Class Activity For each of the following words, write a sentence that describes an experience you had that is associated with that respective word… Train Ice House Meeting Machine Road Rain Tunnel

Class Activity For each experience you wrote down, rate whether the experience was pleasant or unpleasant After you have rated all experiences, tally the total number of pleasant and unpleasant experiences

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

Mood Disorders - Emotional disturbances that interfere with normal life functioning (Axis 1) Depressive disorders Bipolar disorders Major Depressive Disorder Single Recurrent Dysthymia Bipolar II – no mania Bipolar I

Major Depressive Episode (building block) A. During the same 2-week period, five or more of the following symptoms including either 1 or 2 have been present (must be a change in functioning) 1.Depressed mood most of the day, nearly everyday 2.Diminished interest or pleasure in all, or almost all, activities 3.Significant changes in appetite and/or weight 4.Significant changes in sleep patterns 5.Psychomotor retardation or agitation 6.Fatigue or loss of energy 7.Feelings of worthlessness or inappropriate guilt 8.Diminished ability to concentrate or make decisions 9.Recurrent thoughts or death or suicide

Manic Episode (building block) A.Distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week B.During the mood disturbance, 3 or more of the following symptoms have persisted (4 or more if the mood is only irritable) 1.Inflated self-esteem or grandiosity 2.Decreased need for sleep 3.More talkative than usual, or pressure to keep talking 4.Racing thoughts (“flight of ideas”) 5.Distractibility 6.Increase in goal-directed activity 7.Excessive involvement in pleasurable activities that have the potential for negative consequences

Hypomanic Episode (building block) A.Distinct period of persistently elevated, expansive, or irritable mood lasting at least 4 days B.During the mood disturbance, 3 (or more) of the following symptoms have been present (4 or more if mood is only irritable) 1.Inflated self-esteem or grandiosity 2.Decreased need for sleep 3.More talkative than usual, or pressure to keep talking 4.Racing thoughts (“flight of ideas”) 5.Distractibility 6.Increase in goal-directed activity 7.Excessive involvement in pleasurable activities that have the potential for negative consequences

Mood Episodes Depression Mania Hypomania Mixed Episode Normal Mood

Major Depressive Disorder Major Depressive Episode Major Depressive Episode Major Depressive Episode Major Depressive Episode MDD, single episode MDD, recurrent episodes

Major Depressive Disorder: Types Melancholic Catatonic Seasonal Pattern Post-partum onset

Dysthymia A. Depressed mood most of the day, more days than not, for at least 2 years B. Presence, while depressed, of 2 (or more) of the following: 1. Poor appetite or overeating 2. Insomnia or hypersomnia 3. Low energy or fatigue 4. Low self-esteem 5. Poor concentration or difficulty making decisions 6. Feelings of hopelessness C. During the 2-year period, the person has never been without the symptoms for more than 2 months at a time

Dysthymic Disorder Dysthymic disorder lies between a blue mood and major depressive disorder. It is a disorder characterized by daily depression lasting two years or more. Major Depressive Disorder Blue Mood Dysthymic Disorder

Major Depression vs. Dysthymia Recurrent Major Depressive Episodes Dysthymia

Bipolar Disorder Formerly called manic-depressive disorder. An alternation between depression and mania signals bipolar disorder. Multiple ideas Hyperactive Desire for action Euphoria Elation Manic Symptoms Slowness of thought Tired Inability to make decisions Withdrawn Gloomy Depressive Symptoms

Bipolar Disorder Many great writers, poets, and composers suffered from bipolar disorder. During their manic phase creativity surged, but not during their depressed phase. Whitman WolfeClemensHemingway Bettmann/ Corbis George C. Beresford/ Hulton Getty Pictures Library The Granger Collection Earl Theissen/ Hulton Getty Pictures Library

Bipolar Disorder Two Main Distinctions Bipolar I Disorder: –Technically, this should mean Mania/Mixed + Depression –Actually, this means Mania/Mixed ± Depression Bipolar II Disorder: –Hypomania + Depression (No mania ever) It is distinguished from Major Depressive Disorder by the lifetime history of at last one Manic or Mixed Episode

Bipolar I Disorder Major Depressive Episode Manic or Mixed Episode Manic or Mixed Episode One or more manic episode OR Depressed and manic episodes OR

Bipolar II Disorder Major Depressive Episode Hypomanic Episode Hypomanic Episode One or more hypomanic episode OR Depressed and hypomanic episodes OR

