Depression and BiPolar Disorder “I am now the most miserable man living. If what I feel were distributed to the entire human family there would not be one happy face on earth.” - Abraham Lincoln

Abe and Mary Lincoln: Case studies in depression and bipolar disorder Lincoln’s early life was beset by tragedy including watching his mother dies from a horrible illness and helping to make her coffin Lincoln’s early life was beset by tragedy including watching his mother dies from a horrible illness and helping to make her coffin Throughout his adult life Lincoln was plagued by depression, which he was open about calling it “hypo” short for hypochondria Throughout his adult life Lincoln was plagued by depression, which he was open about calling it “hypo” short for hypochondria Lincoln suffered two nervous breakdowns-so severe that both times his friends mounted suicide watches Lincoln suffered two nervous breakdowns-so severe that both times his friends mounted suicide watches As a young man Lincoln stopped carrying a knife because he feared he would commit suicide As a young man Lincoln stopped carrying a knife because he feared he would commit suicide

Abe and Mary Lincoln: Case studies in depression and bipolar disorder As teenager Lincoln watched one of his friends go mad and attempt to kill his mother, for years afterward he was plagued by the fear he would do this too. He eventually wrote a poem about it As teenager Lincoln watched one of his friends go mad and attempt to kill his mother, for years afterward he was plagued by the fear he would do this too. He eventually wrote a poem about it Even in the White House, Lincoln frequently spoke of his fear that he may commit suicide Even in the White House, Lincoln frequently spoke of his fear that he may commit suicide In the days before he was assassinated he had a dream of his own assassination and told he wife and his cabinet about it In the days before he was assassinated he had a dream of his own assassination and told he wife and his cabinet about it

Depression More women than men More women than men Most episodes will last less than 6 months and will cure themselves Most episodes will last less than 6 months and will cure themselves Number one reason people seek psychological help Number one reason people seek psychological help

Genetic Factors Genetic predisposition Genetic predisposition Depletion of norepinephrine and serotonin Depletion of norepinephrine and serotonin Goal of drug therapy to block reuptake or chemical breakdown Goal of drug therapy to block reuptake or chemical breakdown EXERCISE also naturally increases serotonin levels EXERCISE also naturally increases serotonin levels

Cognition Self-defeating beliefs can arise from learned helplessness (being in a situation where an individual’s actions have no effect on the outcome) Self-defeating beliefs can arise from learned helplessness (being in a situation where an individual’s actions have no effect on the outcome)

ATTRIBUTIONAL STYLE! How does a person explain events- Pessimistic explanation can lead to depression How does a person explain events- Pessimistic explanation can lead to depression Global Global Stable Stable Internal Internal

Mary Lincoln: BiPolar? In the early years and continuing throughout the years in the White House Mary Lincoln’s tantrums were legendary. She was frequently seen physically attacking Lincoln In the early years and continuing throughout the years in the White House Mary Lincoln’s tantrums were legendary. She was frequently seen physically attacking Lincoln Mary Lincoln obsessively bought material for curtains while First Lady. She hid her excessive spending and spent sleepless nights before the second election fearing that if Lincoln were not reelected her excessive spending would be revealed. Congress eventually investigated. Mary Lincoln obsessively bought material for curtains while First Lady. She hid her excessive spending and spent sleepless nights before the second election fearing that if Lincoln were not reelected her excessive spending would be revealed. Congress eventually investigated.

In the White House Mary Lincoln conducted séances to speak to her two dead sons In the White House Mary Lincoln conducted séances to speak to her two dead sons She spent days on end locked in her room crying She spent days on end locked in her room crying After the assassination Mary went into a deep depression, lost her ability to care for herself and reason and was eventually committed to an institution in Batavia, IL After the assassination Mary went into a deep depression, lost her ability to care for herself and reason and was eventually committed to an institution in Batavia, IL

Bi-Polar Disorder Less common than major depression Less common than major depression Occurs equally between women and men Occurs equally between women and men Milder forms seem attractive Milder forms seem attractive Worsens without medication Worsens without medication Most commonly treated with lithium Most commonly treated with lithium

Symptoms of Mania in BiPolar Disorder Mood- Expansive, euphoric, elevated Cognition- Grandiose- no limits to what can be accomplished, flight of ideas BUT can be delusional and unrealistic Actions- intrusive, dominating quality, reckless, compulsive (often spending $) Physical- Needs little sleep until the crash sets in usually within days