Mood Disorders

A category of mental disorders in which significant and chronic disruption in mood is the predominant symptom, causing impaired cognitive, behavioral, and physical functioning –Major depression –Dysthymic disorder –Bipolar disorder –Cyclothymic disorder

Major Depression A mood disorder characterized by extreme and persistent feelings of despondency, worthlessness and hopelessness –Prolonged, very severe symptoms –Passes without remission for at least 2 weeks –Global negativity and pessimism –Very low self-esteem

Symptoms of Major Depression Must Exhibit for 2 Weeks or Longer Emotional—sadness, hopelessness, guilt, turning away from others Behavioral—tearfulness, dejected facial expression, loss of interest in normal activities, slowed movements and gestures, withdrawal from social activities Cognitive—difficulty thinking and concentrating, global negativity, preoccupation with death/suicide Physical—appetite and weight changes, excess or diminished sleep, loss of energy, global anxiety, restlessness

Prevalence and Course of Major Depression Most common of psychological disorders. It affects about 12 million Americans annually. Women are twice as likely as men to be diagnosed with major depression Untreated episodes can become recurring and more serious Seasonal affective disorder (SAD)—onset with changing seasons

Self-Rating Depression Scale

Scoring Your Self-Rating Depression Scale Reverse Your responses (1=5, 2=4, 3=3, 4=2, 5=1) to items: 2, 5, 6, 11, 12, 14, 16, 17, 18, 20 Now add up all your numbers (including the new reversed scores) to find you total score. Range of total scores will be 20 to 80. Scores of suggest mild to moderate depression Scores of indicate moderate to severe depression Scores 70 and above indicate severe depression.

Dysthymic Disorder Similar to major depressive disorder but less severe and shorter in duration Chronic, low-grade depressed feelings that are not severe enough to be major depression May develop in response to trauma, but does not decrease with time Some people with dysthymic disorder experience double depression, characterized by one or more episodes of major depression on top of their ongoing dysthymia.

Seasonal Affective Disorder Cyclic severe depression and elevated mood Seasonal regularity Unique cluster of symptoms –intense hunger –gain weight in winter –sleep more than usual –depressed more in evening than morning

Bipolar Disorder A mood disorder in which the person alternates between the hopelessness of depression and the overexcited and unreasonably optimistic state of mania Used to be called manic-depressive disorder Many times will follow a cyclical pattern

Bipolar Disorders Cyclic disorder (manic-depressive disorder) Mood levels swing from severe depression to extreme euphoria (mania) No regular relationship to time of year (SAD) Must have at least one manic episode

Mania Period of abnormally high emotion and activity –Supreme self-confidence - delusional –Grandiose ideas and movements – too many goals in too little time –Flight of ideas – rapid and loosely shifting thoughts that jump from topic to topic.

Depression Extended period of feeling sad, listless, and drained of energy

Cyclothymic Disorder Cyclothymic—mood disorder characterized by moderate but frequent mood swings that are not severe enough to qualify as bipolar disorder

Prevalence and Course of Bipolar Disorder Onset usually in young adulthood (early twenties) Mood changes more abrupt than in major depression No sex differences in rate of bipolar disorder Affects about 2 million Americans annually. Commonly recurs every few years A small percentage of people with the disorder display rapid cycling, experiencing four or more manic or depressive episodes every year. Can often be controlled by medication (lithium)

Biological Factors Mood disorders have a hereditary nature to them. Depressed individuals tend to have depressed brains. –PET scans indicate less activity during periods of depression.

Ups & Downs of Bipolar Disorder PET scans show that brain energy consumption rises and falls with the patient's emotional switches. Red areas are where the brain rapidly consumes glucose. Blue areas are low areas of activity.

Explaining Mood Disorders Neurotransmitter theories –dopamine –norepinephrine –Serotonin Antidepressants increase the availability of norepinephrine and serotonin. They relieve the symptoms of major depression in about 80% of the people who take them Lithium has been used to treat bipolar disorder and to prevent its recurrence. It appears to regulate the availability of the neurotransmitter glutamate. Genetic component –more closely related people show similar histories of mood disorders

Effect of stress was greater for those who were more genetically predisposed for depression (based on the status of their twin sisters, as shown in the key) than for those who were less genetically predisposed. (Adapted from Kendler & others, 1995) The Role of Stress & Genetics

Cognitive Bases for Depression A.T. Beck: depressed people hold pessimistic views of –themselves –the world –the future Depressed people distort their experiences in negative ways –exaggerate bad experiences –minimize good experiences

Cognitive Bases for Depression Hopelessness theory –depression results from a pattern of thinking –person loses hope that life will get better –negative experiences are due to stable, global reasons e.g., “I didn’t get the job because I’m stupid and inept” vs. “I didn’t get the job because the interview didn’t go well”

Negative Automatic Thoughts Finding Your Score Add up your total score. Scores will fall from 30 (no depression) to 150 (maximum depression). Mean (average) score is 79.6 for depressed people and 48.6 for nondepressed people. This “test” looks for specific measures of depression: –Personal dissatisfaction & desire for change (items 14 & 20) –Negative Expectations (items 3 & 24) –Low Self-Esteem (items 17 & 18) –Helplessness (items 29 & 30)

Social-Cognitive Factors Depression may be a variation of learned helplessness. Depressed individuals attribute events using the following characteristics: –Stable: the bad situation will last for a long time –Internal: they are at fault –Global: all of life is bad

Attributions

Explanatory Style and Depression

Situational Bases for Depression Positive correlation between stressful life events and onset of depression –Does life stress cause depression? Most depressogenic life events are losses –spouse or companion –long-term job –health –income

Seriously depressed moods result from a combination of factors, which affect each other. Altering any one component can alter the others. Bio-Psycho-Social Model of Depression

Depression’s Vicious Cycle

SUICIDE

Who Commits Suicide? Each year 500,000 people require emergency room treatment as a result of a suicide attempt. Suicide took the lives of 30,622 people in 2001 Suicide is the third leading cause of death among young people ages 15 to 24. Twice as many Americans die each year from suicide than from homicide. Women outnumber men 3 to 1 in suicide attempts Men outnumber women 4 to 1 in suicide deaths Suicide rate has increased by over 300% over the last four decades Highest suicide rate occurs in those over age 75.

Why do people attempt suicide? To escape the pain of a chronic illness or the slow, agonizing death of a terminal disease. Feelings of hopelessness, depression, guilt, rejection, failure, humiliation, or shame.

Risk Factors Associated with Suicidal Behavior Recent relationship problems or lack of significant relationships Poor coping and problem solving skills Poor impulse control and impaired judgment Rigid thinking or irrational beliefs Having another major psychological disorder Alcohol or Substance Abuse Childhood physical or sexual abuse Prior self-destructive behavior or a family history of suicide. Presence of a firearm in the house

Suggestions for Helping Someone Feeling Hopeless & Suicidal Actively listen as the person talks and vents his/her feelings Don’t deny or minimize the person’s suicidal intentions Identify other potential solutions Ask the person to delay their decision Encourage the person to seek professional help. To access more information on suicide prevention please click HERE.HERE