unit 6a Flashcards
mood disorder: depression
limbic system
collection of brain regions that controls mood & attitude
- is involved in storage of highly charged emotional memories + cntrls appetite + sleep cycles
depression
set of neuropsychiatric disorders characterized by symptoms including:
- a pervasive low mood, low self-esteem, changes in sleep (insomnia/hypersomnia), weight changes, anhedonia/loss of pleasure, thoughts of death, fatigue & loss of energy, psychomotor agitation/retardation, feelings of worthlessness & guilt, lack of concentration, & sometimes delusions/hallucinations (psychotic depression)
anhedonia
inability to experience pleasure or interest in formerly pleasurable or satisfying activities
psychomotor agitation
series of unintentional + purposeless motions that stem f/ mental tension & anxiety of an individual.
- includes: pacing around, wringing hands, uncontrolled tongue mvmts, pulling off & on clothing + similar actions
psychomotor retardation
AKA psychomotor impairment
- visible slowing of physical activity such as mvmt & speech
major depressive disorder (unipolar depression; clinical depression)
having 5 or more depressive symptoms that last w/o remission for at least 2 wks
Usually is characterized by loss of pleasure in most or all activities, psychomotor retardation, weightless, guilt, & insomnia
2 types: Melancholic & Atypical
Melancholic depression
MDD- the most ‘classic’ type of depression
- w/ a low mood ( melancholic = sad), insomnia, loss of appetite/weight loss, anhedonia
Dysthymia
less severe, but long lasting depression that lasts for at least 2 or more yrs
Atypical depression
MDD- type of depression w/ mood reactivity (moods are overall affected by environ.
**Paradoxical anhedonia **despite apparent positive, signif. weight gain or incr. appetite f/ comfort eating, hypersomnia (incr sleep), leaden paralysis (sensation of heaviness in limbs) & signif. social impairment f/ hypersensitivity to perceived interpersonal rejection
Adjustment disorder w/ depressed mood
mood disturbance appearing as psych. response to an identifiable event/stressor where resulting emotional or behavioral symptoms are signif. but DONT meet criteria for major depressive episode
Catatonic depression
rare & severe form of major depression involving disturbances of motor behavior & other symptoms
- patient is mute, immobile/ exhibits purposeless or even bizarre mvmts
Postpartum depression
intense, sustained & sometimes disabling depression experience by women w/ in 3 months after giving birth
- can last as long as 3 months
Likely due to sudden withdrawal of placental hormones at birth
Postpartum psychosis (postpartum mania ) is also possible
Premenstrual dysphoric disorder (PMDD)
severe, debilitating PMS w/ abnormal response to normal hormonal lvls.
Symptoms can be any combo of depression symptoms & typically start abt 1 wk prior to period but abruptly end when menstruation begins
Treatment: may include low-dose anti-depressants taken only during week of symptoms
Seasonal affective disorder (SAD)
depressive disorder related to circadian rhythms in which depressive episodes come on in autumn/winter & resolve in spring
winter time: patients experience intense hunger, weight gain, hypersomnia & lower mood in the evening
Treatment: light therapy (phototherapy) to increase daylight exposure time
Biological causes of depression
monoamine neurotransmitter, hormonal changes (postpartum, PMDD), circadian rhythm changes (SAD), stress responses f/ increased cortisol
includes:
- monoamine hypothesis
- specific monoamine hypothesis
NEW 2022 STUDY HAS CALLED INTO QUESTION ROLE OF SEROTONIN in depression
Monoamine hypothesis
early hypothesis abt biological basis for depression based on observation medications that affect monoamine neurotransmitters dopamine, norepinephrine, & serotonin, may have psychological side effects affecting mood
specific monoamine hypothesis
theory that depression results f/ presynaptic and/or post-synaptic changes in noradrenergic (norephinephrine) and/or serotonergic (5-HT) pathways
PsychoSOCIAL causes of depression
positive correlation b/t stressful life events & onset of depression
includes;
- cognitive model
-learned hopelessness theory
Cognitive model
model of depression that states that depressed patients hold pessimistic views of themselves, the world, & the future w/ recurrent patterns of depressive thinking→ resulting in disordered info processing (led to cogn. behavioral therapy)
