Mood Disorders Lesson 25

Mental Illness: Definition n Characteristically Controversial l *Disorder vs socially unacceptable n Deviations from normal l *Behavior, Cognition & Affect n Harmful dysfunction l Distress l Impairment n Magnitude & duration ~

Mood Disorders n Unipolar depression n Mania n Bipolar disorder n Seasonal Affective Disorder (SAD) ~

Unipolar Depression n Extreme sadness & despair l extent & duration important n Prevalence l females 9-26% l males 5-12% l 2:1 females n Genetic component l Concordance twins: DZ (25%), MZ (70%) n Endogenous vs. reactive ~

Diagnosis & Symptoms n Disrupted eating & sleeping l increased or decreased n Impaired concentration n Changes in activity l increased or decreased n Feelings of guilt / worthlessness n Preoccupation w/ death or suicide ~

n NOT l uncomplicated bereavement l organic n Diagnosis l 5 of 9 symptoms u not complete list l duration > 2 weeks ~ Diagnosis & Symptoms

Treatment n Psychotherapy n Drug Therapy n Electroconvulsive-shock Therapy n Sleep Deprivation n Light Therapy ~

Etiology n Evidence from drug side effects l Produce depression l reserpine – monoamines l propranalol - NE antagonist n Catecholamine hypothesis l DA & NE l Deficiency ~

Drug Treatment: 1 st Generation n Monoamine oxidase inhibitors – MAOIs l more NT in synapse l Cheese effect - tyramine l risk of cerebral hemorrhage n Tricyclic Antidepressants l Block monoamine reuptake l Sympathetic arousal l Possible overdose ~

2 d Generation: SSRIs n Selective serotonin reuptake inhibitors l Prozac (fluoxetine) l Zoloft (sertraline) l Paxil (paroxetine) l Luvox (fluvoxamine) n Blocks 5HT reuptake l Less effect on NE & DA l 5HT modulates others? n Monoamine Hypothesis l 5HT, NE, DA ~

Criticisms n Immediate effects on NT level n Therapeutic effects  2-4 weeks n Explanation? l Compensatory responses l Autoreceptor desensitization n Tetracyclic Antidepressants l Block reuptake & autoreceptors l Faster therapeutic effects l but still a delay ~

Mania & Bipolar n Mania Symptoms l Euphoria l grandiose plans l reduced need for sleep l high risk activities n Bipolar Disorder l Cycling between mania & depression ~

Etiology n Induced by drugs l Monoamine agonists l cocaine, amphetamine, antidepressants l Mostly NE & DA n Treatment l Lithium – mechanism unknown l Anticonvulsants & atypical neuroleptics ~