- Diagnosis of Latiffa: bipolar I, current episode manic w/psychotic featureso 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  videoo Symptom of major depressiono Woman says she wants relief from her state of depressiono Little energyo Talks about a manic episode she had- euphoric, offending her friends with all of her energyo Go from extreme euphoria to deep depression  debilitating disordero ~70% heritability rateo Almost always need medication to get out of depressed state or out of manic episodeo Diagnosis = bipolar I, current episode depressed (because she talked about a manic episode)- Specifying psychotic features in bipolar disordero Can diagnose people as bipolar I or IIo 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 episodeso Thinks he’s brilliant when he’s manico Hearing became acute, didn’t know if was hallucinating sounds or noto Says he is brutally honesto Thoughts are moving quickly  distractibilityo After lithium treatment: a lot more normal, puts thoughts together more clearlyo May or may not have psychotic features (unclear)o *Note: there is variability between individuals, not everyone with bipolar disorder is the same- Graphs of mood stateso Unipolar: depression, some normal, no mania; more stability than people with bipolar disordero Bipolar: some depression, some mania, little normal- What causes mood disorders and how do we treat them?o Cognitive, situational and biological componentso 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 depressiono Prefrontal cortex may also play a role- right brained people are more likely to be depressed- Etiology/causation of mood disorderso Diathesis-stress model: genes are an important determinant, but situational and cognitive components have a big effect as wello 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 depressiono Unmotivated, depressed in late fall/wintero In the spring/summer they feel alrighto When exposed to less sunlight, they become depressedo Artificial lights can help (think clearer, more energized, etc.)  increase amount of ultraviolet light- Situational factors: the bad things that happen in our liveso No one likes being around people who are unhappy, so people with depression lose social support, which increases their depressiono Because of this we encourage depressed people to be involved and find social support- Cognitive componentso The way they process their experience increases their vulnerability of becoming depressedo  “cognitive triad”: irrationally harsh views of self, their present and their future, overlycriticalo “errors of logic”: when you make a mistake you tell yourself you are worthless- Aaron Beck- helplessness theoryo 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 reaction to others who make small mistakes- Some people are more vulnerable to depression, especially those who are more pessimistic and right-brained- Conclusion from diathesis-stress analysiso Both genetic and non-genetic factors contribute to depressiono 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 psychotherapyo Freud, psychoanalysis approacho Humanistic-existential approach Carl Rogers- not compassionate enough with self Abraham Maslowo Behavioral, cognitive-behavioral, and cognitive approaches Behavioral: e.g. go outside and walk three miles, start eating healthy, etc.  changing your behavior Cognitive: restructuring thinkingo Eclecticism: choosing many different ways to treat depression Look at people’s needs and do what is most efficient to get people back on tracko 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) Dream analysiso Behavioral Positive reinforcement (give yourself rewards for good behavior) My use a point system  motivation to reach goals that will alleviate depressiono 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 depressiono People with high self-efficacy (thinking you can change your situation) have a low risk of depression- Beck’s “cognitive triad”- 3 distortions in rational processingo Negative view of selfo Negative view of worldo Negative world of future- Albert Ellis developed ABC approacho “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 jobo Someone with depression will blame themselfo People without depression may be happy