Mood Disorders - Depression Flashcards
(14 cards)
What are the cognitive features of depression?
Relentless negative thoughts Self criticism Rumination and worry Constantly somewhere else Hopelessness/ helplessness Suicidal thoughts
What are the emotional features of depression?
Low, flat, muted, “empty” unable to really enjoy life, tearful, irritable, grumpy, guilt
What are the physical features of depression?
Sluggish, lethargic, tired, OR restless, agitated, sleep disruption (more or less sleep) eating more or less
What are the behavioural features of depression?
Social withdrawal Avoidance, escape Stuck Indecisive Unable to stop/relax
How is depression diagnosed using the DSM?
At least one of the symptoms is 1 or 2:
1- Depressed mood most of the day nearly every day (or irritability in children and adolescents)
2- loss of interest or pleasure in daily activities
And other symptoms including;
Significant weight loss/gain or increase/decrease in appetite
Insomnia or hypersomnia
Fatigue or loss of energy
Feelings of worthlessness
Diminished ability to think or concentrate
What are the rates of comorbidity with depression?
High rates of comorbidity among people with depression with anxiety disorders, substance use disorders, eating disorders etc
What is a risk factor of depression?
Suicide
What causes depression?
Vulnerability and stressful life events
What factors cause an increased risk of depression?
Lack of intimate partner, 3+ children, and loss of mother before age 11
Loss and humiliation, especially death and separation, loss and danger
Experiences of social defeat particularly risky for depression
What are the aetiological biological theories of depression?
First degree relatives of depression sufferers are 2-3x more likely to develop depression
Twin studies suggest heritability of depression is 30-40%
Serotonin allele associated with increased risk of depression but only in those exposed to maltreatment or adverse life events
Cumulative life stress predicts depression only among at risk group
Aetiology - biological
Evidence for lowered levels of serotonin metabolite in people suffering from depression
Some evidence that elevated cortisol (stress hormone) can lower serotonin levels
Widespread use of anti-depressant medications
Why doesn’t biological theories account for all the aetiology of depression?
Not all people who are depressed have depleted serotonin metabolite levels
Depletion of serotonin levels in healthy volunteers doesn’t consistently induce depression
The problem of therapeutic delay; SSRI’s increase serotonin levels within hours but take a few weeks to work
Other neurotransmitters also implicated e,g. Dopamine
Debate over the effectiveness of SSRI’s
What is depression associated with reduced activation of?
Prefrontal cortex
Anterior cingulate
Hippocampus
What is depression associated with the increased activation of?
Amygdala
