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IUB PSY-P 324 - Mood disorders

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Mood DisordersI. 2 DistinctionsA. Depression (unipolar depression) –only one pole, only feel down1. Major Depressive Disorder- FLU (intense symptoms of short duration) can last about 5 months2. Dysthymic Disorder- COLD- less intense, drainage (can last forever) must last up to 2 yearsB. Mania & Depression (Bipolar) to meet criteria you only have to experience a manic episode (episodic) 1. Bipolar Disorder – FLU; episode must last a week2. Cyclothymic Disorder- COLD- over 2 year duration but less intenseII. DepressionA. Major Depressive Episode: Criteria1. Symptoms must be present during the same 2-week period and represent a change from previous functioning 2. at least 1 of the symptoms is either: (ESSAY QUESTION)a. depressed mood SAD and distractedb. loss of interest or pleasure Anhedonia3. 5 or more of the following symptoms:a. depressed mood most of the day, nearly every day(subjective report/observation of others)b. markedly diminished interest or pleasure in all (or almost all) activities most of the day, nearly every day (anhedonia)c. significant weight loss when not dieting or weight gain (change of more than 5% of body weight in month) or decrease or increase in appetite every day (noticeable)d. insomnia(cant fall asleep, or stay asleep[anxiety]) or hypersomnia nearly every day (somatic)e. psychomotor agitation or psychomotor retardation nearlyevery day, observable to others (not just subjective feelings)f. fatigue or loss of energy nearly every dayg. feelings of worthlessness or excessive or inappropriate guilt nearly every dayh. diminished ability to think or concentrate, or indecisiveness nearly every dayi. recurrent thoughts of death (not just fear of dying), recurrentsuicidal ideation, or suicide attempt or specific plan4. Sx cause clinically significant distress or impairment is social,occupational, or other important areas of functioning5. Sx not due to direct effects of substance use or general medical condition6. Sxs not better accounted for by bereavement  death of someone important to the person) (after loss, sx persist for longer than 1 year, with marked impairment)Mary’s depressive portion of bipolar,-no eye contact -fatigue/ loss of energy- diminished interest or pleasure-psychomotor retardation-diminished ability to think- her husband slept with another woman-may be diagnosed with depression with psychosis (because exhibits some symptoms of mania)  look for delusions of grandeur (while Mary is having her depressive episode)- excessive guilt?Manic episode- making eye contact - very happy- chewing bubble gum- beat her husband upB. Major Depressive Disorder1. episodic: symptoms are present for a period of time, then they cleara. episodes tend to recurb. untreated episode may last 5 months or longer2. Never had manic or hypomanic episode3. clinical v. subclinical depression (subclinical  looks like depression however subclinical:- # of symptoms (<5 symptoms)- length of episode (< 2 weeks)Seasonal affective disorder (depression in fall and winter has to do with the level of sunlight) C. Dysthymic Disorder: criteria1. depressed mood for most of the day, for more days than not as indicated either by subjective account or observation of others, for at least 2 years (TEST QUESTION) 2. presence of 2 or more of the following: (don’t need to know for exam)a. poor appetite or overeatingb. insomnia or hypersomniac. low energy or fatigued. low self-esteeme. poor concentration or difficulty making decisionsf. feelings of hopelessness3. during the 2 year period, the person has never been without the Sxs for more than 2 months at a time 4. no major depressive episode during the first 2 years of the disturbance5. never been manic or hypomanic ON TEST: double depression is experiencing dysthymia and MDDD. Features1. Prevalence: 2 times as often in females than malesa. lifetime: 10%-25% female, and 5%-12% maleb. twice as likely in women: why? 1) hormonal: premenstrual/menstral/ postmenstral, pregnancy/menopause2) post partum depression- depression after giving birth Example Of post-pardum psychosis: andrea yates: drown children in bathtub, after marriage - followed strict religion, homeschool, stressful events occur and she develops psychosis, becomes detached from reality, put on antipsychotic drugs and told not to have more children, gets pregnant and goes off drugs, kills all 5 children. By Calling 911, she knew something was wrong so couldn't plead insanity. Insanity Defense: didn't know what you did at the time of the crime3) Cultural: social roles (expressing emotions is okay)4) stressors: interpersonal, demands, lifetime -more likely To live in poverty Women are more likely to ruminate much more likely to lead to depression men tend to distractADDED:Biological: menopause, hormones: menstrual cycle/ pregnancySocial/cultural: societal pressure: appearance and expecationsWomen tend to ruminate more frequentlyWomen seek help more often Men distract themselves2. Coursea. Average age of onset: mid 20’s (more responsibilities, stress)b. Short or long periods of remissionc. > the # of episodes more likely in futureE. Theories 1. Biologicala. Genetic1) Variance = 40%2) > severity > genetic basisb. Neurotransmitters: receptors are less sensitive to:1) Serotonin (mood) SSRI mood, appetite and sleep2) Norepinephrine (emergency) (SNRI) – emergency stress hormone3) Dopamine (pleasure) (wellbutrin) c. Endocrine system: increased stress hormone (cortisol)d. Brain Structures1) Increase Activity in the Amygdala overly sensitive to emotional stimuli 2) Decrease Activity in the Prefrontal Cortex & Hippocampus (CEO of brain)CEO in brain decision-making and concentration/memory2. Psychologicala. Stressful Life Events1) perception of the event—context and the meaning of the event2) related to onset, initial episodes 3) offset by social supporttangible: money, car, groceries, rainboots (material things, or services, emotional support- from friends) perceived support more important than enacted (the actual support) b. Behavioral1) lack of reinforcement (rewards) in your environment 2) depression due to:a) lack of reinforcement in environment1] lack of social skills (close talkers, no eye contact)-lack ability to elicit reward 2] lack of pleasant events3] lack of control b) depressive behavior = reinforcedc. Cognitive1) Learned Helplessness (Seligman)a) dog studies  put dog in cages and shock them (bringsdogs in again and shocks


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IUB PSY-P 324 - Mood disorders

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