Unipolar vs. Bipolar Disorder Bipolar Unipolar Elevated Mood Elevated Mood Depressed Mood Depressed Mood

Explaining Mood Disorders Since depression is so prevalent worldwide, investigators want to develop a theory of depression that will suggest ways to treat it. Lewinsohn et al., (1985, 1995) note that a theory of depression should explain the following: 1.Behavioral and cognitive changes 2.Common causes of depression

Theory of Depression 3.Gender differences

Theory of Depression 4.Depressive episodes self-terminate. 5.Depression is increasing, especially in the teens. Post-partum depression Desiree Navarro/ Getty Images

Mood Disorders Depression often triggered by stress However, unlikely that stress alone causes depression Some people are more vulnerable to depression – biological vulnerability; developmental vulnerability The Etiology of Depression

Biological Perspective Genetic Influences: Mood disorders run in families. The rate of depression is higher in identical (50%) than fraternal twins (20%). Linkage analysis and association studies link possible genes and dispositions for depression. Jerry Irwin Photography

Neurotransmitters & Depression Post-synaptic Neuron Pre-synaptic Neuron Norepinephrine Serotonin A reduction of norepinephrine and serotonin has been found in depression. Drugs that alleviate mania reduce norepinephrine.

The Depressed Brain PET scans show that brain energy consumption rises and falls with manic and depressive episodes. Courtesy of Lewis Baxter an Michael E. Phelps, UCLA School of Medicine

Mood Disorders Freud noted similarities between grief and depression –Theorized that depression is grief (anger & sadness) turned against the self –Actual or symbolic loss can trigger depression –Attachment theorists have expanded the theory –Childhood losses/separations create vulnerability to later depression Psychological Views of Depression Psychodynamic Views

Mood Disorders When people experience a decline in rewards – particularly social rewards – they can enter a downward spiral of decreasing rewards that leads to depression. Theoretical Problem: Does decline in rewards cause depression, or does depression cause decline in rewards? Psychological Views of Depression Behavioral Views

Explanatory Style Explanatory style plays a major role in becoming depressed.

Mood Disorders Depression is the result of ingrained, negative thought patterns. Two main theories: –Beck’s “Explanatory Style” –Seligman’s “learned helplessness” Psychological Views of Depression Cognitive Views

Mood Disorders Negative Thinking Maladaptive attitudes often rooted in childhood –E.g.: “If I make a mistake, I’m worthless” These attitudes develop into entrenched schemas Stress triggers negative schemas Psychological Views of Depression Cognitive Views

Mood Disorders Negative Thinking Controlled by these schemas, self, present & future perceived negatively Schemas lead to “automatic thoughts” that continuously confirm negative perceptions Schemas lead to “thinking errors” –E.g.: “Nobody cares about me” Psychological Views of Depression Cognitive Views

Mood Disorders Negative Thinking Considerable research supports the link between depression and: –Maladaptive attitudes; negative schemas; thinking errors; & automatic thoughts However, do cognitive patterns cause depression – or are they caused by it? Psychological Views of Depression Cognitive Views

Systems Approach

Depression Cycle 1.Negative stressful events. 2.Pessimistic explanatory style. 3.Hopeless depressed state. 4.These hamper the way the individual thinks and acts, fueling personal rejection.

Suicide The most severe form of behavioral response to depression is suicide. Each year some 1 million people commit suicide worldwide.

Suicide Risk Factors: –Best predictor = Prior attempt –Living alone, especially if divorced/separated –Retired/unemployed –Elderly –Loss of a loved one –Chronic illness –Financial troubles –Feelings of hopelessness –Impulsivity –Sexual identity difficulties

Suicide Who attempts? Who completes? –Women: 3-4 times more likely to attempt suicide –Men: 3-4 times more likely to complete suicide –Ages 18-24: Peak age for attempting suicide –Ages 65+: Peak age for completing suicide

Suicide Common Warning Signs –Symptoms of depression –Talking about death, disappearing, “ending it all”, etc., even just in passing –Writing letters, saying last goodbyes –Getting rid of personal effects, making a will –Arranging for the care of pets, plants, etc. –Extravagant spending

Suicide Prevention –Help the person regain ability to cope with immediate stressors –Maintaining supportive contact with the person –Help the person realize that their distress is impairing their judgment –Help the person realize that the distress is not endless –Broad based programs focused on high-risk groups –Crisis hotlines –Call 911/ER