Week 9 - Depression Flashcards
What is a mood disorder?
Disorder in which primary disturbance appears to be one of mood
Can be UNIPOLAR (low mood only) or BIPOLAR (high mood usually also with low mood)
Unipolar Depressive Disorders include: major and minor depression, dysthymia
Bipolar Depressive Disorders include: bipolar I and bipolar II
What is depression and its impacts?
Symptoms: sadness, worthlessness, guilt, foreboding, poor sleep, appetite changes, suicidal thoughts, social withdrawal, fatigue, poor concentration
Every day for at least TWO WEEKS
Dysthymia: depressed mood for at least two years (chronic depression)
Impacts: suicide, relationships, mortality
What is the Cognitive Behavioural Model of Depression? (Beck)
Negative Triad of Beliefs in Depression
- Negative views of the self, the world, and the future
Inner speech seen as full of negative propaganda (voice of criticism) - labelled as Negative Automatic Thoughts (NATs)
- NATs based on negative core beliefs about the self - leading to a viscous spiral of social withdrawal etc.
NATs trap people in a cycle of RUMINATION (obsessing over thoughts)
Outline the course of depression (including relapse and recurrence)
Increasing symptoms lead to major depression
Acute Depression: symptoms will lessen to remission
Relapse: Return of current episode
Can continue for 6-9 months (relapsing and returning to “healthy”
Recurrence: Start of a new episode (very common - around half)
What are the risk factors for depression: bio-psycho-social
Biological
- Being female
- Family history
- Physical illnesses: nervous system, vascular, endocrine
Psychological
- Negative styles of thinking
- Past history of depression
Social
- Stressful life events
- Chronic stress
Cognitive Model: What are core beliefs? Dysfunctional assumptions? Negative thoughts?
Core Beliefs (Schemas)
- A statement about the self that is of a stable nature (all time across all situations)
- Based off early experiences
Dysfunctional Assumptions
- Highly individualised rigid rules
- Dysfunctional in preventing goal attainment
- Violation tends to be associated with extreme emotion
Negative Thoughts
- Views of the self, world, and future
- NATs
Treatments of Depression: Including NICE guidelines for less severe and more severe depression
Less Severe: (steps)
- Guided self-help
- Group CBT
- Individual CBT
- Group mindfulness
- Psychotherapy
- SSRIs
More Severe:
- SSRIs: generally effective at managing biological signs and symptoms
- Individual CBT
- Counselling
CBT for Depression
- Activity monitoring
- Tracking NATs
- Challenging NATs
- Preventing Relapse
What is bipolar disorder?
Bipolar I: One or more manic episodes
Bipolar II: One or more major depressive episodes plus at least one hypomanic episode (no manic episodes)
Differentiate between mania and hypomania?
Mania: A distinct period of abnormal, elevated, or irritable mood, and persistantly increased energy
- Lasts 1 week and is present most of the day
- Inflated self-esteem
- Decreased need for sleep
- More talkative
- Distractibility
- Increase in goal-directed activity
Hypomania: Beneath mania - being on the ‘high’ side but NOT manic
- Shorter: for days rather than weeks
- Not severe enough to cause marked impairment - hospitalisation not necessary, no psychosis
What are the bio-psycho-social factors that may lead to bipolar disorder?
Biological
- Fairly high heritability rate (Gottesman)
- Multiple loci associated
- Increased activity in limbic structures (emotional processing)
- Under activation of prefrontal cortex during emotional tasks
Psychological (Cognitive)
- Psychosis/Depression
Social
- Life events (eg. stress)
What are the targets of CBT for bipolar disorder?
Detecting ‘warning signs’ of manic episodes
Psychoeducation
Medication adherence
Stress management
Social rhythm stabilisation
