Mood Disorders Also known as affective disorders Depression, mania, or both Definition of depression Definition of mania Hypomania

Types of Mood Disorders Unipolar Mood Disorder Technically could mean either depression or mania only, but almost exclusively used for depression Bipolar Mood Disorder Alternates Between Depression and Mania Often referred to as manic-depression

Major Depression Extremely Depressed Mood Lasting at least 2 weeks Anhedonia Cognitive Symptoms Vegetative Symptoms Single or Recurrent Episode

Milder Symptoms than Major Depression But Longer Lasting At least 2 years With no more than two weeks without symptoms Can last a lifetime Dysthymic Disorder

Double Depression Suffer from both Major Depression Dysthymia Dysthymia Typically First

Patterns of Depression

Manic-Depression “Roller Coaster” of Mood Manic Episode Elevated Mood Grandiosity Increased Activity Often Reckless Varied Impairment Bipolar Disorder

Bipolar I Major Depressive Episode(s) and Manic Episode(s) Bipolar II Major Depressive Episode(s) and Hypomanic Episode(s) Cyclothymia Dysthymic Episode(s) and Hypomanic Episode(s)

Patterns of Manic Depression

Familial and Genetic Influences

Table 6-2, p. 217

Lifetime Prevalence See previous chart Sex Differences Females are twice as likely to have a mood disorder compared to men The gender imbalance in depression disappears after age 65 Bipolar disorders are distributed equally between males and females Comorbidity, especially with Anxiety Seasonal Pattern (aka Seasonal Affective Disorder) Additional Aspects

Social and Cultural Dimensions Marriage and Interpersonal Relationships Marital dissatisfaction is strongly related to depression Gender Imbalances Occur across all mood disorders, except bipolar disorders Gender imbalance likely due to socialization

Social and Cultural Dimensions Social Support Grief/Bereavement Age Oppression and poverty Creativity Life Stress

Fig. 6-5, p. 231

Tricyclic Antidepressants Widely Used (e.g., Tofranil, Elavil) Block Reuptake of Norepinephrine and Other Neurotransmitters Takes 2 to 8 Weeks to Take Effect Negative Side Effects Are Common May be Lethal in Excessive Doses

Monoamine Oxidase (MAO) Enzyme that breaks down serotonin/norepinephrine MAO Inhibitors Block Monoamine Oxidase MAO Inhibitors Are Slightly More Effective than Tricyclics Must Avoid Foods Containing Tyramine (e.g., beer, red wine, cheese) Monoamine Oxidase (MAO) Inhibitors

Selective Serotonergic Reuptake Inhibitors (SSRIs) Specifically Block Reuptake of Serotonin Fluoxetine (Prozac) is the most popular SSRI Paxil and others becoming more popular SSRIs Pose No Unique Risk of Suicide or Violence Disclaimer about Adoloescents Negative Side Effects Are Common, but Fewer than Other Antidepressants

Herbal/OTC Treatments St. John’s Wort SAMe Some evidence of effectiveness, but beware Lack of supervision Interactions

Lithium Lithium Is a Common Salt Traditional mood stabilizer for bipolar disorders However, does not help everyone Side Effects May Be Severe Dosage must be carefully monitored Why Lithium Works Remains Unclear

Lithium (cont.)

Table 6-5, p. 235

Electroconvulsive Therapy (ECT) ECT Brief electrical current applied to the brain Results in temporary seizures Several treatments are often required ECT Is Effective for Cases of Severe Depression (When All Else Fails) Side Effects Include Short-Term Memory Loss Uncertain Why ECT Works and Relapse Is Common

Psychological Treatment of Mood Disorders Cognitive Therapy Addresses cognitive errors in thinking Also includes behavioral components Behavioral Activation Increased contact with reinforcing events Interpersonal Psychotherapy Focuses on problematic interpersonal relationships Outcomes with Psychological Treatments Are Comparable to Medications

pp

Suicide Facts and Statistics 30,000+ Kill Themselves Annually 8 th Leading Cause of Death Higher among Young Adults More Men Kill Themselves More Women Attempt Pattern in Adolescents (see graph)

Fig. 6-10, p. 245

Fig. 6-9, p. 245

Suicide Risk Factors Past Suicidal Behavior Suicide in the Family Age Gender A Psychological Disorder Alcohol Use and Abuse Low Serotonin Levels Publicity about Suicide and Media Coverage