1Listen to the audio lecture while viewing these slides1Psychology 372Physiological PsychologySteven E. Meier, Ph.D.Mood/Affective Disorders2Psyc 372 – Physiological PsychologyOverview•Mood Disorders• Usually are relat ed to sustained emotional states• Lasts weeks or more• Range of stimuli causing mood variability is more limited• Affective Disorders• Usually relates to immediate or momentary states of emotion• Lasts a short period of time• Are more directly responsive to external stimuli3Psyc 372 – Physiological PsychologyMood Disorders• Generally classified in two groups• Unipolar disorders•Depression•Mania•Bipolar Disorders4Psyc 372 – Physiological PsychologyUnipolar Depression• First described by Hippocrates• Thought depression was caused by an excess of Black Bile• Called Melancholia = Black Bile• First really to propose that a psychological problem was caused by a physiological problem.5Psyc 372 – Physiological PsychologyToday• Is described in approximately 5% of the world population• 8 Million people in the U.S. suffer from the disorder.• Most (70%) have more than one episode•Average onset age = 28• Women are affected 2-3 times more often than men• May be a diagnosis issue• Men may not seek out treatment• Occurs both in young children and the elderly• Most are not diagnosed• Has several major subtypes• Melancholic Depression• Atypical Depression• Dysthymia6Psyc 372 – Physiological PsychologySome Symptoms• Unpleasant mood• Mental Anguish• Inability to experience pleasure• Loss of interest in the world27Psyc 372 – Physiological PsychologyRequires Three of these Symptoms• Disturbed sleep• Loss of Appetite and weight loss• Loss of energy• Decreased sex drive• Restlessness• Psychomotor retardation• Difficu lty in co ncentrating• Indecisiveness• Feelings of worthlessness•Guilt• Pessimistic thoughts• Thoughts of dying or suic ide•Can be others8Psyc 372 – Physiological PsychologyOther Variables• Depression needs to greater than the loss experienced• Time of duration (days vs. weeks)• No recent precipitating event• Death of a family member• Is not pervasive or unrelenting•No health disorder•Thyroid Problems•Others9Psyc 372 – Physiological PsychologyDiagnosis• Should be done by a professional• Many types of tests• Beck Depression Inventory10Psyc 372 – Physiological PsychologySubtypes of Unipolar Depression• Mechancholic Depression•Atypical• Dysthymia11Psyc 372 – Physiological PsychologyMechancholic Depression• Most frequent 40-60%• Has no precipitation event• Often occurs more than once• May lead to motor retardation• Responds well to •ECT• Tricycles•SSRI’s12Psyc 372 – Physiological PsychologyAtypical• Less common than melancholic depression• Symptoms are opposite of melancholic depression• Appears earlier in life• Tends to be chronic• Can cheer up temporarily • Often overeat and sleep more• Depression is worse in the evening• Respond better to MAOIs313Psyc 372 – Physiological PsychologyDysthymia• Is a milder depression• Lasts for at least two years• Symptoms are milder than major depression14Psyc 372 – Physiological PsychologyCauses• Genetic Causes• Concordance rates in Bipolar Depression can reach 80% in monozygotic twins• Suicide rates higher as well• No one specific gene has been identified• Chromosome 18 (198q22-23) appears linked with depression15Psyc 372 – Physiological PsychologyBiogenic Amine Hypothesis• Developed from the Catecholamine Hypothesis• Contends that depression occurs from a reduction of Norepinephrine, Serotonin, or both.16Psyc 372 – Physiological PsychologySupport• MAOIs, Tricycles, and SSRI’s increase the levels of Biogenic Amines and decrease depressive symptoms.• ECT also increases serotonin levels17Psyc 372 – Physiological PsychologyProblem• Tricycles and SSRI’s rapidly block reuptake systems of NE and Serotonin• Recovery from depression is often slow (weeks).• Some patients with depression actually have an increase of serotonin18Psyc 372 – Physiological PsychologyNeuroendocrine Function• Severely depressive individuals also have excessive secretion of Adrenocorticotropic hormone (ACTH) secretion by the pituitary.• Increases levels of cortisol from the adrenal cortex• Follows a circadian rhythm• Many depressive individuals also have a disruption of their circadian rhythms. • Returns to normal levels following recovery from depression419Psyc 372 – Physiological PsychologyConclusion• Not as clear cut as before. May involve multiple systems.• Regardless of cause, have effective treatments.20Psyc 372 – Physiological PsychologyTreatment for Unipolar Depression• Tricyclic Antidepressants (TCA’s) • Monoamine Oxidase Inhibitors• Selective Serotonin Reuptake Inhibitors•ECT21Psyc 372 – Physiological PsychologyTricyclic Antidepressants (TCA’s)• Block the reuptake of Norepinephrine• Block the reuptake of Serotonin• Block postsynaptic Histamine receptors• Block postsynaptic Acetylcholine receptors22Psyc 372 – Physiological PsychologyMany Types• Imipramine (Tofranil)• Desiparmine (Norpramin)• Amitriptyline (Elavil)• Nortriptyline (Pamelor)23Psyc 372 – Physiological PsychologyClinical Limitations• Have slow onset of action• Exert a wide variety of effects on the CSN causing side effects not shared by SSRIs.• Are cardiotoxic and can be potentially fatal 24Psyc 372 – Physiological PsychologyOther Issues• Do not produce euphoria in normal individuals• Are not reinforcing – low abuse potential• Withdrawal is usually no problem.• Have a long half-life• Readily cross the placental barrier525Psyc 372 – Physiological PsychologyMonoamine OxidaseMAO•Are enzymes• Break down NE and Serotonin after vesicular release•Two types• MAO-A (Good MAO) •Found in NE and Serotonin synapses• MAO-B (Bad MAO)•Found in Dopamine Synapses26Psyc 372 – Physiological PsychologyMAO A and B•MAO-A• Blockage is responsible for antidepressant activity•MAO-B• Blockage is responsible for side effects27Psyc 372 – Physiological PsychologyMonoamine Oxidase InhibitorsMAOIs• Have been around since the 1950’s• Have serious side effects (especially with some foods)• Can be as safe as TCAs or SSRIs• Can work in patients who do not respond to other drugs.• Are excellent for