Week 5: Disorders Flashcards
Affective Disorders
= A persistent mood problem that negatively impacts one’s life
- Depression (depressive disorders (unipolar)
- Bipolar disorder and related disorders (up and down cycling
- Each includes subtypes and variations in severity
- Anxiety disorders & Schizophrenia share some characteristics
____
How low, how extreme, what brought it on, how long?
- Depressive disorders differentiated by 4 factors:
• Severity • Frequency • Duration • Precipitating factors (loved one died?)
Different questions can be asked to discern these details
Depressive Disorder
Vegetative signs of depression include the following:
- Disrupted sleep patterns
- Difficulty with appetite and weight regulation
- Decreased cognitive functioning (concentration, memory, problem solving)
- Decreased libido, or sex drive
- Lack of motivation, anergia
- Anhedonia
Depression can alter the expression of your DNA; change neurotransmitters
In a study n= 1100. DNA modified in clinically depressed group. Telomeres shortened; caps on end of DNA. Everytime DNA replicates they shorted. Thought to relate to longevity.
Depression: Role of Denial
Depression involves feelings of shame
- No one wants to be mentally ill
Individuals believe they are weak and inferior
➡︎ self-medication with drugs rather than risk being labeled “depressed”
Often viewed as a Disease:
- Known etiology
- Progressive
- Negative consequences
Some common affective disorders are:
- Major depression
- Dysthymic disorder
- Atypical depression
- Organic depression
- Bipolar disorder, formerly referred to as manic-depressive illness (most often with SUD)
- Cyclothymic (mood-cycling) disorder; postpartum depression
Major Depressive Disorder (MDD)
May occur as a single episode or repeated episodes
- episodes last from 6-12 months (prof says at least 2 weeks)
- longer episode = more severe
- only 25% of patients diagnosed & treated
- some spontaneous remission
- Unipolar *never manic epidoses”
Prevalence and Course
- about 8% of Canadians suffer from depression at one point in life.
- ➡︎ Recurrent; gap between gets shorter.
Criteria for Major Depressive Disorder Part A
Part A: Specific symptoms, at least 5 of the following 9, present during the
same 2-week period, not due to another medical condition. *At least 1 of the 5 symptoms MUST be 1 or 2. :
- Depressed mood most of the day, nearly every day, as indicated by either subjective report or observation made by others.
- Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day.
_____
- Significant weight change (5%); or change in appetite nearly every day.
- Insomnia or hypersomnia
- Change in activity
- Fatigue or loss of energy
- Feelings of worthlessness or excessive or inappropriate guilt (may be delusional)
- Concentration
- Suicidality
Criteria for Major Depressive Disorder Part B
Part B: The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
- The episode is not attributable to the physiological effects of a substance or to another medical condition.
- People mourning a recent death can be diagnosed with depression if symptoms meet criteria for depression
About 8% of Canadiancs sufffers from depression
Persistent Depressive Disorder / Dysthymia
= mood disorder that lasts longer than major depression
- persists for at least 2 years
- lower-grade depression than MDD
➡︎ often undiagnosed because severity is lower
- complaints of never being completely happy
- anxiety symptoms, headache, muscle tension frequently present with depression symptoms
Dysthymia (PDD): Criteria
- Depressed mood, most of the day, for more days than not, for at least 2 years
- Presence of two or more of the following symptoms:
- Poor appetite or overeating
- Insomnia or hypersomnia
- Low energy or fatigue
- Low self-esteem
- Poor concentration or difficulty making decisions
- Feelings of hopelessness
____
possible to have persistent MDD
Higher levels of impairment, younger age of onset, higher rates of comorbidity, stronger family history of psychiatric disorder, lower social support, higher stress à harder to treat than episodic MDD
Atypical Depression (abandonment depression)
- experiences intense & sudden depressions in response to (or threat of) interpersonal loss. Often wrongly diagnosed as Major Depression
- Frequent diagnosis for adult children of addicts
- Patients don’t have as many symptoms as MDD
➡︎ distinguished by mood reactivity
- Accompanied by increase in appetite, sleep (hypersomnia), and sensitivity to rejection
- Feeling of being weighed down (“leaden”)
- Likely increased drug use during depressive episode
Organic Depression
= depression caused by medical (organic) factors
ex. brain tumors, head injuries, nutritional deficiencies, physical illness, or drug use
AKA nutritional depression ➡︎ should get better if addict stops using drug
Or, “Opponent process depression”
➡︎ due to depletion of NT in brain
Bipolar and Related Disorders
Located between schizophrenia and MDD in DSM-5
- repeated depressive episodes (that meet the criteria)
- less frequent, intense highs (manic episodes )
AKA manic depression
‘Normal’ mood meter
Bipolar Disorder
- Depressive episodes: Similar to MDD episode
- Mixed with manic episodes: a distinct period of elevated, expansive, or irritable mood that lasts at least one week
- A time of impaired judgment/activities: Activities with high potential for painful consequences: spending sprees, substance abuse, risky sexual behaviour, aggression, etc. (the more agitated the more like Schizophrenia it appears)
Manic Episodes
During the period of mania, 3 or more of 7 symptoms are present to a significant degree and represent a noticeable change from usual behaviour:
- Inflated self-esteem or grandiosity.
- Decreased need for sleep.
- More talkative than usual or pressure to keep talking.
- Flight of ideas or subjective experience that thoughts are racing.
- Distractibility as reported or observed.
- Increased goal-directed activity (socially, work,school, or sexually) or psychomotor agitation
- Excessive involvement in activities that have a high potential for painful consequences
At least 1 manic episode is required for a iagnosis of bipolar disorder. If none then Major Depressive Disorder.
Bipolar Disorders 1 and 2
BPD1: Mania: a distinct period of elevated, expansive, or irritable mood that
lasts at least one week
BPD2: Hypomania: a less severe form of mania that involves a similar number of symptoms to mania, but:
- Need only be present for 4 days
- Involve no psychotic features
Sometimes mistaken for __________
Cyclothymic Disorder / Cyclothymia
AKA mood-cycling disorder (also a cycling disorder but less severe)
= less severe form of bipolar disorder
- For at least 2 years, there have been numerous periods with hypomanic symptoms that do not meet criteria for a hypomanic or manic episode, and numerous periods with depressive symptoms that do not meet criteria for a major depressive episode.
- Frequency of the cycling & the amplitude of highs/lows are aggravated by drug abuse
➡︎ Especially apparent with cocaine, amphetamines, and hallucinogens. Sometimes marijuana. Drugs an aggravate the existing disorder. (Taking drug history is important)
➡︎ Nuthymia (normal mood)
