Week 8 Mood & Anxiety Disorders Flashcards
What are the 5 categories of Emotional and Physical Sx of Depression?
HINT; MAFSS
M - Miscellaneous: Increased somatic complaints
A - Appetite Changes: Including dramatic changes in body weight
F - Feelings: intense sadness, loss of interest (anhedonia)
S - Social: Withdrawal and Isolation
S - Sleep: Problems sleeping
Is Grief a form of Depression?
A. Yes
B. No
Explain why!
B. No.
Grief dominant feeling is loss and emptiness. It occurs in waves, vacillates with exposure to reminders and decreases with time. People suffering from grief still have the capacity for positive emotional experiences, and they have preserved self-esteem.
Depression falls under the classification of
A. Personality Traits and Mood Disorders
B. Personality Disorders and Mood Disorders
C. Mood Disorders and Affective Disorders
D. Projection and Hostility Disorders
C. Mood Disorders and Affective Disorders
‘Affect’ refers to feelings, emotions and desires which together made up ‘Mood’.
What are some Signs and Symptoms of Major Depression?
M - Miscellaneous: Increased somatic complaints
A - Appetite Changes: Including dramatic changes in body weight
F - Feelings: intense sadness, loss of interest (anhedonia)
S - Social: Withdrawal and Isolation
S - Sleep: Problems sleeping - In/Hypersomnia
Plus these other signs and symptoms
- Depressed Mood: Intense Sadness
- Fatigue
- Feelings of worthlessness of guilt
- Reduced concentration
- Recurring thoughts of death or suicide
For a person to be diagnosed with Disruptive Mood Dysregulation Disorder (DMDD)?
A. They suffer from Bipolar and have temper outbursts
B. Must be diagnosed before the age of 6
C. Suffer from Autism as DMDD is a comorbidity
D. Occurs 3+ times a week for at least 12 months
D. Occurs 3+ times a week for at least 12 months
Essential Feature: Severe temper outbursts with underlying persistent angry or irritable mood.
Onset starts before age 10, cannot be diagnosed before age 6 and or after age 18
What percentage of Australians will experience a mental health condition in their lifetime?
A. 25%
B. 35%
C. 45%
D. 55%
C. 45%
In Australia, it’s estimated that 45 per cent of people will experience a mental health condition in their lifetime
In any one year, around 1 million Australian adults have depression and over 2 million have Anxiety
Which is correct about Depression?
A. FHx increase the likelihood by 6x
B. Neurotransmitter imbalance
C. Fluctuations of estrogen and progesterone
D. Usually is a co-morbidity to another chronic illness
E. All the above
E. All the above
Others include
- Sunlight Deprivation (Seasonal Affective Disorder)
- Sleep Disorders
What are the three emotional components to a perceived or actual threat ‘fight or flight’?
Endocrine and Autonomic: the release of cortisol and sympathetic innervation
Motor: Run, Hide, Fight
Cognitive-Evaluative: Decision making, minimise the threat or downplay the stimulus
Which part of the brain plays a strong role in fear processing?
A. Amygdala
B. Cingulate Gyrus
C. Temporal Lobe
D. Substatia Nigra
A. Amygdala
The fear response starts in a region of the brain called the amygdala. This almond-shaped set of nuclei in the temporal lobe of the brain is dedicated to detecting the emotional salience of the stimuli – how much something stands out to us.
When the amygdala is damaged, previously threatening stimuli come to be treated as benign.
What is the Hypothalamic - Pituitary - Adrenal axis?
A. Response to emotional stimuli (fear/anxiety)
B. Endocrine and autonomic cascade leading to cortisol release
C. Triggers the release of adrenal cortisol and adrenaline via the same axis
D. A and B
D. A and B
The hypothalamic pituitary adrenal (HPA) axis is our central stress response system.
- Hypothalamic release of corticotropin-releasing factor or hormone (CRF or CRH)
- CRH binds to the Anterior Pituitary gland which causes the release of adrenocorticotropic hormone (ACTH)
- ACTH binds to receptors on the adrenal cortex and stimulates the Adrenal gland release of cortisol.
Isolated lesions of the Amygdala with calcifications results in the inability to recognise?
A. The faces as a whole
B. The cannot differentiate between stranger and friend
C. They cannot recognise the emotion on the persons face
D. All the above
C. They cannot recognise the emotion on the persons face
Aka - Urbach-Wiethe disease
The disease does not affect the ability to discriminate fine differences in faces, nor the ability to recognize faces –specifically affects discerning emotions
Furthermore, people suffering from Narcissistic Personality Disorder have structural abnormalities of the amygdala and “reduced feedback modulation of fusiform gyrus by the amygdala during fear processing”
If you stimulate the right side of the Amygdala you would experience which emotions?
A. Negative emotions only
B. Both sad and happy emotions
C. Apathy and disinterest
D. None of the above
A. Negative emotions only
Left side stimulation can have both positive and negative emotions according to the lecture slide.
Which is not true for the Amygdala
A. Identifies the emotional significance of events
B. Involved in the formation of emotional memories
C. Can both receive and send information to other brain areas.
D. Is a relay station for the primitive and higher parts of the brain
D. Is a relay station for the primitive and higher parts of the brain
From the Cerebral cortex and Hypothalamus (relay station) information of emotional significance is transmitted to the Amygdala.
