10/28/20091Chapter 6Mood DisordersBipolar DisorderClass ObjectivesWhat is Bipolar Disorder?ˉ How does this differ from Unipolar Mood Disorder?How do Mood Disorders develop?How are Mood Disorders treated?What do you know about Bipolar Disorder?How would you describe this disorder to someone?10/28/20092Someone who alternates between depression and mania has “Bipolar disorder”(formerly called Manic-Depressive illness.)This disorder is a roller coaster ride of moodBipolar disorderBipolar disorder, affects approximately 2.3 million adult Americans—about 1.2 percent of the population.ˉ Men and women are equally likely to develop this illness. The disorder typically emerges in adolescence or early adulthood, ˉ but in some cases appears in childhood.A Milder but more chronic version of bipolar is Cyclothymic disorder.The symptoms are not as severe, patients cycle between mild depression and hypomania.10/28/20093Cyclothymic DisorderA person with this disorder tends to be in one state or the other for many years with few periods of neutral mood (Euthymia)ˉ This pattern of mood is chronic lasting at least 2 years.The behavior is not severe enough to require hospitalization but the fluctuations in mood are enough to interfere with functioning.People with Cyclothymic disorder are at an increased risk of developing the more severe bipolar I or II.ˉ Bipolar I:alternation of depression with full manic episodesˉ Bipolar II: alternation of depression with hypomanic episodesWhen does Bipolar emerge?On average, Bipolar disorder develops between the ages of 18-22. ˉ Although childhood cases of bipolar have been documented (Weissman et al., 1991).ˉ It is relatively rare for a person to develop Bipolar disorder after the age of 40.10/28/20094How much do you know about Mood Disorders?True or false?Women are approximately twice as likely as men to be diagnosed with a mood disorder. How much do you know?True or false?Women are approximately twice as likely as men to be diagnosed with a mood disorder. TRUE!How much do you know?True or false?It is often difficult to diagnose depression in the elderly because its symptoms are similar to those of medical problems or dementia.10/28/20095How much do you know?True or false?It is often difficult to diagnose depression in the elderly because its symptoms are similar to those of medical problems or dementia. TRUE!How much do you know?True or false?Depression requires life experiences, which is why young children cannot experience the disorder.How much do you know?True or false?Depression requires life experiences, which is why young children cannot experience the disorder.FALSE!10/28/20096What Causes Mood Disorders?Is it biology?Is it in our genes?The best evidence that genes contribute to mood disorders comes from twin studies:ˉ Where the frequency that identical twins have the disorder is compared.Research suggests that an identical twin is 2-3 times more likely to present with a mood disorder than a fraternal twin if the first twin had a mood disorder (McGuffin, 2003).Strong support for genetic contributionStudies examining bipolar disorder report:ˉ 66.7% of identical twins compared with only 18.9% of fraternal twinsˉ 45.6% versus 20.2% if the first twin had unipolar disorder.If one twin has unipolar disorder the chances of the other twin having bipolardisorder are slim to none.10/28/20097What does this all mean?This research suggests that severe mood disorders may have a stronger genetic contribution than less severe disordersHow much do life events effect mood disorders?Life stressors and events are stronglyrelated to the onset of mood disorders.The Impact of Life StressorsResearch supports the notion that severe events precede all types of depression. Major life stress is a strong predictor for initial episodes of depression (Brown et al, 1994).10/28/20098The context and personal meaning to any event are more important than the actual event itself and there are some events that are particularly likely to lead to depression.-Very common events are a break-up of a relationship or a death of a loved one.These stressful events often become “triggers” for mania and depression.Although almost everyone who becomes depressed has experienced a significant stressful event, most people who experience such events do not become depressed.ˉ Somewhere between 20%-50% of individuals who experience severe events become depressed (Barlow, 2002).Group work!How can the development of a mood disorder be explained? Why don’t all people who experience a life stressor develop depression?10/28/20099Can your PERCEPTION cause depression? People become anxious and depressed when they decide they have no controlover the stress in their lives (Seligman, 1978).Learned HelplessnessThis research has become an important model called the learned helplessness theory of depression.The sense of hopelessness develops and is characterized by the behavior of giving upPerception is keySeligman discovered that a depressed person thought about the bad event in more pessimistic ways than a non-depressed person.‐ People who have experienced depression in the past are more likely to accept depression in their future.- Therefore less likely to attempt change.10/28/200910Seligman’s research on Learned Helplessness has become a major source in understanding and treating depression The concept that thinking influences depression is currently one of the most popular theoriesOvercoming DepressionSeligman suggests that people can overcome depression by learning new explanatory styles.‐ This is the basis of cognitive therapy. In such therapies, the counselor challenges the client's beliefs and explanations of life's events.Treatments for Mood DisordersThere are a variety of treatments for mood disorders that are proven effective.ˉBoth biological and psychological10/28/200911Cognitive Behavioral Therapy(CBT)Aaron Beck also suggested that depression may result from a tendency to interpret everyday events in a negative way.ˉ People with depression make the worst of everything. ˉ These negative thoughts as “cognitive errors”. The “Depressive Triad”According to Beck, people who are depressed make cognitive errors in thinking negatively about:ˉ Themselvesˉ The worldˉ Their futureCognitive Behavioral TherapyReflect on the process, how does the therapist confront the depression?10/28/200912Cognitive Behavioral TherapyTreatment OptionsMedications such as