Exam 2 Chapter 5 Mood Disorders PPT Chapter 8 in book Bipolar disorder o Bipolar 1 o Bipolar 2 diagnosed when the individual has experienced at least one major diagnosed when at least one episode of mania has occurred Most people also experience episodes of depression however it is not required depressive episode and at least one episode of hypomania characterized by swings between elation and depression over at least a 2 year period but with moods not so severe as manic or major depressive episodes o Cyclothymic disorder Major depression individuals who have experienced episodes of depression but not of mania Depression episodes are marked by sadness or loss of pleasure accompanied by symptoms such as feelings of worthlessness guilt withdrawal from others loss of sleep appetite sexual desire lethargy and agitation Dysthymic disorder chronic mood disorder o Individual isn t extremely depressed but is moderately depressed and persists for 2 years o Persistent depressive disorder o Depressive symptoms last at least 2 years but do not meet criteria to be diagnosed with major depressive disorder Cyclothymic disorder chronic mood disorder o Milder chronic form of bipolar disorder o Hypomania and depressive symptoms o Symptoms do not reach full blown mania but people with this disorder and the people that are close to them can notice the ups and downs Pressured speech symptom of mania or hypomania in bipolar disorder Its presence is in combination with several other symptoms and can confirm a diagnosis Beck s Cognitive Behavioral Theory CBT behavior therapy that incorporates theory and research on cognitive processes such as thoughts perceptions judgments self statements and tacit assumptions a blend of both the cognitive and behavioral paradigms o Negative triad o Negative schema negative view of self world future underlying tendency to see the world negatively Ex No one will ever love me I m stupid etc o Negative schema cause cognitive biases tendency to process information in negative ways o People develop depression because their thinking is negative Attributions the explanations a person forms about why a stressor has occurred o 3 key dimensions Internal personal vs external environmental causes Stable permanent vs unstable temporary causes Global relevant to many life domains vs specific limited to one area causes depression Attribution theory cognitive processes explain only one type of depression hopelessness o Symptoms include decreased motivation sadness suicidality decreased energy sleep disturbances etc o Most important trigger of depression is hopelessness Desirable outcomes will not occur Person has no ability to change situation Models of suicide o Psychological disorders Half of suicide attempts are depressed o Neurobiological models Heritability of 48 for suicide attempts Overly reactive HPA system Low levels of serotonin o Social factors Economic recessions Media reports of suicide Social isolation and a lack of social belonging o Psychological models Problem solving deficit Hopelessness Life satisfaction Focus of treatment of depression between CBT vs Interpersonal Psychotherapy o Interpersonal therapy builds on the idea that depression is closely tied to interpersonal problems such as role transitions interpersonal conflicts etc Therapist and patient focus on one or two of the issues with the goal of helping the person identify his or her feelings about these issues make important decisions and make changes to resolve problems related to these issues Typically brief about 16 sessions Techniques include discussing interpersonal problems exploring negative feelings and encouraging their expression problem solving etc Effective in relieving major depressive disorder and that it appears to prevent relapse when treatment is continued after recovery o Cognitive behavioral therapy keeping with Beck s theory that depression is caused by negative schemata and cognitive biases this is aimed at altering maladaptive thought patterns Therapist tries to help the person with depression to change his or her opinions about the self When a person states that he or she is worthless because nothing goes right and everything I try to do ends in a disaster the therapist helps the person look for evidence that contradicts this overgeneralization Behavioral activation treatment inactivity withdrawal and inertia are common symptoms of depression however the function of these behaviors is crucial These behaviors will diminish the already low levels of positive reinforcement associated with depression o Behavioral activation seeks to increase participation in positively reinforcing activities to as to disrupt the spiral of depression withdrawal and avoidance Common treatments for depression o 3 major categories of antidepressant drugs Monoamine oxidase MAO inhibitors Tricyclic antidepressants Selective serotonin reuptake inhibitors SSRIs o Clinical effectiveness of the three drugs is about the same Common medications for bipolar disorder o Medications that reduce manic symptoms are called mood stabilizing medications o Lithium Up to 80 of people with bipolar 1 disorder receive at least some relief with this mood stabilizer Symptoms become milder but people may still experience mild manic and depressive symptoms Potentially serious side effect lithium toxicity o Newer mood stabilizers Anticonvulsants Depakote Antipsychotics Zyprexa Both also have serious side effects Chapter 6 Anxiety Disorders PPT Chapter 5 in book Specific phobia an unwarranted fear and avoidance of a specific object or circumstance for example fear of non poisonous snakes or fear of heights o Disproportionate fear of a particular object or situation o Fear out of proportion to actual threat o High comorbidity of specific phobias Social anxiety disorder causes more life disruption than other phobias o More intense and extensive than shyness Persistent intense fear and avoidance of social situations Fear of negative evaluation or scrutiny Exposure to trigger leads to anxiety about being humiliated or embarrassed socially Onset often adolescence o 33 also diagnosed with Avoidant Personality Disorder Overlap in genetic vulnerability for both disorders However APD is a more severe disorder with earlier onset and more pervasive symptoms o Symptoms persist for at least 6 months Panic disorder characterized by frequent panic attacks that are unrelated to specific situations and by worry about having more panic attacks o Panic
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