The Amygdala also receives info from brain regions involved in the processing of stimuli, memory and understanding:
- Association, olfactory cortices and the medial temporal lobe
- Hippocampus (learning and memory)
- Cingulate Gyrus (Social awareness and empathy)
- Hypothalamus
Pathophysiology of Depression
When something stressful happens there is an increased level of glucocorticoids. This is due to specific receptors in the Hippocampus, activating the Hypothalamus to secrete Corticotropin-Releasing Hormone (CRH), which leads to activation of the HPA cortisol secretion.
In depressed patients, what happens to the HPA negative feedback loop?
Under normal circumstance - this process creates a negative feedback loop in which the excess cortisol activates the brains glucocorticoid receptors and suppresses the production of CRH.
In depressed patients, this loop no longer works, as the loop no longer works, resulting in excess production of CRH and hence high levels of cortisol.
Chronic excess stress on the HPA –> structural changes in the Hippocampus.
Decrease glucocorticoid receptors in the Hippocampus and Prefrontal Cortex.
What does a hyperactive HPA lead to?
A. Changes in the brain leading to minute cortisol production
B. Excess Cortisol
C. Cortisol Hypersensitivity
D. All the above
B. Excessive Cortisol
Chronic excess stress on the HPA –> structural changes in the Hippocampus.
Decrease glucocorticoid receptors in the Hippocampus and Prefrontal Cortex.
True or False
Cushing syndrome patients suffer from depression
True
Cortisol influences functions of several neurotransmitter systems involved in depression
- Serotonin (Raphe Nuclei)
- Noradrenaline (Locus Ceruleis)
- Dopamine (Substantia Nigra)
Why do we see weight gain in people with depression?
Cortisol and Metabolism changes with insulin release and maintenance of blood sugar levels
These changes can also lead to a decrease in appetite which would result in weight loss
True or False
Glucocorticoids decrease the formation of flashbulb memories of events associated with strong emotions, both positive and negative.
False
Glucocorticoids enhance the formation of flashbulb memories
This has been confirmed by studies whereby blockage of either glucocorticoids or noradrenaline activity impaired the recall of emotionally relevant information.
Additional sources have shown subjects whose fear learning was accompanied by high cortisol levels had better consolidation of this memory.
Cortisol is a glucocorticoid released by the adrenal gland in response to stressful events. Which of the following is a metabolic effect produced by elevated levels of this hormone?
A. Hyperglycaemia
B. ncreased insulin sensitivity
C. Reduced lipolysis
D. Reduced Proteolysis
A. Hyperglycaemia
Cortisol increases nutrient availability for the brain and vital organs in times of stress by raising blood glucose, amino acids & triglyceride levels.
Elevated blood sugar is achieved by a combination of increased glucose production by the liver (gluconeogenesis) & antagonizing insulin’s action to lower plasma glucose.
Increased breakdown of muscle protein provides fuel for hepatic gluconeogenesis, and increased activity of hormone-sensitive lipase produces increased fatty acid release, which increases insulin resistance.
Patients who are on long-term glucocorticoids can experience a number of significant side effects. Most side effects are reversible when drug therapy is tapered to levels physiologically equivalent to normal cortisol.
Which effect, if it developed, would be reversible?
A. Fatigue and Weakness B. Increased blood pressure C. Increased likelihood for infections D. Moon face appearance E. All the above
E. All the above
True or False
High levels of Glucocorticoid leads to changes in serotonergic receptors found in the cerebral cortex and hippocampus
True
Changes have been observed in humans who have committed suicide or suffered from diseases that cause hypersecretion of glucocorticoids.
The continued administration of antidepressants causes changes in the serotonergic receptors that are the opposite of the changes produced by chronic stress. It also reverses the hypersecretion of stress hormones (cortisol)
Panic Attacks are linked to what?
A. Underactivity of the Locus Ceruleis and hyperactivity of Raphe Nuclei
B. Hyperactivity of the Substantia Nigra and Dopamine
C. Overactivity of the Locus Ceruleis and hypoactivity of Raphe nuclei
D. Changes in the Hippocampus and Prefrontal Cortex leading to excessive Cortisol
C. Overactivity of the Locus Ceruleis and Hypoactivity of Raphe nuclei
Locus Ceruleis is the primary site of Noradrenaline production in the brain.
The Raphe Nuclei are the primary location in the brain for the production of the neurotransmitter serotonin.
Excessive amounts of NorAdrenaline lead to feels of anxiety
Which drug in Ambulance is used as an Anxiolytic?
A. Atropine
B. Morphine
C. Midazolam
D. Ondansetron
What is the presentation of the drug you chose for the answer?
B. Midazolam
5mg/1mL
15mg/3mL
Short-acting CNS depressant Actions: - Anxiolytic - Sedative - Anti-convulsant
Contras: Known hypersensitivity to benzodiazepines
What would we not expect to see on a brain image from a person with a panic disorder?
A. Decrease Benzodiazepine binding
B. Increase GABA levels
C. Decrease serotonin binding
D. Decrease Prefrontal cortex volume
B. Increase GABA levels
GABA is an inhibitory neurotransmitter and therefore decrease amount leads to the unabated excitatory neurotransmitter action.
