1. Abnormal Behavior Behavior that causes people to experience distress and prevents them from functioning in their daily lives. Part 2…

2. Mood Disorders Major Depressive Disorder Bipolar Disorder

3. Mood Disorders are made up of one or more different kinds of “episodes.”  Major Depressive Disorder  Major depressive episode  Bipolar Disorder  Major depressive episode  Manic episode

4. Major Depressive Episode  Depressed mood or anhedonia + 3 more symptoms for at least 2 weeks  Cognitive symptoms  Worthlessness or excessive guilt  Poor concentration  Recurrent thoughts of death/suicide  Somatic symptoms  Weight or appetite changes  Sleep problems  Loss of energy  Psychomotor agitation or retardation

5. Manic Episode Elevated, expansive, or irritable mood, for 1 week, plus 3 of the following:  Grandiosity   need for sleep  Pressured speech  Racing thoughts  Distractibility   goal-directed activity   pleasurable but high risk activities

6. Major Depressive Disorder  1 or more MDE without manic symptoms  Runs in families; more common in women  Course – onset ~ age 20, and usually recurrent  Prognosis – 2/3 completely recover; 1/3 partially

7. Bipolar Disorder  Manic episodes usually accompanied by one or more Major Depressive episodes  Much less common than depression  Runs in families  Rapid cycling = poor prognosis

8. Mood Disorder: Case Studies Major Depressive Disorder  http://www.youtube.com/watch?v=r5aC 02zLDd0 http://www.youtube.com/watch?v=r5aC 02zLDd0 Bipolar Disorder  http://www.youtube.com/watch?v=dwW alEE0Yus&feature=related http://www.youtube.com/watch?v=dwW alEE0Yus&feature=related

9. Etiology & Treatment of Mood Disorders

10. Etiology of Mood Disorders  Genes  Neurochemical imbalance (norepinephrine, serotonin)  Cognitive Factors: negative thoughts  Conditioning: not enough positive reinforcement  Stressors

11. Treatments for Mood Disorders  Major Depressive Disorder  Antidepressant medications  Psychotherapy  Cognitive-behavioral therapy  Cognitive: challenge negative thoughts  Behavioral: schedule activities  Combination is most effective  Bipolar Disorder  Medications (mood stabilizers)

12. Anxiety Disorders Panic Disorder Obsessive-Compulsive Disorder

13. What is anxiety?  A negative mood state with bodily symptoms of physical tension and concern about the future

14. Panic Attack: NOT a mental disorder  Sudden onset of intense fear often associated with feelings of impending doom  Shortness of breath, palpitations, chest pain, choking or smothering sensations, and fear of "going crazy," dying, or losing control  Can be uncued or situational

15. Panic Disorder  Recurrent unexpected panic attacks  At least one of the following:  Persistent concern about future attacks  Worry about the implications of the attack or its consequences  A significant change in behavior related to the attacks

16. Panic Disorder  http://www.youtube.com/watch?v=277Q 8dsArhI&feature=related http://www.youtube.com/watch?v=277Q 8dsArhI&feature=related  2:25

17. OCD in Media http://www.youtube.co m/watch?v=44DCWslb sNM&feature=related

18. Obsessive-Compulsive Disorder  Obsessions  Persistent, unwanted thoughts or ideas that keep recurring  E.g., A man is driving along and fears that he hit someone. He cannot shake the thought that he hit someone.  Compulsions  Irresistible urges to repeatedly carry out an act that seems strange or unreasonable to them.  The person experiences extreme anxiety if they cannot carry out the action.  E.g., The man above will feel extremely anxious if he doesn’t pull his car over every 5 minutes.

