Introduction to Psychology Mood Disorders November 28, 2011 Mood Disorders November 28, 2011

Class Agenda Unipolar depression (major depressive episode/disorder) Dysthymic disorder Bipolar disorder Suicide

Class Activity For each of the following words, write a sentence that describes an experience you had that is associated with that respective word.... TrainHouseIceMeetingRoadRain

Class Activity For each experience you wrote, rate whether it was pleasant or unpleasant. Tally the number of unpleasant and pleasant experiences.

Class Activity How have you felt today? Happy? Sad? The number of pleasant vs. unpleasant experiences you recalled may be related to your mood today. When we are depressed, we remember more unpleasant than pleasant events.

Major Depressive Disorder Symptoms At least 2 weeks of depressed mood (feelings of worthlessness or guilt) OR loss of interest in pleasurable activities Significant weight loss or gain (not due to diet) Insomnia/Hypersomnia Restlessness/Sluggishness (psychomotor agitation/retardation) Indecisiveness, lack of concentration Fatigue or loss of energy Thoughts of death or suicide

Major Depressive Disorder Point prevalence rate (snapshot) in adults is 4% Lifetime prevalence (number of people who have experienced depression at some point in their life) is ~25% ~80% of people will experience recurrent episode (high estimate) Most frequent comorbid disorder is anxiety (GAD, Panic, PTSD)

Major Depressive Disorder Gender Differences Women: Men = 2:1 Possible explanations? Hormones Interpersonal orientation and rumination Traumatic events Comorbid anxiety or substance abuse?

Major Depressive Disorder Possible causes: Stress (Diathesis-Stress Model) GeneticsBiology Neurotransmitters (Norepinephrine and Serotonin) CortisolSleep Brain structures (prefrontal cortex, hippocampus, amygdala)

Major Depressive Disorder Irrational beliefs Learned helplessness Cognitive schemas

Major Depressive Disorder Seligman’s Learned Helplessness Internal “It’s because of something about ME” External “It’s because of something about the situation” Global “Everything in my life is a failure” Specific “I failed at this, but I can do other things” Stable “It will always be like this” Unstable “Things will get better”

DysthymiaDysthymia

DysthymiaDysthymia Same symptoms but milder form Lasts for 2 or more years Symptoms integrated in person’s normal functioning 20% - 40% people with depression experience dysthymia Dysthymia plus MDD = Double Depression

Bipolar Disorder

Types: Bipolar I: manic episode OR mixed episode Delusions and hallucinations (psychotic features; associated with incomplete recovery between episodes) Bipolar II: one or more major depressive episodes and at least one hypomanic episode Major depressive episode - ~70% of manic episodes occur immediately before or after manic episode Time between episodes decreases with age

Bipolar Disorder Manic phase: Easily distracted Little need for sleep Poor judgment Poor temper control Reckless behavior Very elevated mood Depressed phase: Low mood or sadness Difficulty concentrating Eating problems Fatigue/lack of energy Feelings of worthlessness Loss of pleasure in activities Sleep problems Thoughts of death and suicide

Bipolar Disorder Causes Genetics (40% - 70% familial component) Neurotransmitters (norepinephrine and serotonin) Environmental stressors

SuicideSuicide >34,000 suicides in U.S. ~94 suicides per day ~one suicide every 15 minutes eleventh leading cause of death Second most common death among college students (American College Health Association) Increased risk with depression and bipolar disorder Gender differences Age differences Racial and Ethnic differences

Suicide: Females CDC

Suicide: Males CDC

SuicideSuicide Warning signs (CDC): IS PATH WARM

SuicideSuicide I: Ideation S: Substance abuse P: Purposelessness A: Anxiety T: Trapped H: Hopelessness W: Withdrawal A: Anger R: Recklessness M: Mood change