Unit 12/13: Mental Illness and Therapies CHS AP 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.

Our emotions tell us how we are doing in life! Mood Disorders Our emotions tell us how we are doing in life! Depressive Disorders cause an individual to suffer from depression—an unrelenting lack of pleasure in life. Major Depressive Disorder Prolonged hopelessness and lethargy Bipolar disorder Alternating between depression and mania, a hyperactive state Preview Question 9: What are mood disorders, and what forms do they take?

Major Depressive Disorder https://www.youtube.com/watch?v=XiCrniLQGYc Depression is the “common cold” of psychological disorders. 350 million people worldwide suffer from depression in any given year (WHO, 2012). Major depressive disorder occurs when signs of depression last two weeks or more and are not caused by drugs or medical conditions. Signs include: Lethargy and fatigue Feelings of worthlessness Loss of interest in family & friends Loss of interest in activities Sleeping too little or too much Eating too little or too much

Major Depressive Disorder: Types Persistent Depressive Disorder (dysthymia) Seasonal Affective Disorder (SAD) Post-partum onset

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: OBJECTIVE 13| Discuss the facts that an acceptable theory of depression must explain. Behavioral and cognitive changes Common causes of depression

Theory of Depression Gender differences

Theory of Depression Depressive episodes self-terminate. Depression is increasing, especially in the teens. Desiree Navarro/ Getty Images Post-partum 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. OBJECTIVE 14| Summarize the contribution of the biological perspective to the study of depression, and discuss the link between suicide and depression. Jerry Irwin Photography

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

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

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

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

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

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

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

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

Hypomanic 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 Mixed Episode Mania Hypomania Normal Mood Depression

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

Catherine Zeta-Jones: Actress Bipolar Disorder Many great writers, poets, and composers suffered from bipolar disorder. During their manic phase creativity surged, but not during their depressed phase. Catherine Zeta-Jones: Actress Tim Burton: Film Maker Virginia Woolf: Writer

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: 3-4 times more likely to attempt suicide Men: 3-4 times more likely to complete suicide Ages 18-24: Peak age for attempting suicide Ages 65+: Peak age for completing suicide

Suicide 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 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