Mood Disorders Unipolar Depression & Bipolar Disorder

Mood Disorders in Chapter 9  Unipolar Depression  Major Depression  Dysthymic Disorder  Bipolar Disorder  Also known as Manic Depression

Symptoms of Depression EmotionalSadness Depressed Mood Anhedonia (loss of interest) Irritability Physiological and Behavioral Sleep Disturbances Appetite Changes Psychomotor Retardation Catatonia Fatigue and Loss of Energy CognitivePoor Concentration Indecisiveness Worthlessness or Guilt Poor Self-Esteem Hopelessness Suicidal Thoughts Delusions and Hallucinations

Major Depression  5 or more symptoms including sadness and loss of interest  Must be persistent for at least 2 weeks

Dysthymic Disorder  3 or more symptoms  Must be persistent for at least 2 years

Subtypes of Depression  Depression With:  Melancholic Features  Psychotic Features  Catatonic Features  Atypical Features  Postpartum Onset  Seasonal Pattern

Prevalence and Prognosis  Ages most likely to have a major depressive episode in the last month  Depression is less common among children than adults  Depression is most likely to leave psychological and emotional scars if occurs in childhood

Age Differences

Bipolar Disorder  Experience periods of depression and mania  Less common than unipolar depression  Manic-tremendous energy  Depression- depressive symptoms  Diagnosed with Mania:  Elevated, irritable mood for 1 week with at least 3 other symptoms

Manic Symptoms  Elation  Mixed with irritability and agitation  Decreased need for sleep  More talkative, pressure to keep talking  Excessive involvement in potentially dangerous activities  Flight of ideas or the feeling that you are racing

Diagnosis of Mania CriteriaBipolar IBipolar II Major Depressive Episodes Can occur but not necessary for diagnosis Necessary for Diagnosis Episodes meeting Full Criteria for Mania Necessary for Diagnosis Cannot be present for Diagnosis Hypomanic Episodes Can occur between episodes; not necessary Necessary for Diagnosis

Diagnosis of Mania  Bipolar I: experience manic episodes, depression can be severe to mild  Bipolar II: sever depression, milder mania (hypomania)  Cyclothymic:  Alternates between hypomania and moderate depression  For at least 2 years

Prevalence of Bipolar  90% of people with disorder have multiple episodes or cycles during their lifetime  Length of episode can vary  Women and Men Equal  Most develop in late adolescence or early adulthood  Face chronic problems with work and relationships  Rapid cycling bipolar disorder  o/demi-lovato-bipolar-diagnosis-shocks

Bipolar Disorder- Good?  Theorists argue that symptoms of mania can benefit  Melancholy depression inspirational for artists  Influential Sufferers:  Abraham Lincoln  Winston Churchill  Napoleon, Mussolini

Biological Theories  Genetic  Neurotransmitter  Neurophysiological (Brain Abnormalities) Theories  Neuroendocrine Abnormalities

Psychological Theories  Behavioral Theories  Reduction of Positive Reinforcers  Learned Helplessness  Cognitive Theories  Aaron Beck

Theories  Psychodynamic Theories  Interpersonal Theories  Social Perspectives  Cohort Effect in Depression  Social Status  Cross-Cultural Differences

Biological Treatments for Depression Type of TreatmentDescription and Mode of Action Medication (antidepressants) Alter levels of neurotransmitters ECTElectrical current in the brain to cause release of neurotransmitters, stimulate hypothalamus Repetitive Transcranial Magnetic Stimulation Magnetic pulses focused on particular brain structures Vagus Nerve StimulationDevice implanted similar to pacemaker; stimulate hypothalamus and amygdala Light TherapyExposure to bright light to reset circadian rhythm

Biological Treatments for Bipolar Disorder TypeDescription LithiumMost common treatment, prevents relapses AnticonvulsantsTegretol, Depakene AntipsychoticsCan result in irreversible tardive dyskensia Calcium Channel BlockersSafe in women to take during pregnancy, not known how it lowers manic symptoms

Other Therapies for Depression Type of TreatmentProposed Mechanisms of Action Behavior TherapiesChanging aspects of environment, teach new skills, teach mood- management Cognitive-Behavioral Therapy Change negative hopeless patterns of thinking and develop skills to function Interpersonal TherapyFocuses on 4 problems Psychodynamic TherapyAnalyze the sources of the patient’s depression, observe recollection of events