Unit 6: Mood Disorders (book) Flashcards
Mood Disorders
Represent a spectrum of mood disturbances, from the extremely low mood of depression to the extremely elevated mood of mania.
Depressive Disorders
- Include MDD and Dysthymic Disorder
- Often referred to as “unipolar depression,” as they do not include mood variances on the other end of the mood spectrum
MDD Symptoms
- Often referred to as major depression
- Characterized by symptoms such as sadness, hopelessness, guilt, irritability, and cognitive impairments, like poor concentration and difficulty making decisions
MDD Diagnosis
Diagnosis requires the presence of a major depressive episode (a period of depressed or irritable mood, with additional symptoms lasting at least 2 weeks, resulting in severe impairments in functioning
BPD Spectrum
BPD1, BPD2, and Cyclothymia
- All involve some degree of elevated mood and usually a history of at least one major depressive episode
- DSM-5 includes substance induced BPD and BPD related to a medical condition
BPD1
Characterized by mood swings from extremely high (mania) to extremely low (depression)
- Manic behaviors include euphoria, irritability, grandiosity, decreased sleep, impulsivity, and distractibility, which significantly interfere with daily functioning
- A diagnosis is warranted when an individual presents with either a manic or mixed episode
Manic Episode (BPD1)
Highly elevated or irritable mood lasting at least 1 week, with or without psychotic symptoms such as delusions and hallucinations
-Severity of symptoms results in significant impairment in functioning, which may require hospitalization
Mixed Manic Episode
Characterized by the presence of both manic and major depressive symptoms almost daily for at least 1 week, resulting in rapid mood cycling with or without psychotic symptoms
BPDII
Characterized by the presence or history of MDD and at least 1 hypomanic episode
-Hypomania involves similar but less intense mood and energy elevation than does mania
Cyclothymia
Represents a chronic (at least 2 years), but less severe, mood disturbance involving both hypomanic behaviors and depressive symptoms that do not meet the criteria for either a manic or major depressive episode
Mood Spectrum
Terms to describe the clinical symptoms of mood disorders include:
- Affect
- Anhedonia
- Avolition
- Dysphoria
- Euphoria
- Flight of Ideas
- Grandiosity
- Hypomania
- Psychomotor agitation
- Psychomotor retardation
- Psychosis
Affect (mood disorders)
The display of emotion, particularly facial expression
Anhedonia (mood disorders)
Lack of interest in previously pleasurable activites
Avolition (mood disorders)
Lack of drive or ambition to complete goal-directed tasks or activites
Dysphoria (mood disorders)
A depressed or negative mood state
Euphoria
Highly elevated, exaggreated mood
Flight of Ideas (mood disorders)
Rapidly changing, disconnected thoughts
Grandiosity
Inflated sense of self-esteem or importance
Hypomania
Elevated mood that is less intense than full mania
Psychomotor Agitation (mood disorders)
Increased physical movements that are purposeless and reflective of an agitated or anxious state (ex. wringing hands, fidgeting, pacing)
Psychomotor Retardation (mood disorders)
Abnormally slowed or reduced movements or speech
Pychosis (mood disorders)
The presence of delusions or hallucinations without insight
Etiology of Mood Disorders
Despite ongoing research, there is still no known cause
- Both MDD and BDP are widely believed to result from a complex combination of biological, genetic, and psychosocial factors
- Many factors can influence the development of mood disorders, including genetic makeup, biology, other co-occurring medical and psychiatric conditions, cognitive abilities, personality, support systems, personal history, exposure to stress, and coping strategies
- Can also be triggered at childbirth, seasonal changes, substance use, and other medical conditions
Biological Factors of Mood Disorders
Much of the research over the past 50 years has focused on biological changes in brain function
- Current research using advanced technologies of brain imaging to examine structures and brain activity provides evidence that mood disorders are disorders of the brain
- fMRI, PET, PECT, MRS studies reveal abnormal functioning in regions of the brain that regulate mood, sleep, thinking, appetite, and behavior
In studies of MDD, functional abnormalities have been found in…
The Limibic System, the brain region that represents centers of emotion
- Parts include the amygdala, hippocampus, insula, regions of the anterior cingulate cortex, and dorsolateral prefrontal cortex
- Functional abnormalities including reduced cortical thickness of the frontal and temporal lobes and within limbic system have also been found in studies of BPD
In a systematic revire of controlled studies with BPD, changes were also found in the…
Hippocamous
-Abnormalites are consistent with studeies in which both MDD and BPD subjects demonstrated blunted or decreased behavioral and psychological reactivity to sad or negative stimuli such as pics and vids
The Role of Neurotransmitters in Mood Disorders
Neurotransmitters include: Serotonin, Acetylcholine, and Melationin
- Studies have focuses on the role of genes that may predispose an individual to dysregulated levels of neurotransmitters
- Current research focuses on neurotransmitter systems such as the effects of dysregulated dopamine, noradrenaline, and serotonin transporters and receptors in the brain and research related to the improvement of primary and augmented medication therapies for MDD and BPD
Biological abnormalities in the brain may not be the cause of a mood disorder but may develop as a result of the disorder…
For example, some researchers believe that chronic stress can trigger depression, as the body continually responds to stress through neurochemical changes
-One stress response is the excessive secretion of cortisol, which can interfere with limbic cortical systems (challenge for researchers is to differentiate which abnormalities are causal factors and which develop in response to environmental factors that trigger neurochemical changes)
Genetics associated with MDD and BPD
Known to run in families as heritable traits but researchers had minimal success in isolating any specific responsible genes
- Genetic variations associated with both MDD and BPD support the growing belief among researchers that mood disorders involve a combo of altered genes that interact with environmental factors such as stress, to explain why some family members with a known genetic risk develop either MDD or BPD while other family members do not
- The research on biomarkers for MDD and BPD also shows promise which could lead to improved diagnosis in primary care and other first-line providers based on lab testing and not simply clinical presentation or family history
