Diagnosis of Latiffa bipolar I current episode manic w psychotic features o Want to stabilize her mood and her delusions will go away E g of psychomotor retardation slow thoughts and little movement NOT the same as catatonic video o Symptom of major depression o Woman says she wants relief from her state of depression o Talks about a manic episode she had euphoric offending her friends with all of her o Go from extreme euphoria to deep depression debilitating disorder o Little energy energy o 70 heritability rate o Almost always need medication to get out of depressed state or out of manic episode o Diagnosis bipolar I current episode depressed because she talked about a manic episode Specifying psychotic features in bipolar disorder o Can diagnose people as bipolar I or II o Specify current episode manic depressed hypomanic o Whether or not there are psychotic features e g hearing voices Video on man with bipolar disorder manic I m Brilliant o Describes his manic episodes o Thinks he s brilliant when he s manic o Hearing became acute didn t know if was hallucinating sounds or not o Says he is brutally honest o Thoughts are moving quickly distractibility o After lithium treatment a lot more normal puts thoughts together more clearly o May or may not have psychotic features unclear o Note there is variability between individuals not everyone with bipolar disorder is the o Unipolar depression some normal no mania more stability than people with bipolar Graphs of mood states same disorder o Bipolar some depression some mania little normal What causes mood disorders and how do we treat them o Cognitive situational and biological components o There is a high genetic factor in depression Monozygotic twins are 4x more likely to have depression if one twin has it Changing norepinephrine and serotonin have helped treat depression neurotransmitters play a role Heritability 33 45 for depression o Prefrontal cortex may also play a role right brained people are more likely to be depressed Etiology causation of mood disorders o Diathesis stress model genes are an important determinant but situational and cognitive components have a big effect as well o Twin research Monozygotic concordance 72 for bipolar 72 of people with an identical twin with bipolar also have bipolar and 40 for depression Dizygotic concordance 14 bipolar and 11 for depression proves genetic contribution Seasonal Affective Disorder SADS o In climates with little sunshine some people develop seasonal depression o Unmotivated depressed in late fall winter o In the spring summer they feel alright o When exposed to less sunlight they become depressed o Artificial lights can help think clearer more energized etc increase amount of ultraviolet light Situational factors the bad things that happen in our lives o No one likes being around people who are unhappy so people with depression lose social support which increases their depression o Because of this we encourage depressed people to be involved and find social support Cognitive components depressed critical o The way they process their experience increases their vulnerability of becoming o cognitive triad irrationally harsh views of self their present and their future overly o errors of logic when you make a mistake you tell yourself you are worthless Aaron Beck helplessness theory o People with depression feel helpless about their depression they feel stuck as a worthless person Internal stable and global attributions that are problematic Internal e g you made a mistake on an exam and you tell yourself you are stupid blaming yourself Stable you will always do poorly on exams unchanging over time Global because you did poorly you think you are a stupid person you feel worthless about everything not just this situation o Treatment identifying their harsh thoughts tell them that they wouldn t have the same Some people are more vulnerable to depression especially those who are more pessimistic and reaction to others who make small mistakes right brained Conclusion from diathesis stress analysis o Both genetic and non genetic factors contribute to depression o Stress and MLE major life events can trigger depression Note stressors aren t always bad they are just major life events e g a wedding the birth of a child death of a family member objective hassles like needing to buy food etc o Our thought processes and personalities play a role as well Approaches to psychotherapy o Freud psychoanalysis approach o Humanistic existential approach Carl Rogers not compassionate enough with self Abraham Maslow o Behavioral cognitive behavioral and cognitive approaches Behavioral e g go outside and walk three miles start eating healthy etc changing your behavior Cognitive restructuring thinking o Eclecticism choosing many different ways to treat depression Look at people s needs and do what is most efficient to get people back on track o Psychoanalytic have the client talk they may have realizations about themselves Free association Transference transfer emotions about one person onto someone else e g emotions about mother therapist Positive reinforcement give yourself rewards for good behavior My use a point system motivation to reach goals that will alleviate Dream analysis o Behavioral depression o Cognitive and social Change how you think and reason about things Seligman s ABC model Changing from pessimism to optimism o What is your did you do when you encountered adversity o What are your beliefs thoughts o What did you do when that happened o Adversity beliefs consequences o Learn to argue with yourself about negative thoughts behavior Cognitive processes in depression depression o People with high self efficacy thinking you can change your situation have a low risk of Beck s cognitive triad 3 distortions in rational processing o Negative view of self o Negative view of world o Negative world of future Albert Ellis developed ABC approach o musterbation people have internal sentences that they should watch I must do I should do etc o This leads people into depression and demand too much of themselves E g if you lose your job o Someone with depression will blame themself o People without depression may be happy because they realize their boss was a jerk o Vicious cycle in depression Stressful experience negative explanatory style depressed mood cognitive and behavioral changes more stressful experiences o It s not the event that causes depression it s how you think about it Biological