1. Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Mood Disorders © http://office.microsoft.comhttp://office.microsoft.com

2. Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. ____________________: Unpleasant feelings, such as sadness or irritability. __________________: A feeling state that is more cheerful and elated than average, possibly even ecstatic.

3. Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. A time-limited period during which specific symptoms of a disorder are present. ____________ The clinician will: 1. ________________________________. 2. Note whether it’s the first episode or a recurrence. 3. Specify nature of a prominent set of symptoms (e.g., catatonic, postpartum). The clinician will: 1. ________________________________. 2. Note whether it’s the first episode or a recurrence. 3. Specify nature of a prominent set of symptoms (e.g., catatonic, postpartum).

4. Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Depressive Disorders

5. Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. MAJOR DEPRESSIVE DISORDER  Depressed mood.  ____________________.  Disturbed eating and/or sleeping.  Duration: ____________________.  Most cases run their course some time after 6 months.

6. Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Types of Depression In episodes with _________________, people lose interest or pleasure in most daily activities. Clip art copyright © 2005 www.clipart.com. Used with permission. ________________ - develop depressive episode at about the same time each year

7. Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Dysthymic Disorder  Have symptoms of major depression, but not as deeply or as intensely.  Chronic: Have symptoms for at least 2 years, during which they are symptom- free for no more than 2 months.

8. Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Major Depressive Disorder Dysthymic Disorder 5 or more symptoms including sadness or loss of interest or pleasure. 3 or more symptoms including depressed mood. At least 2 weeks in duration. At least 2 years in duration.

9. Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Disorders Involving Alterations in Mood

10. Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. BIPOLAR DISORDER A mood disorder involving manic episodes and very disruptive experiences of heightened mood, possibly alternating with major depressive episodes.

11. Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display.  Suffer mania and sometimes depression  Manic episode _____________ Hyperactivitiy Easily distracted _____________________ May hear voices _________________ BIPOLAR DISORDER Clip art copyright © 2005 www.clipart.com. Used with permission.

12. Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display.  ________________: One or more manic episodes, and maybe depressive episodes.  ___________________: One or more major depressive episodes and at least one hypomanic (mildly manic) episode. TYPES BIPOLAR DISORDER Clip art copyright © 2005 www.clipart.com. Used with permission.

13. Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Prevalence and Course _______of the U.S. population. First episode for men more likely to be _________. First episode for women more likely to be ________________. After a single manic episode, 90% experience subsequent episodes. Under 15% have 4-8 mood episodes in a single year: ___________.

14. Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Cyclothymic Disorder _______________________. Not as intense as bipolar. Chronic condition: Lasts at least ___________. May feel productive and creative but others regard them as moody, irritable. Clip art copyright © 2005 www.clipart.com. Used with permission.

15. Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Bipolar Type I Cyclothymic Disorder Manic episodes and possibly depressive episodes. Hypomania with major depressive episodes. Duration varies. At least 2 years in duration. Bipolar Type II Hypomania with mild depressive episodes. Duration varies.

16. Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Theories and Treatment of Mood Disorders

17. Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. BIOLOGICAL PERSPECTIVES ON MOOD DISORDERS GENETICS  First-degree relatives twice as likely to develop depressive disorders BIOCHEMICAL FACTORS  Catecholamine hypothesis  Indolamine hypothesis  Monoamine depletion model  Stress hormone

18. Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. PSYCHOLOGICAL PERSPECTIVES PSYCHODYNAMIC  __________________________.  Defensive mechanisms. BEHAVIORAL & COGNITIVE  Low response-contingent positive reinforcement.  _____________________.  _______________________.

19. Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Stressor leads to reduction in reinforcers Person withdraws Reinforcers further reduced More withdrawal and depression Lewinsohn’s Behavioral View of Depression

20. Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. LEARNED HELPLESSNESS _____________________: The passive resignation produced by repeated exposure to negative events that are perceived to be unavoidable.

21. Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. COGNITIVE PERSPECTIVES A negative view of 1.the self 2.the world, and 3.the future. A negative view of 1.the self 2.the world, and 3.the future. Drawing erroneous or negative conclusions from experience.

22. Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. SOCIOCULTURAL PERSPECTIVE INTERPERSONAL DISTURBED SOCIAL FUNCTIONING IMPAIRED SOCIAL RELATIONSHIPS SIGNIFICANT INTERPLAY WITH BEHAVIORAL AND COGNITIVE PERSPECTIVES

23. Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. BIOLOGICAL TREATMENT Medications individuals treated with SSRIs exhibit lower suicide rate than those treated with other antidepressants.

24. Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. BIOLOGICAL TREATMENT Electroconvulsive Therapy (ECT) “Shock Treatment” lifesaving in severe depression cases where medications alone were ineffective _____________________________

25. Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Behavioral Treatment 1Assessment  Frequency,  ___________, and  Range of Activities and Social Interactions. 2.Implementation of Treatment  Change _____________.  Change environment.  Develop new behaviors.

26. Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Cognitive Treatment COGNITIVE RESTRUCTURING  identifies and monitors dysfunctional automatic thoughts/assumptions  learns to recognize connection between thoughts, emotions, and actions.  learns to substitute more reasonable thoughts

27. Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Suicide

28. Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. SUICIDE WHO COMMITS SUICIDE?  About _________ Americans a year.  Women attempt more often, but male success rate is 4 times as high.  More _______.  More unmarried.  Associated DSM disorders. Clip art copyright © 2002 www.arttoday.com. Used with permission.

29. Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

30. WHY SUICIDE? BIOLOGICAL  Family history.  Abnormal neurochemical levels.  ____________________________. PSYCHOLOGICAL  Expression of hopelessness.  __________________________.  Plea for interpersonal communication. SOCIOCULTURAL  ____________.

31. Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. ASSESSMENT OF SUICIDALITY ASSESS RISK FACTORS  Suicidal intent.  Suicidal lethality.  Talking about suicide.  Giving away possessions.

32. Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. TREATING SUICIDALITY PROVIDE SOCIAL SUPPORT THERAPY  Cognitive/behavioral techniques.  Suicide prevention centers.  Suicide hotlines.