PSY-P324 Exam # 3 Study Guide Lectures: 18 - 23Mood DisordersI. 2 Distinctionsa. Depressioni. Major Depressive Disorder: like the flu. Lasts relatively short time,but pretty intense ii. Dysthymic Disorder: like a cold, lasts a long time, but less intense b. Mania and Depressioni. Bipolar Disorder: like the flu,ii. Cyclothymic Disorder: like a cold II. Depressiona. Major Depressive Episode: Criteria i. Symptoms must be present during the same 2-week period and represent a change from previous functioning ii. Need to have a least one symptom1. Depressed mood (sad) and/or loss of interest or pleasureiii. 5 or more of the following symptoms 1. Depressed mood most of the day, nearly every day 2. Diminished interest in interest or pleasure in all or most activities3. Significant weight loss or gain or decrease/increase in appetite4. Insomnia (can’t fall asleep/stay asleep) or hypersomnia (sleep too much) nearly every day 5. Psychomotor Agitation (can’t stop moving) or Retardation (moving slowly) 6. Fatigue or loss of energy7. Feelings of worthlessness or inappropriate guilt 8. Diminished ability to think or concentrate or indecisiveness9. Recurrent thoughts of death, suicidal ideation or attempt iv. Symptoms cause significant distress or impairment in areas of functioningb. Major Depressive Disorder i. Episodic: symptoms are present for some time, then clear. Tend to recur but if untreated, may last 5 months or longer ii. Clinical v. Subclinical Depression1. # of symptoms (less than 5, subclinical)2. length of episode (less than 2 weeks, subclinical) c. Features i. Prevalence: lifetime (10-25% for female, 5-12% for male) 1. Twice as prevalent in women b/c of hormones, culture (women “allowed” to show depression, seek treatment, etc)ii. Course 1. Average onset in mid 20s, short or long periods of remission, higher the number of episodes, higher the change of future episodesd. Theories i. Biological 1. Genetic a. Variance about 40% (approx. 40% of an episode is explained by genetics) b. The greater the severity of the episode, the greater the genetic influence 2. Neurotransmitters a. Receptors are less sensitive toi. Serotonin (mood), norepinephrine (stress), dopamine (pleasure)3. Endocrine System (increased stress hormones (cortisol)) 4. Brain Structure a. Increased activity in amygdala (fear), shared with anxiety)b. Decreased activity in prefrontal cortex (higher level thinking, decision making etc), and hippocampus (memory) ii. Psychological 1. Stressful life events a. Perception of the event (what it means to the person) i. Exam might not be stressful for one person but very stressful for another b. Related to the onset, initial episodec. Offset by social support i. The things that people in your social network do for you1. Tangible support: things or services that people provide ($, rides, food) 2. Emotional support2. Behavioral a. Lack of reinforcement in environment (lack of reward)i. Lack or social skills (can’t elicit reward)ii. Lack of pleasant events iii. Lack of control b. Depression due to: reinforcement c. Cognitive i. Beck’s Theory 1. Irrational, dysfunctional thoughts 2. Cognitive triad: negative thoughts about ourselves, world, future3. Cognitive errorsd. Psychoanalytic: depression = anger toward self iii. Bipolar Disorder 1. Manic Episode Criteriaa. A distinct period of abnormally and persistently elevated mood lasting at least 1 week b. During period of disturbed mood, at least 3 of following symptoms i. Inflated self-esteem or grandiosity ii. Decreased need for sleep iii. More talkative than usual iv. Racing thoughtsv. Distractability vi. Increase in goal-directed activity vii. Excessive involvement in pleasure activities that have high potential for consequences c. Mood disturbance severe enough to cause marked impairment in occupational functioning 2. Hypomanic Episode: a little less than fully manic a. Mood lasts shorter time b. Not as severe e. Categories i. Bipolar 1 Disorder 1. 1 or more manic episodes, often have to have 1 major dep. Episode2. prevalence: 1%3. gender is equal4. onset: 18 years (younger than MDD) a. much more kids diagnosed now bc they were misdiagnosed back in the dayb. kids should not be put on bipolar drugs bc they are really strong and brains are still developing 5. much more recurrent than