in mood disorders (Monoamine Hypothesis)
- Aetiology of Mood disorders
- Treatment of mood disorders (brief)
“1. and mania
- show pictures
- cover a bit on NTs bc important”
3 - What is Depression?
Many people will wake up feeling sad, tired or worn out and say they are feeling depressed. But depression is MORE than just waking up one morning and feeling a bit fed up.
4 - Features of depressive disorders
Features of depressive disorders
Patient usually have the symptoms continually for 2 weeks and consist of
• CORE SYMPTOMS – Low mood – Lack of energy – Lack of enjoyment & interest • Depressive thoughts • Somatic symptoms/Biological symptoms • In severe cases may have psychotic symptoms
“Diagnosing people with depression - usually symptoms need to be present for at least 2 weeks – not enough to just wake up one morning not happy.
You need at least 2 of 3 core symptoms - don’t actually have to have low mood. These symptoms need to be there most of the time for at least 2 weeks.
1b. Usually people with depression will feel exhausted. Even things they can normally do will exhaust someone with depression.
1c. Anhedonia – lack of enjoyment and interest – another core and common symptom. Often people with q severe depression will lie in bed e.g. even up to 20 hrs at a time, staring at the ceiling doing very little, getting no enjoyment from things, including things they’d normally enjoy, and lacking in energy.
Can be mild, can still go to work. Usually still be able to function. Can be moderate. Very severe depression can lead to psychosis – lose contact with reality e.g. might believe they caused a death of a family member, responsible for some monstrosity etc., when that isn’t true.
Severe cases of depression may even lead to suicide, and suicidality is increased in all psychiatric disorders essentially. Suicide rates in all psychiatric disorders is q high. Suicide is the most common form of death in psychiatry. There are other causes of death in those who are severely depressed. Sometimes people who are so severely depressed might not even have the motivation to kill themselves, they might just be lying in bed, it might be psychiatrists/GPs treating them they then develop motivation to kill themselves before they recover. Can get pts who become stuporised – don’t eat, don’t drink. How long can I go without eating? Q a while, but Can only got a 3-4 days without drinking before kidneys pack up. So core symptoms, Depressive thoughts, usually about guilt (whether Catholic or not). And then somatic/Biological symptoms i.e. lack of appetite, not eating – often pts with severe depression do lose stones of weight over a short period of time (not recommended as a diet!). Lack of sleep, poor concentration, lack of libido. “
5 - Adjustment reactions and depression
Difference between a ‘normal’ adjustment reaction and clinical depression
Adjustment reaction
• Symptoms develop sudden after and ‘event’
• Symptoms fluctuate
• Time limited
• Preoccupation with ‘event’
• Energy not low
• No particular pattern to sleep disturbance
• Reduced or increased appetite
• Feelings of anger and frustration more typical
Depression • Symptoms develop gradually • Symptoms continuous • Usually at last two weeks • Lack of interest • Low energy • Sleep disturbance with typically EMW • Loss of appetite and weight loss are typical • Low self esteem and feelings of guilt and blame are typical
“Important to get in your mind the diffs between mood disorders/actually being depressed and actually having a reaction to a normal life event.
Adjustment reaction might get in response to death, relationship breakdowns etc., and actually the symptoms you get in those situations are v different symptoms to those you get with depression – so start thinking of these as different things. Some pts, however, will get depressed from social situations – circumstances that happen to them trigger depression. The more genes you have to association with depression, the more genetic loaded you are to suffer from depression, probably the less push you need or social disruption you need – q often get pts where there is ‘no social trigger’ for depression and yet they are depressed, bc it is a v genetically inheritable disease.”
6 - Personality
Personality as a cause for depressive symptoms
Our personality is defined by:
• How we get on with people, ability to make relationships
• Extrovert or introvert
• How empathetic we are
• How anxious and nervous we are; or how confident
• How we can make plans and stick to these plans
• How we respond in stressful circumstances
• OUR OVERRIDING MOOD
Some people have a sense of not being happy within themselves, sometimes related to a feeling of emptiness. This does not necessarily mean that they are depressed
“Essentially, personality is a very complex issue. Some pts will talk about chronic feelings of emptiness and low – actually you often see this in individuals with v unhappy childhoods, see a marked correlation between this and people with sexual, physical etc. abusive childhoods. So personality, depression not necessarily linked to personality.”
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