Abnormal Psychology Chapter Seven Notes Mood Disorders An Overview pages 215 217 Mood disorders severe alterations in mood for long periods of time Two key moods involved in mood disorders are mania and depression mixed episode cases are also a possibility Types of Mood Disorders o Unipolar depressive disorders person experiences only depressive episodes o Bipolar disorders person experiences both manic and depressive episodes o Major depressive episode person must be markedly depressed for most of every day and for most days for at least two weeks and show three or four other symptoms cognitive behavioral or physical o Manic episode person shows markedly elevated euphoric or expansive mood often interrupted by occasional outbursts of intense irritability or even violence o Hypomanic episode person experiences abnormally elevated expansive or irritable mood for at least four days much less severe than manic The Prevalence of Mood Disorders o Lifetime risk for unipolar disorders is 17 o Rates for unipolar depression are always much higher for women than for me among school children boys are equally likely or slightly more likely to be diagnosed with depression o Lifetime risk for bipolar disorder is 1 rates are gender equal Unipolar Mood Disorders pages 217 223 Depressions That Are Not Mood Disorders o Loss and grieving process four phases of normal response Numbing and disbelief Yearning and searching for the dead person Disorganization and despair that sets in when the person accepts the loss Some reorganization as the person gradually begins to rebuild his or her as permanent life o Postpartum Blues Different from postpartum depression include changeable mood crying easily sadness irritability often liberally intermixed with happy feelings Occur in as many as 50 to 70 of women within 10 days of the birth of their child and usually subside on their own o Dysthymic disorder person must have a persistently depressed mood most of the day for more days than not for at least two years 1 year for children and adolescents mild to moderate intensity and must have at least two of the six additional symptoms when depressed o Often people have periods of normal moods lasting for a few days to a few weeks max of two months o Lifetime prevalence rate of 2 5 to 6 average duration is four to five years o Chronic stress increases severity of symptoms often begins in teen years Dysthymic Disorder Major Depressive Disorder o High degree of overlap between depression and anxiety o When diagnoses of depression are made it is specified as to if it is an initial episode or a recurrent episode o Average duration of untreated depressive episode is six to nine months o Chronic major depressive disorder when symptoms of depressive continue for over two years 10 to 20 of people Most depressive disorders to remit when depressive symptoms stop for at o Difference between recurrence and relapse relapse return of symptoms within least two months a fairly short period of time o 40 to 50 of depressed people will experience a recurrence o 1 to 3 of children meet criteria for some form of unipolar depressive disorder o Anaclitic depression form of depression infants if they are separated for a prolonged period from their attachment figure at least 18 months of age o 15 to 20 of adolescents experience major depression at some point likely to recur in adulthood o Specifiers different patterns of symptoms that sometimes characterize major depressive episodes which may help predict the course and preferred treatments for the condition o Important specifiers Major depressive episode with melancholic features patient either has lost interest or pleasure in almost all activities or does not react to usually pleasurable stimuli or desired events more heritable than other forms of depression Severe major depressive episode with psychotic features when psychotic symptoms characterized by loss of contact with reality and delusions false beliefs or hallucinations false sensory perceptions accompany other symptoms of major depression Mood congruent delusions or hallucinations that are persistent with one s mood Major depressive episode with atypical features pattern of symptoms characterized by mood reactivity person s mood brightens in response to potential positive events more people with this specifier are women Major depressive episode with catatonic features range of psychomotor symptoms from motoric immobility catalepsy a stuporous state to extensive psychomotor activity as well as mutism and rigidity Recurrent major depressive episode with a seasonal pattern individuals who experience recurrent depressive episodes in a seasonal pattern have at least two episodes of depression in the past two years at the same season making full remission during the rest of the year o Double depression major depression coexisting with dysthymia Casual Factors in Unipolar Mood Disorders pages 223 240 Biological Casual Factors o Moderate genetic contribution to the causal patterns of unipolar major depression proven from family and twin studies o Three main neurotransmitters involved in depression norepinephrine dopamine and serotonin low levels of these o Two main hormones involved in depression corticotrophin and cortisol depressed patients often have elevated levels of cortisol because of increased levels of corticotrophin releasing factor leading to increased corticotrophin and increased cortisol Figure 7 2 o Damage to the left anterior prefrontal cortex often leads to depression as well as lowered levels of brain activity in this region o Lowered activity levels in prefrontal cortex hippocampus anterior cingulate cortex and amygdala also linked to depression o Depressed patients enter REM sleep around 60 minutes while normal people enter around 90 minutes and show greater amounts of REM sleep during early cycles o Depressed patients have trouble with circadian rhythms size magnitude of the circadian rhythms is blunted and or various circadian rhythms that are normally well synchronized with each other become desynchronized or uncoupled o Some depressed patients seasonal affective disorder are affected by amounts of sunlight o Hormonal factors account for sex differences in depression Psychological Casual Factors o Different types personality and cognitive diatheses and early adversity diathesis o Freud believed that we unconsciously hold negative feelings toward those we love in part because of their power over us lead to