19. OCD Case Studies:  http://www.youtube.com/watch?v=Rn1 OYlYzgm8 http://www.youtube.com/watch?v=Rn1 OYlYzgm8  http://www.youtube.com/watch?v=x4sa dYeLHKU&feature=related

20. Anxiety Disorders Panic Disorder (PD) Obsessive-Compulsive Disorder (OCD)

21. Causes & Treatments Anxiety Disorders

22. Etiology of Anxiety Disorders  Biological Factors  Genetics  If one identical twin has it, the other has a 30% chance  Neurotransmitters  norepinephrine  Overactive limbic system  Learning - Classical Conditioning  Cognitive Factors - catastrophic thinking

23. Exposure Therapy for Anxiety Disorders (Behavior Therapy)  Have the patient face what it is they fear  Do so in a GRADUATED order using a FEAR HIERARCHY.  Help them sit with their anxiety until it naturally begins to go away  Treatment is ruined if they escape before their anxiety has significantly dropped

24. Start easy and progress upwards…

25. How would you expose a person with germ-related OCD? A. Have them think about germs until the anxiety decreases. B. Have them touch the sole of their shoe and then not wash it until the anxiety decreases. C. Have them touch the sole of their shoe and then wash their hand 5 minutes later.

26. How would you expose a person with Panic Disorder? A. Ride in an airplane with them and have them watch movies about plane crashes. B. Have them ride in an elevator and secretly arrange to have it get stuck. C. Have them run up and down the stairs, causing their heart rate to increase, and keep it up until their anxiety decreases.

27. What did we just cover?  Mood Disorders  Major Depressive Disorder  Bipolar Disorder  Etiology & Treatment of Mood Disorders  Anxiety Disorders  Panic Disorder  Obsessive Compulsive Disorder (OCD)  Etiology & Exposure Therapy

28. Case Studies Mood & Anxiety Disorders

29. What are the symptoms & diagnosis?  Kenneth is 11-years-old. He is failing in school because he cannot concentrate. Instead of listening to the teacher, Kenneth feels an urge to count and recount the ceiling tiles. Kenneth does this everywhere he goes. He tries to resist the urge but cannot. He often counts the ceiling tiles over 100 times per class period.

30. What’s your diagnosis? A. Panic Disorder B. Generalized Anxiety Disorder C. Obsessive-Compulsive Disorder D. No disorder present

31. His ceiling tile counting is an example of what? A. obsession B. psychosis C. compulsion D. habit

32. What are the symptoms & diagnosis?  Frances is a 43yo Caucasian woman who refuses to ride in elevators because she is afraid of having a panic attack in one. She has had 4 unexpected panic attacks in the last month. Frances’s job requires that she frequently go to various floors in her 15-story office building, so avoiding elevators is interfering with her work.

33. Which is the main symptom? A. A fear of elevators B. Anxiety about everything C. Obsessions D. A fear of experiencing panic

34. What’s your diagnosis? A. Panic Disorder B. Generalized Anxiety Disorder C. Obsessive-Compulsive Disorder D. Phobia

35. What are the symptoms & diagnosis?  Chris was brought in by his parents after he did not return their calls for one week. Chris had been attending a local university. His roommates report that he has not left his room in several weeks. He no longer plays basketball with them, which he used to enjoy. He has stopped attending classes. Chris reports that he sleeps nearly 21 hours a day. He has lost 20 points over the past 2 months. Chris feels like his life will never get better.

36. What disorder best fits Chris? A. Bipolar Disorder B. Panic Disorder C. Schizophrenia D. Major Depressive Disorder

37. The presence of which of the following symptoms would NOT cause you to change your diagnosis? A. Anhedonia B. Hearing voices C. A history of mania D. Disordered thoughts

38. Write your diagnosis.  Sara and her husband, Dave, come in for couples counseling. Dave complains that Sara has put them into bankruptcy with her gambling and excessive spending. He reports that a couple of times a month she stays out all night and engages in reckless behavior. Additionally, Sara goes through periods where she barely leaves her bed. She cries uncontrollably. Dave says that she has very high highs and very low lows.

39. What’s your diagnosis? A. Major Depressive Disorder B. Generalized Anxiety Disorder C. Schizophrenia D. Bipolar Disorder

40. Which is not a symptom of a manic episode? A. Decreased need for sleep B. Reckless behavior C. Staying in bed D. Spending sprees/gambling

41. Thank you!