W4L1: Mood Disorders Part II Flashcards
Genetic Etiology of Mood Disorders
bipolar and schizophrenia have highest heritability, and are among the most severe mental disorders
much higher heritability for bipolar than MDD
heritability estimates up to 93%
comorbidity/shared genes for bipolar and schizophrenia
shared genetic risk for substance use disorder and conduct disorder
Neurobiological Etiology of Mood Disorders
original models relied on neurotransmitters norepinephrine, dopamine, and serotonin (low levels MDD, high levels for mania, except serotonin)
because medication takes time to affect, new focus on postsynaptic receptor sensitivity
people more vulnerable to depression may have less sensitive serotonin receptors
depressed states shows changes in frontal cortical activity in depressed states: dorsal PFC suppressed in contrast to ventral PFC, more active
amygdala consistently more activated in depressed patients
antidepressants normalize these areas of the brain
in healthy controls, dorsal prefrontal activity temporarily decreased with transient sadness
abnormalities in prefrontal cortex in bipolar (hard time stopping behavior that feels good)
Default-Mode Network
plays a role in self-reflective processes, sustaining and retaining attention, critical to rumination
MDD patients can’t deactivate certain components, constantly thinking about negative things
training to focus on positive things can help
Executive Network
structures that subserve cognitive control and play a role in dysregulated emotional responding in MDD
decreased DLPFC function in MDD at rest and in response to negative stimuli
Salience Network
structures play a role in being aware of/responding to biologically relevant stimuli
may mean that in MDD inability to process negative stimuli, work harder to understand
ex. heightened response in amygdala
Neuroendocrine Etiology of Mood Disorders
overactivity of HPA axis triggers cortisol, which is linked to depression
MDD is decreased neural plasticity: stress, depression, anxiety induce degeneration of neurons, maybe through cortisol
Social Factors Etiology of Mood Disorders
stressful life events occurred prior to depression onset in ~50%
lack of social support may be a reason a stressor triggers depression
interpersonal difficulties, marital conflicts predict
behavior of depressed people leads to rejection, cyclic nature
Interpersonal Therapy
short term psychodynamic therapy, focus on current relationships, lifestyle
Cognitive Therapy
monitor and identify automatic thoughts, balance positive and negative
Mindfulness-Based Cognitive Therapy
strategies, including meditation, to prevent relapse; try to allow us to be comfortable in the present moment
Behavioral Couples Therapy
enhance communication and satisfaction; core of depression thought to be relationships
Psychoeducational Approaches of Bipolar Treatment
provide information about symptoms, course, triggers, treatments
Family-Focused Treatment
educate family about disorder, enhance family communication, improve problem solving
Electroconvulsive Therapy (ECT)
used for very severe, hard to treat depression that has high risk of suicide
induce brain seizures and momentary unconsciousness
memory loss is a side effect
SSRI
selective serotonin reuptake inhibitors; first line of treatment for mood disorders; most helpful in moderate to severe depression