Learned hopelessness theory
model of depression that states patient loses hope that life will get better, possibly** based on early life experiences,** & they believe that negative experience are due to stable- global reasons
Treatments of depression
-Psychotherapy
-Medication
-Stimulation
Psychotherapy (CBT)
Cognitive behavioral therapy
- Empirically testes & wideness used type of psychotherapy for treating depression
→ patients typically meet in groups & are taught to alter their recurrent patterns of depressive thinking so thy can restore normal info processing
Monoamine oxidase inhibitors (MAOIs)
antidepressant medication
- results in general incr ^^ in monoamine neurotransmitters (serotonin, norepinephrine, dopamine) but carries dietary risks
Tricyclic antidepressants
antidepressant medications used to treat depression named for 3-ring chemical structure
- works on serotonin & norepinephrine
Selective serotonin reuptake inhibitors (SSRIs)
antidepressant drug that acts by blocking reuptake of serotonin
→ more serotonin is available to act on receptors in the brain
Noradrenergic serotonergic reuptake inhibitors (NSRI)
antidepressant drug- acts similar to SSRIs-
- Affects BOTH serotonin & norepinephrine (AKA noradrenaline ; neurotransmitter of noradrenergic pathway)
Electroconvulsive shock therapy (ECT)
electric shock therapy used to treat severe cases of depression that haven’t been effectively treated by other means
Grand mal siezure is induced in sedate patient to ‘jumpstart’ or ‘reboot’ brain
- patients will lose memory of hour/day of ECT & may have some fatigue
Transcranial magnetic stimulation
depression therapy done by inducing an electrical current in brain
- can only affect brain regions on the surface of brain
Deep brain stimulation (DBS)
therapy used to treat severe depression where electrodes are implanted into basal ganglia (as in Parkinson’s disease)
- stimulate basal ganglia at particular frequency according to patient
Bipolar disorder
Mania & Hypomania
Mania
a psych. state characterized by irritability, anger/rage, delusions, grandiose ideas & plans, hypersensitive, hyper sexuality, hyper-religiousity, hyperactivity, impulsiveness, racing thoughts, pressured speech (pressure to keep talking, rapid speech) & decreased need for sleep
Hypomania
mood state characterized by persistent disinhibition & euphoric mood but generally less severe than full mania
Characteristic behaviors: being extremely energetic, talkative w/ flight of creative ideas & confident
While hypomania behavior often generates productivity & excitement - it is considered to be precursor to mania ( can put subjects at great risk)
bipolar disorder I
episodes of severed depression alternate w/ MANIA
bipolar disorder II
episodes of severed depression alternate w/ HYPOMANIA
Cyclothmia
dysthymia alternates w/ hypomania
Mixed affective disorder
disorder characterized by combined manic + depressive symptoms
including: agitation, impulsiveness, anxiety, restlessness, aggressiveness, irritability, rage, confusion, fatigue, insomnia, morbid and/or suicidal ideation, panic, paranoia, persecutory delusions, pressured speech, & racing thoughts
Rather than experiencing periods of depression that alternate w/ periods of mania (+normal mood periods) - patients experience MANIC + DEPRESSIVE SYMPTOMS ALL AT THE SAME TIME
Causes of Bipolar Disorder
Genetic link + environmental disorder
- possibly related to anxiety/depression spectrum disorders
Uncontrolled changes in hormonal ways:
- hypothalamus-pituitary adrenal axis
Hypothalamus-pituitary adrenal axis
major part of neuroendocrine system that controls reactions to stress & regulates many body processes, including mood + emotion
- may be abnormal in anxiety + depressive disorders
Treatments of Bipolar Disorder
-Psychotherapy (CBT)
-Medication
Medication for Bipolar Disorder
Mood Stabilizers (lithium)
Anticonvulsants
Antidepressants
Antipsychotic medication
Mood Stabilizers
Used to prevent mania
LITHIUM- used to treat bipolar together w/ anti-depressants. acts as mood stabilizers (preventing mania), but must be carefully managed b/c its toxic
Anticonvulsants (anti-seizure medications)
generally lower neural activity brain-wide
Antidepressants (for bipolar)
(eg SSRIs) but ONLY W/ MOOD STABILIZER [to stop mania]
Antipsychotic medication
for manic agitation;
- usually act to directly or indirectly lower ↓ dopamine
