Mood DisordersUnipolar Depression & Bipolar Disorder

Mood Disorders in Chapter 9 Unipolar Depression

Major Depression Dysthymic Disorder

Bipolar Disorder Also known as Manic Depression

Symptoms of DepressionEmotional Sadness

Depressed MoodAnhedonia (loss of interest)Irritability

Physiological and Behavioral

Sleep DisturbancesAppetite ChangesPsychomotor RetardationCatatoniaFatigue and Loss of Energy

Cognitive Poor ConcentrationIndecisivenessWorthlessness or GuiltPoor Self-EsteemHopelessnessSuicidal ThoughtsDelusions and Hallucinations

Major Depression 5 or more symptoms including sadness

and loss of interest Must be persistent for at least 2 weeks

Dysthymic Disorder 3 or more symptoms Must be persistent for at least 2 years

Subtypes of Depression Depression With:

Melancholic Features Psychotic Features Catatonic Features Atypical Features Postpartum Onset Seasonal Pattern

http://www.youtube.com/watch?v=FjJuN9Qfr0I

Prevalence and Prognosis Ages 15-24 most likely to have a major

depressive episode in the last month Depression is less common among

children than adults Depression is most likely to leave

psychological and emotional scars if occurs in childhood

Age Differences

15-24 25-34 35-44 45-5401234567

Percentage of Major Depression in Last Month

Percentage of Major Depression in Last Month

Bipolar Disorder Experience periods of depression and

mania Less common than unipolar depression Manic-tremendous energy Depression- depressive symptoms Diagnosed with Mania:

Elevated, irritable mood for 1 week with at least 3 other symptoms

Manic Symptoms Elation Mixed with irritability and agitation Decreased need for sleep More talkative, pressure to keep talking Excessive involvement in potentially

dangerous activities Flight of ideas or the feeling that you

are racing

Diagnosis of ManiaCriteria Bipolar I Bipolar II

Major Depressive Episodes

Can occur but not necessary for diagnosis

Necessary for Diagnosis

Episodes meeting Full Criteria for Mania

Necessary for Diagnosis

Cannot be present for Diagnosis

Hypomanic Episodes

Can occur between episodes; not necessary

Necessary for Diagnosis

Diagnosis of Mania Bipolar I: experience manic episodes,

depression can be severe to mild Bipolar II: sever depression, milder

mania (hypomania) Cyclothymic:

Alternates between hypomania and moderate depression

For at least 2 years

Prevalence of Bipolar 90% of people with disorder have multiple episodes

or cycles during their lifetime Length of episode can vary Women and Men Equal Most develop in late adolescence or early

adulthood Face chronic problems with work and relationships Rapid cycling bipolar disorder http://abcnews.go.com/GMA/Entertainment/video/

demi-lovato-bipolar-diagnosis-shocks-13426166

Bipolar Disorder- Good? Theorists argue that symptoms of mania

can benefit Melancholy depression inspirational for

artists Influential Sufferers:

Abraham Lincoln Winston Churchill Napoleon, Mussolini

Biological Theories Genetic Neurotransmitter Neurophysiological (Brain Abnormalities)

Theories Neuroendocrine Abnormalities

Psychological Theories Behavioral Theories

Reduction of Positive Reinforcers Learned Helplessness

Cognitive Theories Aaron Beck

Theories Psychodynamic Theories Interpersonal Theories Social Perspectives

Cohort Effect in Depression Social Status Cross-Cultural Differences

Biological Treatments for DepressionType of Treatment Description and Mode of

Action

Medication (antidepressants)

Alter levels of neurotransmitters

ECT Electrical current in the brain to cause release of neurotransmitters, stimulate hypothalamus

Repetitive Transcranial Magnetic Stimulation

Magnetic pulses focused on particular brain structures

Vagus Nerve Stimulation Device implanted similar to pacemaker; stimulate hypothalamus and amygdala

Light Therapy Exposure to bright light to reset circadian rhythm

Biological Treatments for Bipolar DisorderType Description

Lithium Most common treatment, prevents relapses

Anticonvulsants Tegretol, Depakene

Antipsychotics Can result in irreversible tardive dyskensia

Calcium Channel Blockers Safe in women to take during pregnancy, not known how it lowers manic symptoms

Other Therapies for DepressionType of Treatment Proposed Mechanisms

of Action

Behavior Therapies Changing aspects of environment, teach new skills, teach mood-management

Cognitive-Behavioral Therapy

Change negative hopeless patterns of thinking and develop skills to function

Interpersonal Therapy Focuses on 4 problems

Psychodynamic Therapy Analyze the sources of the patient’s depression, observe recollection of events