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FSU CLP 4143 - Depression

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Exam 2

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1DepressionSymptoms of Depression o Anhedonia: Losing interest in everything In lifeo Change in sleep Some suffer from insomnia Others want to sleep all day o Change in appetite Do not eat  Binge Eat o Psychomotor retardation: They walk more slowly, gesture more slowly, and talk more slowly and quietly. o Lack Energy and feel chronically fatigued o Psychomotor agitation: They feel psychically agitated, cannot sit still, and may move around or fidget aimlessly. o Trouble concentrating and making decisions o Thoughts are filled with themes of : suicide, guilt, hopelessness, and worthlessnesso Lose touch with reality  Experience delusions- beliefs with no basis in reality  Hallucinations- seeing, hearing, or feeling things that are not real Diagnosing Depressive Disorders Two types of unipolar depression:1. Major Depression 2. Dysthymic disorderMajor Depression:o Must experience either depressed mood or loss of interest in usual activities, plus at least four other symptoms of depression, chronically for at least two weeks. People who experience only one depressive episode receive diagnosis of major depression, single episode Two or more episodes sepearted by at least 2 months without symptoms merit the diagnosis of major depression, recurrento Symptoms must be severe enough to interfere with the person’s ability to perform everyday functions Dysthymic disorder- less severe than major depression but more chronic o A person diagnosed with dysthymic disorder must experience depressed mood plus two of the following symptoms for at least 2 years A. Poor appetite or overeating B. Insominia or hypersomnia C. Low energy or fatigue D. Low self-esteem2E. Poor concentration or difficulty making decisions F. Feeling of helplessness o During these two years, the person must never have been without the symptom of depression for longer than a 2-month period.o Double Depression: When individuals with dysthymic disorder also experience episodes of major depression intermittently Major Depression & Dysthymic disorder o Lasting more than two years may fall under the proposed diagnosis chronic depressive disorder o 70% of people diagnosed with either have another psychological disorder at the same time in their lives.  Substance abuse, eating disorders, panic disorders and anxiety disordersSubtypes of depression1. Depression with melancholic features: the physiological symptoms of depression are particularlyprominent 2. Depression with psychotic features: people experience delusions and hallucinations during a major depressive episode 3. Depression with catatonic features: show the strange behaviors collectively known as Catatonic:which can range from a complete lack of movement to excited agitation 4. Depression with atypical features: odd assortment of symptoms 5. Depression with postpartum onset: given to women when the onset of a major depressive episodes occurs within 4 weeks of delivering a child 6. Depression with seasonal pattern: Seasonal affective disorder or SAD- they become depressed when the daylight hours are short but recover when the daylight hours are longa. In order to be diagnosed, the person’s mood changes cannot be a result of psychologicaleventsb. More common in latitudes with fewer daylight in the winter months7. Premenstrual dysphonic disorder: describe women who frequently have significant increase in distress symptoms prior to menstruation Prevalence and Course of Unipolar Depressive Disorders o 16% of Americans experience episodes of major depression o In the U.S, 18-29 yr olds are most likely to have major depressive episodes in the past yearo Depression is low among adults over age 60  The diagnosis is difficulty with older adults  They are less willing to report symptoms because they grow up in a time where depression was less accepting  Depressive symptoms often occur in the context of a serious medical illness, interfering with the diagnosis  Older people are more likely to have mild to severe cognitive impairment, and it is often difficult to distinguish between a depressive disorder and an early stage of a cognitive disorder3 Explanation? Older people learn how to cope and have a psychologically healthier outlook on life. o Less common among children than among adults o 24 percent of youth will experience an episode of major depression before the age of 20 o 75 percent of people who experience a first episode of depression will experience subsequent episodes o People who are depressed lose an average of 27 days of work per year because of their symptoms.o Depression in workers cost employers an estimated $37 billion per year in lost productivity aloneo Most people with depression never seek care  They may lack insurance or the money to pay for care  They expect to get over their symptoms on their own  They believe that the symptoms are simply a phase that will pass with time and won’t affect their lives over the long term. Theories of unipolar depression Biological Theories:1. Genetic factors:o Family history studies find that first-degree relatives of people with unipolar depression are two to three times more likely to also have depression. o There is higher concordance rates for monozygotic twins than dizygotic o Depression that begins early in life appears to have a stronger genetic base than depression that begins in adulthood o Studies suggest that the types of genes responsible for depression may differ in women and men. o Abnormalities on the serotonin transporter gene could lead to dysfunction in the regulation of serotonin  Could affect the stability if individuals’ moods Abnormalities in the STG were at increased risk for depression when they faced negative life events2. Neoutransmiter Theories o The NT that are often implicated in depression are monoamines. Norepinephrine, serotonin and to a lesser extent, dopamineo These NT are found in the limbic system Brain area associated with regulation of sleep, appetite and emotional processeso Abnormalities in the synthesis of serotonin and norepinephrine may contribute to depression o The release process of the pre-synaptic cell (regulated by the serotonin transporter gene) may be abnormal in depression o The receptors for these two NT may be less sensitive than normal people or may malfunction43. Brain abnormalities o Prefrontal cortex: attention, short-term memory, planning and problem solving Many studies show reduced metabolic


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