Mood Disorders Everyone gets depressed Talking about actually clinically diagnosable depression Depression and mania are considered affective disorders Simple depression without mania is also referred to as unipolar depression This is depression without mania If one has both one is bipolar Before doing any clinical diagnoses one must perform a differential diagnosis ruling out everything else that can cause depression Such as medication bereavement medical conditions etc Depression has been referred to as the common cold of psychology about 10 of individuals have been depressed at least once in their life There is a gender difference Females are more likely to be depressed than males Age of onset varies anywhere from 25 to 44 If depression is untreated it can last anywhere from 6 months to a year one may have a single episode or multiple episodes The average number is about 4 through a lifespan Depression is different from dysthymia Dysthymia is a less severe form of depression It s more chronic but it s not as debilitating Major depressive disorder There is a genetic link for depression Concordance rate for monozygotic twins is about 50 fraternal is 40 No one knows what causes depression There is very likely not a single cause Few cases of depression have been caused by the Borna virus In animals it can cause either psychomotor excitation or retardation In some cases MDD is triggered by hormonal alterations 41 of women in a particular study who were admitted to psychiatric hospital with diagnoses of MDD were admitted on days preceding or during their menstrual cycle Postpartum depression is fairly common 1 in 5 women who have given birth 1 in 1 000 of these women become psychotic These women are typically those who have been diagnosed with depression earlier It s somewhat likely that thyroid hormones are involved Many people who are depressed have minor thyroid hormone issues For a few individuals who have hemisphere dominant issues that can also result in depression As far as theories of depression are concerned one is the cytokine theory The thought there is that immune chemicals may result in depression If you have individuals who are treated for certain medical conditions and have cytokine therapy they commonly become depressed In the cases that a person is depressed because of a medical condition they may be diagnosed with secondary depression not MDD The cytokine theory probably plays a major role in almost every case of secondary depression Another theory is the realistic theory of depression It basically states that depressed individuals aren t really depressed they re simply more realistic They know the world is truly nuts It truly is psychologically and physiologically to our benefit to view the world through rose colored glasses The theory of the day is the brain amine theory of depression This theory argues that low levels of norepinephrine and serotonin are responsible for depression This is our main theory because NE is a catecholamine and serotonin is an indolamine Given that it s no surprise that most antidepressants are agonists to boost levels of neurotransmitters At least 30 of depressed individuals attempt suicide Antidepressants in 4 major categories First is the MAOIs I stands for inhibitor MAO is an enzyme that breaks down NE and serotonin so if one inhibits that one prevents breakdown MAOI is typically the last line of choice Has a particular side effect that s potentially deadly Few foods one can t consume cheese being one contains particular amine that can t be broken down without MAO Blood pressure rises so high as a result of amine not being broken down that one will suffer stroke Second category is the tricyclics These drugs prevent the reuptake of NE and serotonin Lets them remain longer in the synapse to be used Third class are SSRIs Second generation antidepressant meds SSRIs have an effect on serotonin prevents reuptake Depression and anxiety often coexist That will play a role in what kind of meds one may prescribe for a person One of the side effects of SSRIs may produce nervousness so it may not be prescribed for someone with anxiety SS stands for selective serotonin Fourth category is the atypical antidepressants These drugs will act on atypical neurotransmitters like NE and dopamine Many don t act on serotonin at all St John s worts are SSRIs and also affect the effectiveness of other medications such as birth control pill Increase serotonin levels exercise As far as these drugs are concerned the fewer neurotransmitter systems affected the better SSRIs are more popular because they affect fewer neurotransmitter systems They all have side effects Interesting caveat with all these medications is that although the neurochemical changes are pretty immediate one doesn t see behavioral changes in individuals for about 2 weeks Research on why that is the case is confusing at best Very recently there is a lot of controversy relating to the efficacy of these meds at all The 1 reason that clinical trials looking at any depression meds fail is the placebo effect More than 80 of the effects of antidepressant meds are placebo effects These meds work but only for individuals who are incredibly severely depressed which are by far the minority of patients taking these meds Probably best treatment for depression is cognitive psychotherapy It works pretty well Problem is that it takes time and costs money It s as and more effective than drugs and patient is less likely to relapse Another option for certain people with depression is ECT electroconvulsive shock therapy Initially introduced to treat schizophrenia but now it s used almost exclusively for depression Only used for those who are delusional or suicidal ECT effects are much faster see behavioral changes within a week ECT is administered every other day for about two weeks The primary problem with ECT is memory loss Some immediate retrograde and anterograde amnesia These individuals will relapse It is also expensive For some people with depression they have altered circadian rhythms So that their sleep patterns are messed up For those individuals one might try to adjust their sleep patterns Do that over time Mania does not occur alone very rarely does It s an element of a cycle of mood swings called bipolar Bipolar can be either bipolar I or bipolar II Bipolar I contains incidents of full blown mania With bipolar II the individual is hypomanic they re more agitated than manic About 1 of the