DOWN IN THE DUMPS.. UP IN THE CLOUDS… Mood Disorders

SWINGS IN EMOTIONAL STATES THAT ARE MORE EXTREME (THAN NORMAL) AND MORE PROLONGED (LONGER LASTING) COMMON DISORDERS SEASONAL AFFECTIVE DISORDER DEPRESSION BIPOLAR DISORDER What is a mood disorder?

LIFE BRINGS EVENTS THAT MAKE US SAD, DISAPPOINTED, FRUSTRATED… Depression

What is Depression?  Range (5 or more symptoms)  Typically lasting 2 or more weeks (no apparent reason) Symptoms  Profound unhappiness (most of the time)  Lack of interest in usual life pleasures (eating, sex, hobbies, sports, work, etc.)  Weight loss/gain  Fatigue  Insomnia  Feelings of death/suicide  Difficulty concentrating  Feelings of worthlessness, helplessness/anxiety

How Common is Depression? Depression is the “common cold” of mental illness 21.3% of women seek treatment for depression at some time in lifetime. 12.7% of men seek treatment at some time in lifetime.

Why are 2/3 of all patients women? Women Men

Suicide  7 th Leading cause of death in US  Suicide is the 2 nd leading cause of death in young people.  Roughly- 1 person in 100 attempts suicide  On average- Between adolescents commit suicide every day in the US (30% increase in past 18 years)  Highest range is  Women make more attempts- Men 3X more successful

Major Risk Factors Warning Signs Drug or alcohol abuse A prior suicide attempt Depression Hopelessness Antisocial or aggressive Family history of suicide/bipolar disorder Shame, humiliation Availability of firearm Withdrawal from others Sudden swings in mood Recent crisis or shock Giving away prized possessions Depression/hopelessness Risk taking Preoccupation with death Direct threats of suicide Suicide

SSRI –Treatment (do antidepressants cause suicide?) The only Antidepressant approved by the FDA is Prozac (all others contain “black box” warning) Slight significant increased risk for suicide (approximately 2%)

Do antidepressants work?  What is your definition of “work”?  For people with mild to moderate depression, placebos work nearly as well as antidepressants.  Dysthymia is exception (chronic conditions generally have poor response to placebo)  Why is this controversial?  Alternative treatments: cognitive behavior rational emotive Learned optimism

Causes of Depression Life situation/behavior Genetic factors Substance abuse Abnormal brain chemistry (reduced norepinephrine and reduced serotonin)= importance of serotonin Learned helplessness (Martin Seligman) Negative self beliefs

Symptoms Causes Rapid Speech (push) Extreme hyperactivity Elation/Grandiosity Decreased need for sleep Flight of ideas Harmful activities Genes: 1987 Amish Study (why study the Amish?) Biology (neurotransmitters in the brain) Environmental Bipolar Disorder= wide swings in mood from deep depression to wild elation (mania) was previously called Manic-depression

Establishing the line between “normal” and “clinically” abnormal depression can be challenging Clinicians focus on “self-report” Cyclothymia= similar to bipolar but involves less severe bouts of mania and depression. (over 2-year)

Medication Cognitive Psychology Lithium (mostly for mania/suicide) Depakote (anticonvulsants) Anti psychotic medication SSRI (Antidepressant) Hospitalization (when necessary) (1) View that says Individuals with depression see bad events as:  Internal= blame themselves  Stable= likely to last  Global= major impact (2) Aaron Beck= negative view of self (3) Martin Seligman=learned helplessness Bipolar Treatment