- same cognitive an bodily problems as depression - less severe - Last longer (2 yrs or more) - can function - poor appetite; insomnia; low self esteem; feelings of hopelessness; poor concentration; can't make decisions

- major depression - dysthymia - major periods of major depression

- persistent elevated, expansive or irritable mood - secrecy need for sleep - more talkative - racing thoughts - attention to irrelevant stimuli - high potential for painful consequences - marked impairment always and sometimes psychotic features

- restless, consumed with confidence - not as prone to gloom following mania - can cause bursts of creative work - problem: can lose balance between right amount of energy and too much - no psychotic features - no marked impairment

- alternating between mood states within an episode - special case of rapid cycling

- bipolar I - delusional; scattered, distracted; grandiose; doesn't sleep - treatment: medication

Mood Disorders Flashcards by monika r

Major depressive disorder

severely depressed mood
last 2 or more weeks
feeling of worthlessness and lack of pleasure, lethargy and sleep and appetite disturbances
significant loss or gain of weight
agitation or retardation
insomnia, hypersomnia

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Dysthymia (unipolar)

same cognitive an bodily problems as depression
less severe
Last longer (2 yrs or more)
can function
poor appetite; insomnia; low self esteem; feelings of hopelessness; poor concentration; can’t make decisions

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Double depression

major depression
dysthymia
major periods of major depression

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Seasonal affective disorder

seasonal pattern of depression
due to reduced levels of light during some seasons
higher latitudes

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Biological factors of depression

heritability depends on severity
inc levels of NE and serotonin-linked with depression
less activity in left prefrontal Cortex (process emotions)
stroke patients have high incidence of depression

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Psychological factors

helplessness theory

- negative thoughts must precede this disorder

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Helplessness theory

Individuals prone to depression automatically attribute neg experiences to causes that are internal, stable and global

depressive biases in thinking and memory
Aaron beck

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Suicide risk and prevention

11th leading cause of death in us 3rd in hs and college
variety of motives: biological or contagious (werther effect)
white males: higher risk earlier in life
black males: higher risk later in life

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Bipolar disorder

Unstable emotional condition cycles of high mood (mania) and low mood (depression)
-also includes cyclothymia

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Manic episodes

persistent elevated, expansive or irritable mood
secrecy need for sleep
more talkative
racing thoughts
attention to irrelevant stimuli
high potential for painful consequences
marked impairment always and sometimes psychotic features

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Hypo manic episode

restless, consumed with confidence
not as prone to gloom following mania
can cause bursts of creative work
problem: can lose balance between right amount of energy and too much
no psychotic features
no marked impairment

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Types of bipolar disorder

bipolar I: history of manic and depressive episodes

- bipolar II: hypo manic episodes and major depressive episodes

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Cyclothymia

-2 yr duration of numerous alternating periods of hypomanic symptoms and depressive symptoms

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Bipolar disorder without psychotic features

Mental state can be
-manic episode
-mixed episode
-major depressive episode
The diagnosis is bipolar as long as there’s a history of mania
-ie: if person is depressed and has history of mania, diagnosis will be bipolar disorder, depressed

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Mixed episode

alternating between mood states within an episode

- special case of rapid cycling

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Psychotic features

specifier: add to end of diagnosis
presence of psychotic features in mood disorders seen in:
- mood congruent delusions
-hallucinations
-add to bipolar or major depression: so severe it leads to psychotic disorders

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Mood congruent delusions

depressive delusions of worthlessness/repulsion of self
manic delusions of grandeur
unlimited power and influence
delusions match mood: ie depressed, should feel worthless
ie depressed and have hallucinations that CIA is on roof, that’s consistent with schizophrenia

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Hallucinations

Typically auditory

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Video-latiffa

bipolar I
delusional; scattered, distracted; grandiose; doesn’t sleep
treatment: medication

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Video-psychomotor retardation

major depressive episode; bipolar I disorder; not psychotic
understands that she went too far with mania bc now she is depressed
being dead isn’t much different
no emotional response

Unipolar vs bipolar

unipolar: more time in normal state; less oscillation

- bipolar: less time in normal state, oscillating between manic and depressed

Biological component of depression

twins: 4 times higher rate in monozygotic twins
medicine targets NE and serotonin to modulate mood
heritability is 33-45%
mz accordance: 40%
dz accordance: 11%

Part of brain affected in depression

-dec activity in left prefrontal cortex and increased activity in right prefrontal cortex

Biological factors in bipolar disorder

heritability is 40-70%
NE and serotonin can contribute to roller coaster of emotions
take lithium to dec symptoms, but don’t know why
mz accordance: 72%
dz accordance: 13%

Cause of mood disorders

- diathesis stress model | - not doomed by genes, but they are important

Situational components of mood disorders

- social support-lack of can lead to mood disorder | - downward spiral- caused by negative reactions from others-->isolation

Cognitive components

- Beck's cognitive triad: negative an irrational views of self, present ad future - errors in logic: magnify depressive negativity

Treating mood disorders

- psychodynamic approach - humanistic approach - cognitive behavioral approach - eclecticism

Psychodynamic approach

- anger turned inwards - push role of superego - insight, expand ego control - how? Free association, analysis of transference, dream analysis

Behavior learning theory

- positive environment | - change behavioral responses to increase reinforcement of non-depressed behavior

Cognitive and social learning

- emotions and moods are cognitive processes - depression and moods result from irrational thinking - use optimism (ABCs)

Seligman's ABC model (borrowed from Ellis)

Adversity (what we do when we encounter it) Beliefs (thoughts become beliefs) Consequences (results, behaviors based on beliefs) -learn to argue with yourself -changing pessimism to optimism -we make ourselves more miserable with our thinking

Beck's cognitive triad-3 distortions in rational processing

- negative view of self - negative view of the world - negative view of the future

Dissociative disorder

- normal cognitive processes are fragmented and disjointed | - significant disruptions in memory, awareness and personality

Cognitive processes in depression

- expectations of uncontrollability-pessimism | - bandura-self-efficacy: low motivation, low expectations, low effort

Dissociative identity disorder

-presence of two or more identities that take control at different times

Goal of treatment in cognitive processes in depression

- explore rationality to alter expectations | - alter behavior to change reinforcement

Dissociative amnesia

- sudden loss of memory for significant personal information - usually for a traumatic event

Summary of cognitive approaches

- use ABCDE - appraisal - belief - consequence - dispute - evaluate

Dissociative fugue

- sudden loss of memory for ones personal history - abrupt departure from home - assume new identity

Cycle of sustaining depression

Stressful experience-->negative explanatory style-->depressed mood-->cognitive and behavioral change Repeat

Biological therapies-drugs

- anti anxiety drugs: GABA - depression drive: serotonin and NE - antipsychotic drugs: dopamine

Antidepressant drugs-3 types

1) MAO 2) trycyclins 3) SSRIs

MAO inhibitors

-slow down enzyme breakdown process of NE and serotonin

Trycyclics

- inhibit reuptake of NE - more side effects - easier to OD - work on 60% of medications

Electro convulsive therapy

- can lose memory - rarely used now - why does it work, we don't know - jump start someone out of depression

Lithium carbonate

- treatment for bipolar disorder - antimanic properties - side effects

Adjunctive psychotherapy-bipolar disorser

- medication management - family and social relations - education - reality testing