CHS AP Psychology CHS AP CHS AP Psychology Psychology Unit 12/13: Mental Illness and Therapies Essential Task 12/13.2:Discuss the major diagnostic category of mood disorders with specific attention to the diagnoses of major depressive disorder, dysthymia, Bipolar I and Bipolar II, detail the defining symptoms of each and identify the best approach(es) for explaining the cause(es) of each.

2 Mood Disorders Emotional extremes of mood disorders come in a few principal forms. 1.Dysthymic Disorder 2.Major depressive disorder 3.Bipolar disorder

Dysthymic Dysthymic Disorder Dysthymic disorder Dysthymic disorder lies between a blue mood and major depressive disorder. It is a disorder characterized by daily depression lasting two years or more. Major Depressive Disorder Blue Mood Dysthymic Disorder

DepressionDysthymia Major Depression vs. Dysthymia in a two-year span…. Recurrent Major Depressive Episodes Dysthymia

5 Depressive Major Depressive Disorder Depression is the “common cold” of psychological disorders. 350 million people worldwide suffer from depression in any given year (WHO, 2012). Chronic shortness of breath Gasping for air after a hard run Major Depressive DisorderBlue mood

6 Depressive Major Depressive Disorder Major depressive disorder occurs when signs of depression last two weeks or more and are not caused by drugs or medical conditions. 1.Lethargy and fatigue 2.Feelings of worthlessness 3.Loss of interest in family & friends 4.Loss of interest in activities Signs include:

Depressive Major Depressive Disorder: Types Melancholic Catatonic Seasonal Pattern Post-partum onset

Depression Explaining Depression Since depression is so prevalent worldwide, investigators want to develop a theory of depression that will suggest ways to treat it. Lewinsohn et al., (1985, 1995) note that a theory of depression should explain the following: 1.Behavioral and cognitive changes 2.Common causes of depression

Depression Theory of Depression 3.Gender differences

Depression Theory of Depression 4.Depressive episodes self-terminate. 5.Depression is increasing, especially in the teens. Post-partum depression Desiree Navarro/ Getty Images

Depression Biological Perspective of Depression Genetic Influences: Mood disorders run in families. The rate of depression is higher in identical (50%) than fraternal twins (20%). Linkage analysis and association studies link possible genes and dispositions for depression. Jerry Irwin Photography

Depression Neurotransmitters & Depression Post-synaptic Neuron Pre-synaptic Neuron Norepinephrine Serotonin A reduction of norepinephrine and serotonin has been found in depression.

13 Bipolar Bipolar Disorder Formerly called manic-depressive disorder. An alternation between depression and mania signals bipolar disorder. Multiple ideas Hyperactive Desire for action Euphoria Elation Manic Symptoms Slowness of thought Tired Inability to make decisions Withdrawn Gloomy Depressive Symptoms

Manic Episode A.Distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week B.During the mood disturbance, 3 or more of the following symptoms have persisted (4 or more if the mood is only irritable) 1.Inflated self-esteem or grandiosity 2.Decreased need for sleep 3.More talkative than usual, or pressure to keep talking 4.Racing thoughts (“flight of ideas”) 5.Distractibility 6.Increase in goal-directed activity 7.Excessive involvement in pleasurable activities that have the potential for negative consequences

Mixed Episode A. The criteria are met for both a Manic Episode and a Major Depressive Episode (except duration) nearly every day during at least a 1-week period B. The symptoms cause significant distress or impairment in functioning C. Not due to a GMC or substance

Manic Episode C. The symptoms do not meet criteria for a Mixed Episode D. The symptoms cause significant impairment in functioning or necessitate hospitalization to prevent harm to self or others E. Not due to a GMC or substance

Hypo manic Episode A.Distinct period of persistently elevated, expansive, or irritable mood lasting at least 4 days B.During the mood disturbance, 3 (or more) of the following symptoms have been present (4 or more if mood is only irritable) 1.Inflated self-esteem or grandiosity 2.Decreased need for sleep 3.More talkative than usual, or pressure to keep talking 4.Racing thoughts (“flight of ideas”) 5.Distractibility 6.Increase in goal-directed activity 7.Excessive involvement in pleasurable activities that have the potential for negative consequences

Hypo manic Episode C. The episode is associated with an unequivocal change in functioning that is uncharacteristic of the person when not symptomatic D. The mood disturbance and change in functioning are observable to others E. The episode is not severe enough to cause marked distress or impairment in functioning and does not require hospitalization F. Not due to a GMC or substance

Mood Episodes Depression Mania Hypomania Mixed Episode Normal Mood

20 Bipolar The Bipolar Brain PET scans show that brain energy consumption rises and falls with manic and depressive episodes. Courtesy of Lewis Baxter an Michael E. Phelps, UCLA School of Medicine

21 Bipolar Bipolar Disorder Many great writers, poets, and composers suffered from bipolar disorder. During their manic phase creativity surged, but not during their depressed phase. Whitman WolfeClemensHemingway Bettmann/ Corbis George C. Beresford/ Hulton Getty Pictures Library The Granger Collection Earl Theissen/ Hulton Getty Pictures Library

22 Negative Thoughts and Moods Remember: someone’s “explanatory style” can play a major role in becoming depressed

23 Depression Depression Cycle 1.Negative stressful events. 2.Pessimistic explanatory style (how you explain to yourself what has happened) 3.Hopeless depressed state. 4.These hamper the way the individual thinks and acts, fueling personal rejection.

Suicide The most severe form of behavioral response to depression is suicide. Each year some 1 million people commit suicide worldwide.

Suicide Risk Factors: – Best predictor = Prior attempt – Living alone, especially if divorced/separated – Retired/unemployed – Elderly – Loss of a loved one – Chronic illness – Financial troubles – Feelings of hopelessness – Impulsivity – Sexual identity difficulties

Suicide Who attempts? Who completes? – Women: – Women: 3-4 times more likely to attempt suicide – Men: – Men: 3-4 times more likely to complete suicide – Ages 18-24: – Ages 18-24: Peak age for attempting suicide – Ages 65+: – Ages 65+: Peak age for completing suicide

Suicide Warning Common Warning Signs – Symptoms of depression – Talking about death, disappearing, “ending it all”, etc., even just in passing – Writing letters, saying last goodbyes – Getting rid of personal effects, making a will – Arranging for the care of pets, plants, etc. – Extravagant spending

Suicide Prevention Prevention – Help the person regain ability to cope with immediate stressors – Maintaining supportive contact with the person – Help the person realize that their distress is impairing their judgment – Help the person realize that the distress is not endless – Broad based programs focused on high-risk groups – Crisis hotlines – Call 911/ER