1. Mood Disorders Also known as affective disorders Depression, mania, or both Definition of depression Definition of mania Hypomania

2. Types of Mood Disorders Unipolar Mood Disorder Technically could mean either depression or mania only, but almost exclusively used for depression Bipolar Mood Disorder Alternates Between Depression and Mania Often referred to as manic-depression

3. Major Depression Extremely Depressed Mood Lasting at least 2 weeks Anhedonia Cognitive Symptoms Vegetative Symptoms Single or Recurrent Episode

4. Milder Symptoms than Major Depression But Longer Lasting At least 2 years With no more than two weeks without symptoms Can last a lifetime Dysthymic Disorder

5. Double Depression Suffer from both Major Depression Dysthymia Dysthymia Typically First

6. Patterns of Depression

7. Manic-Depression “Roller Coaster” of Mood Manic Episode Elevated Mood Grandiosity Increased Activity Often Reckless Varied Impairment Bipolar Disorder

8. Bipolar I Major Depressive Episode(s) and Manic Episode(s) Bipolar II Major Depressive Episode(s) and Hypomanic Episode(s) Cyclothymia Dysthymic Episode(s) and Hypomanic Episode(s)

9. Patterns of Manic Depression

10. Familial and Genetic Influences

11. Table 6-2, p. 217

12. Lifetime Prevalence See previous chart Sex Differences Females are twice as likely to have a mood disorder compared to men The gender imbalance in depression disappears after age 65 Bipolar disorders are distributed equally between males and females Comorbidity, especially with Anxiety Seasonal Pattern (aka Seasonal Affective Disorder) Additional Aspects

13. Social and Cultural Dimensions Marriage and Interpersonal Relationships Marital dissatisfaction is strongly related to depression Gender Imbalances Occur across all mood disorders, except bipolar disorders Gender imbalance likely due to socialization

14. Social and Cultural Dimensions Social Support Grief/Bereavement Age Oppression and poverty Creativity Life Stress

15. Fig. 6-5, p. 231

17. Tricyclic Antidepressants Widely Used (e.g., Tofranil, Elavil) Block Reuptake of Norepinephrine and Other Neurotransmitters Takes 2 to 8 Weeks to Take Effect Negative Side Effects Are Common May be Lethal in Excessive Doses

18. Monoamine Oxidase (MAO) Enzyme that breaks down serotonin/norepinephrine MAO Inhibitors Block Monoamine Oxidase MAO Inhibitors Are Slightly More Effective than Tricyclics Must Avoid Foods Containing Tyramine (e.g., beer, red wine, cheese) Monoamine Oxidase (MAO) Inhibitors

19. Selective Serotonergic Reuptake Inhibitors (SSRIs) Specifically Block Reuptake of Serotonin Fluoxetine (Prozac) is the most popular SSRI Paxil and others becoming more popular SSRIs Pose No Unique Risk of Suicide or Violence Disclaimer about Adoloescents Negative Side Effects Are Common, but Fewer than Other Antidepressants

20. Herbal/OTC Treatments St. John’s Wort SAMe Some evidence of effectiveness, but beware Lack of supervision Interactions

21. Lithium Lithium Is a Common Salt Traditional mood stabilizer for bipolar disorders However, does not help everyone Side Effects May Be Severe Dosage must be carefully monitored Why Lithium Works Remains Unclear

22. Lithium (cont.)

23. Table 6-5, p. 235

24. Electroconvulsive Therapy (ECT) ECT Brief electrical current applied to the brain Results in temporary seizures Several treatments are often required ECT Is Effective for Cases of Severe Depression (When All Else Fails) Side Effects Include Short-Term Memory Loss Uncertain Why ECT Works and Relapse Is Common

25. Psychological Treatment of Mood Disorders Cognitive Therapy Addresses cognitive errors in thinking Also includes behavioral components Behavioral Activation Increased contact with reinforcing events Interpersonal Psychotherapy Focuses on problematic interpersonal relationships Outcomes with Psychological Treatments Are Comparable to Medications

27. pp. 256-257

28. Suicide Facts and Statistics 30,000+ Kill Themselves Annually 8 th Leading Cause of Death Higher among Young Adults More Men Kill Themselves More Women Attempt Pattern in Adolescents (see graph)

29. Fig. 6-10, p. 245

30. Fig. 6-9, p. 245

31. Suicide Risk Factors Past Suicidal Behavior Suicide in the Family Age Gender A Psychological Disorder Alcohol Use and Abuse Low Serotonin Levels Publicity about Suicide and Media Coverage