Session 12 Mood disorders Flashcards
(22 cards)
What are the two main classes of mood disorders?
- Depression
2. Bipolar (type 1 and type 2)
What are the main features of depressive disorders?
Patients usually have the symptoms for 2 weeks and consist of:
CORE symptoms
- low mood
- lack of energy
- lack of enjoyment and interest
depressive thoughts
somatic symptoms / biological symptoms
severe case –> psychotic symptoms
Outline the differences between a ‘normal’ adjustment reaction and clinical depression
Adjustment reaction
- symptoms develop sudden after an ‘event’
- symptoms fluctuate
- time limited
- preoccupation with ‘event’
- energy not low
- no particular pattern to sleep disturbance
- reduced or increased appetite
- feelings of anger and frustration more typical
Depression
- symptoms are gradual
- symptoms are continuous
- usually at least two weeks long
- lack of interest
- low energy
- sleep disturbance with typical EMW
- loss of appetite and weight loss = typical
- low self esteem and feelings of guilt = typical
KEY
- symptoms sudden vs gradual
- symptoms fluctuate vs continual
- energy not low vs low
- no pattern of sleep disturbance vs sleep disturbance
What are 9 features of Mania?
- elated mood
- increased energy
- pressure of speech
- decreased need for sleep
- flight of ideas
- normal social inhibitions are lost
- attention cannot be sustained
- self esteem is inflated
- psychotic symptoms
How is the diagnosis of Bipolar affective disorder made?
following 2 episodes of a mood disorder at least of of which is mania or hypomania (don’t need to have depression)
Bipolar 1 = discrete episodes of..
Bipolar 2 = discrete episodes of…
1 = of mania only OR mania AND depression
2 = of hypomania OR hypomania AND depression
to remember:
1 man
2 HO
What are the 3 brain structures involved in mood disorders?
- Limbic system
- Frontal lobe
- Basal Ganglia
What are the 3 main functions of the limbic system?
- Emotion
- Motivation
- Memory
What is the ventromedial prefrontal cortex thought to be involved in?
the generation of emotions
What is the orbital prefrontal cortex thought to be involve in?
emotional responses (think - eyes crying) - possibly via connection with the amygdala
Malfunction of the basal ganglia are implicated in neurological illnesses such as?
Parkinson’s
Wilson’s
Huntington’s
diseases
What are 3 psychological functions of the basal ganglia?
emotion
cognition
behaviour
What are the two main neurotransmitters for depressive disorders?
Serotonin
Noradrenaline
What does the ‘monoamine hypothesis’ suggest about depressive disorder?
that it is due to abnormality in the availability of these neurotransmitters
serotonin and noradrenaline are monoamines
Where is serotonin produced?
in the brain stem - RAPHE NUCLEI
What is serotonin thought to have roles in?
sleep
impulse control
appetite
mood
NB: serotonin is thought to be low in depression
Where is noradrenaline produced?
in the locus coeruleus (pons)
projects to limbic system and the cortex
What are the functions of noradrenaline in the brain?
mood
suggests a role in behaviour (arousal and attention) - fight or flight response
implication in memory functions
Outline the treatment of depression
biological:
psychological:
social:
biological
- first line = SSRI’s
- other = SNRI, TCAs
- life-threatening or treatment resistant = ECT (electroconvulsive therapy)
psychological
* CBT
social
* help with isolation, social stressors inc. housing and finances
Outline the treatment of mania
biological:
psychological:
social:
biological:
* first line = antipsychotics
* alternative = mood stabiliser
psychological:
* psychoeducation
social:
* treat in place of safety - where risk to self and others is minimal
* consideration of implications of mania e.g. debts (excessive spending)
Outline the treatment of bipolar depression
biological:
psychological:
social:
biological:
* antidepressant but only with mood stabiliser cover such as ECT or lithium
psychological:
* CBT
social:
* help with isolation, social stressors inc. housing and finances
What could you use to try and maintain stability in bipolar disorder?
biological:
psychological:
social:
biological:
* mood stabilisers: lithium, sodium valproate, antipsychotic
psychological:
* psychoeducation
* CBT - to help prevent relapses
social:
* consider effect of illness on employment e.g. shift work,
* family involvement and education
