PSYC 410 1st EditionExam # 2 Study GuideDepressive DisordersA) Disruptive Mood Dysregulation DisorderCharacterized by severe recurrent temper outbursts thata. Are out of proportion to the situationb. Are inconsistent with developmental levelc. Occur 3 or more time per week-Mood is persistently angry; occurs predominately in males-Can be a precursor to bipolar disorder in adulthood-Is only diagnosed between the ages of 6 and 18 (is a childhood disorder)B) Major Depressive DisorderSymptoms: five or more must occur during 2 consecutive weeksa. Depressed mood most of the day, almost every dayb. Anhedonia – the inability to experience pleasure from activities that are usually func. Significant weight loss or gaind. Insomnia or hypersomniae. Psychomotor agitation or retardationf. Fatigueg. Feeling worthless or guiltyh. Inability to think, concentrate, or make decisionsi. Recurrent thoughts of death or suicide attempt with or without a plan-Does not include a manic or hypomanic episode-More women attempt suicide, but more men complete suicide since they use more violent/efficient methods.-Vegetative depression – lethargy, over eating, hypersomnia-Agitative depression – psychomotor agitation, weight loss, insomniaC) Persistent Depressive Disorder-A more long-standing problem: consistently depressed mood for at least two years.-Presence of two or more of these symptoms while depressed:a. Poor appetite or overeatingb. Insomnia or hypersomniac. Low energy or fatigued. Low self-esteeme. Poor concentration or difficulty making decisionsf. Feelings of hopelessnessD) Premenstrual Dysphoric Disorder-This disorder can be controversial, since these symptoms are “normal.”-However, the symptoms are more extreme in PMDD.-At least five symptoms must be present before onset of menses, but be absent after menses:a. Affective lability (mood instability)b. Irritability or angerc. Depressed mood, hopelessness, self-depreciationd. Anxiety, tensione. Decreased interest in usual activitiesf. Difficulty concentratingg. Lack of energyh. Change in appetitei. Hypersomnia or insomniaj. Breast tenderness, joint or muscle pain, bloating sensationE) Substance/Medication-Induced Depressive DisorderF) Depressive Disorder due to another medical conditionBipolar Disorders-Bipolar disorders are chronic, meaning they cannot be cured.Manic episode – a distinct period of abnormally and persistently elevated, expansive, or irritablemood and increased goal-directed activity or energy, lasting at least a week-All things in your life that are unrelated seem to be related-Hallucinations can be seenHypomanic episode – same criteria as a manic episode, except only lasting at least 4 days and does NOT cause marked impairment in social or occupational functioningMajor depressive episode – all symptoms included in major depressive disorderSymptoms occurring during manic and hypomanic episodes:a. Inflated self-esteemb. Decreased need for sleepc. Excessive talkingd. Flight of idease. Distractibilityf. Increase in goal-directed activity or psychomotor agitationg. Excessive involvement in activitiesA) Bipolar I Disorder-At least one manic episode has occurred B) Bipolar II Disorder-At least one hypomanic and one major depressive episode have occurred, but there has never been a manic episodeC) Cyclothymic Disorder-A less severe version of Bipolar-Hypomanic symptoms have been present for at least 2 years-Can look the same as agitated depression, but cyclothymia has more delusional thinkingTreatment for Bipolar Disorder1) Lithium2) Anti-convulsants – are safer than lithium, have fewer side effects, are more tolerableSome people don’t want to take medications because it slows them down to normal functioning, and they feel like they are living in a cloud.3) Psychotherapy – more effective in the long-term, but medication is more effective in the short-termBlack Box Warning – antidepressants may increase suicidal thoughtsOn the way back to normal, a person has more energy, but still has low moodDepression and Suicide-Risk factors: hopelessness, isolation, anxiety, agitation-In people with Bipolar I: 15 times greater chance of dying by suicide-1/3 of patients with Bipolar II make suicide attempts-Depression overlaid with hypomania can cause a person to act on suicidal thoughts/plansAnxiety DisordersA) Specific Phobia-Fear or anxiety about one specific object or situation that is out of proportion to the actual danger posed by the object or situation-Fear or anxiety lasts for at least 6 monthsTreatment - systematic desensitization (a slow exposure to phobic object or situation by successive approximations)Selective Mutism – failure to speak in specific social situations, usually in childrenB) Social Anxiety Disorder- Marked fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others (fear of being negatively evaluated)-Fear is out of proportion to situation and lasts at least 6 months-Social situations are avoided or endured with intense fear or anxietyTreatment1) Combat negative thoughts with positive thoughts2) Anxiolytic medication – decreases response of the sympathetic nervous system-Daily exercise is very important for any anxiety disorder.C) Panic Disorder-Recurrent, unexpected panic attacksPanic attack - an abrupt surge of intense fear or discomfort that reaches a peak within minutesPeople who get these are usually already high-strung, up-tight people-Panic attacks are followed by persistent worry about additional panic attacks and/or a significant maladaptive change in behavior related to the panic attacks.-An unhealthy response would be avoiding situations in which panic attack occurs because it causes the anxiety to grow. You must confront your fear to make it subside.D) AgoraphobiaMarked fear or anxiety about two or more of the following five situations:a. Using public transportationb. Being in open spacesc. Being in enclosed spacesd. Standing in line or being in a crowde. Being outside of the home alone-Avoidance of situations which provoke fear-Fear is out of proportion to the situation-Lasts for 6 or more monthsBreathing technique – inhale for 4 counts, hold it for 4 counts, exhale for 4 counts-Cognitively – forces the person to focus on something else-Physiologically – slows heart rateE) Generalized Anxiety Disorder-Excessive anxiety and worry occurring for at least 6 months that is difficult to control-Anxiety is so intense