Chapter 9 Mood Disorders

Symptoms of Depression Cognitive Poor concentration, indecisiveness, poor self-esteem, hopelessness, suicidal thoughts, delusions Physiological and Behavioral Sleep or appetite disturbances, psychomotor problems, catatonia, fatigue, loss of memory Emotional Sadness, depressed mood, anhedonia (loss of interest or pleasure in usual activities), irritability

5 or more symptoms including sadness or loss of interest or pleasure Major Depression Dysthymic Disorder 5 or more symptoms including sadness or loss of interest or pleasure 3 or more symptoms including depressed mood At least 2 weeks in duration At least 2 years in duration Number of symptoms Duration

Subtypes of Depression Depression with Melancholic Features Depression with Psychotic Features Depression with Catatonic Features Depression with Atypical Features Depression with Postpartum Onset Depression with Seasonal Patterns

Prevalence and Prognosis Among adults, 15-to-24-year olds are most likely to have had a major depressive episode in the past month. Depression is less common among children than among adults. Depression may be most likely to leave psychological and social scars if it occurs initially during childhood, rather than during adulthood.

Biological Theories of Mood Disorders Genetic Theory Disordered genes predispose people to depression or bipolar disorder Neurotransmitter Theories Dysregulation of neurotransmitters and their receptors Neurophysiological Abnormalities Altered brain-wave activities affect mood Neuroendocrine Abnormalities Chronic hyperactivity in the hypothalamic-pituitary-adrenal axis and slow return to baseline after stressor, affect the functioning of neurotransmitters.

Biological Theories Neurotransmitter theories Genetic Theory Disordered genes predispose people to depression or bipolar disorder Dysregulation of neurotransmitters and their receptors Neuroendocrine abnormalities Neurophysiological abnormalities Chronic hyperactivity in the hypothalamic-pituitary-adrenal axis and slow return to baseline after stressor affect the functioning of neurotransmitters. Altered brain-wave activities affect mood

Risk of Bipolar Disorder Percent with bipolar disorder

Psychological Theories of Mood Disorders Behavioral Theories Lewinsohn’s theory Learned helplessness theory Cognitive Theories Aaron Beck’s theory Reformulated learned helplessness theory Ruminative response styles theory Psychodynamic Theory Interpersonal Theories

Integrative Theory of Depression C Reduced rate of positive reinforcement and/or elevated rate of aversive experience D Increased self-awareness (state): focus on oneself self-criticism negative expectancies B Disruption of “scripted” or automatic behavior patterns and/or immediate emotional response E Increased dysphoria/ depression A Antecedents: depression evoking events G Predisposing characteristics: vulnerabilities immunities F Consequences: behavioral cognitive emotional somatic interpersonal

Biological Treatments for Mood Disorders Medication Electroconvulsive therapy (ECT) Repetitive transcranial magnetic stimulation Vagus nerve stimulation Light therapy

Psychological Treatments for Depression Behavioral Therapy Increase positive reinforcers and decrease aversive events by teaching the person new skills for managing interpersonal situations and the environment Cognitive-Behavioral Therapy Challenge distorted thinking and help the person learn more adaptive ways of thinking and new behavioral skills Psychodynamic Therapy Help the person gain insight to unconscious hostility and fears of abandonment to facilitate change in self-concept and behaviors