CH. 7 Depressive and Bipolar Disorders Flashcards
(26 cards)
4 Symptom Domains
-Mood: long lasting EX. depression -cognitive -behavioral -physiological
Emotion
-temporary
EX. sad, happy
Major depressive disorder
MDD
5-9 symptoms for 2 weeks DSM: -depressed mood most of the day -changes of pleasure -weight changes -sleep problems -more agitated/ restless -drop in energy -feelings of worthlessness -recurrent thoughts of death
Ruling out other disorders: MDD
- categorical & dimension (severity)
- specifiers, season affective disorder
- post partum
- catatonia ( psychomotor minimization)
Persistent Depressive Disorder (Dysthymia)
- depressed mood that lasted for more than 2 yrs
- less severe but more long term
Premenstraul Dysphoric Disorder
- understudied bc didnt want to pathologize
- 5 symptoms present 1 wk before the onset of menses, improve 5 days after
DSM:
- fatigue
- sleep
- irritability
- deceased interest in activities
- associated w clinical distress, not just an exacerbation
Disruptive Mood Dysregulation
- present for at least 1 yr
- children/adolescents (age 6-18yrs)
- behavioral patterns misdiagnosed
- tied w puberty
- tied to outburst occurring several times a week (irritable/angry throughout the day)
Mania (mood)
-elevated states DSM: -1 wk & 3 symptoms -inflated / grandiose -rested only 3 hours -more talkative -easily distracted -impulsive (goal directed activity)
-not due to a drug or sleep deprivaton
Bipolar Disorder I (mood)
-both male and female are about the same in prevalence
- 1 full manic episode
- could be co-occuring w depression
Bipolar Disorder II (mood)
-depressed episodes AND hypomania
Hypomania (mood)
-elevate but not quite as severe as mania
DSM:
-at least 4 days symptoms
Cyclothymic Disorder (mood)
-2 yrs or more of mild (hypomanic) & mild depression
DSM: symptoms of MDD, manic, or hypomanic have NEVER been met
Etiology: Depression
Social:
- lack of social support
- women report vs men dont
- Females socialized to talk about their problems
- neglect, maltreatment, parental loss
Biological -SSRIs decrease REM cycle -predisposition -frontal lobes shut down -shorter alleles lower levels of serotonin & dopamine & cortisol (higher levels = higher depression) -more reactive to stress -hippocampus smaller
Socio-Culture
- cultural views
- racial discrimination
- usually a overgeneralization
- tending & befriending
Psychological
-insufficient reinforces, negative thoughts, self blame & guilt
rumination
Permissive hypothesis
- SSRI (Zoloft, Lexapro, Prozac, Paxil)
- serotonin regulation (gate keeper)
- balanced = neurotransmitters balanced as well
- dropped = dropped neurotransmitters
Learned Helplessness
Seligman
-develop a depressed or pessimistic thinking
3 components (attributions: assigning a cause)
- internal (blame themselves)
- global: failing everything
- stable: this is who i am
> > teach ppl to argue w themselves
-gather evidence > CBT
Cognitive Behavioral Therapy
-Aaron Beck
- cognitive triad w depression
- negative contributions to self, the world, and future is dark and bleak
- may need medication in order to start rehab
Ex Alcoholism : might be stable but is it changeable
Treatment: Depression, Biological
-medications
to help moderate or certain periods of time
-2-8 wks effects w side effects that become more minimal
(sexual, sleep)
-never take multiple at at time due to bad interactions
ECT (shock therapy not responding to other treatments)
- just depression, under sedation
- puts the brain into normal rhythm or normal neurotransmitter
TMS (Transcranial Magnetic Stimulation)
- newer experimental treatment
- less invasive
- potential benefit
Effexor
“atypicals”
-mixed reuptake inhibitor
-more broader based = more side effects
> Wellbutin (few sexual side effects, decrease urges for smoking)
Tricyclics
-noepinephrine reuptake
EX. NE-RI
MAOIs
Mono Amine Oxidase Inhibitor -breaking down neurotransmitters -what if too much ? then inhibit it EX. parnate -significant interactions w specific foods (alc & cheese, meats)
Treatment : Bipolar Disorder
-mood stabilizer drugs
EX. lithium
-mania levels monitored by blood test (naturally produced salt)
- antipsychotics
Treatment:
Depression, psychological
CBT
- maladaptive beliefs
- Socratic > Hypothesis testing : challenging thoughts
Behavior Activation Therapy (operant)
- setting up reward
- positive thinking & behavior “its going to be a good day”
- gaining evidence
Interpersonal Therapy (family)
- component of CBT
- role of relationships in our life
- hurts w/o social support system
Mindfulness
- being present
- yesterday is not longer reality
- what do i need to do to make myself healthier ?
- make changes today for a better tomrw and future
- motivation
Sx
- 10th leading cause of death
- 1 in 25 ppl complete
-intentional, direct, and conscious
-thoughts, ideation, plan, attempt, commit
-different types: protective, altruistic
-progression of thoughts
18% college students
8-14% attemped
- prevention
- white
- older
- adolescents : increasing rates
Common characteristics : Sx
-belief that things will never change
-trying to solve as what they perceive as unend tolerable pain
> tunnel vision
-many painful things are temporary
-risk factors
-substance abuse
-hopelessness, impulsivity, access to methods
-well protected & prevented
-finding reason to live
