EXAM 2 Chapter 5 Mood Disorders Mood Disorders two broad types 1 Depressive Symptoms 2 Manic Symptoms Bipolar Disorder Three forms Bipolar I Bipolar II Cyclothymia Mania is the defining feature of each Depressive episode required for bipolar II and NOT bipolar I but almost everyone who has had a manic episode will have a depressive episode Highest hereditability rates 93 Mania The state of intense elation or irritability High norepinephrine and dopamine and low serotonin Manic episodes symptoms last for 1 week or cause hospitalization Cause significant stress Hypomania Hypo under and Hyper above symptoms of mania but less intense Does not involve significant impairment but mania does Bipolar II Symptoms last at least 4 days Clear changes in functioning that are observable to others No impairments No psychotic symptoms Flight of Ideas Subjective impression that thoughts are racing Pressured Speech Unusual talkativeness Cyclothymia Milder chronic form of bipolar disorder Lasts at least 2 years in adults 1 year in children Numerous periods with hypomanic and depressive symptoms Does not meet the criteria for mania or major depressive disorder Symptoms do not clear for more than 2 months at a time Major Depressive Disorder anhedonia 5 or more symptoms has to be in a sad mood or have a lost of interest or pleasure Episodic symptoms tend to dissipate over time Recurrent once depression occurs future episodes are likely avg 4 37 heritable Low levels of norepinephrine dopamine and serotonin Dysthymia Persistent Depressive Disorder Combines two disorders formerly named Dysthymia and MDD Depressed for at least 2 years 1 year for children 2 other symptoms In a 10 yr study 95 of patients with this disorder developed MDD Chronic subtype Neuroticism personality trait Tendency to react with higher levels of negative affect It predicts the onset of depression Hopelessness Theory Lynn Abramson Most important trigger of depression is hopelessness Desirable outcome will not occur Person has no ability to change situation Attribution Theory Martin Seligman Stable and Global attributions can cause hopelessness Behavioral activation therapy BA Depression Increased participation in positively reinforcing activities sot disrupt spiral of depression withdrawal and avoidance When a client tracks feelings of depression Interpersonal Therapy a short term psychodynamic therapy that focuses on current relationships Biological Treatment of Mood Disorders Electroconvulsive Therapy ECT Induce brain seizure and momentary unconsciousness More effective than medications but it is unclear how ECT works Medications for treating mood disorders Lithium Up to 80 receive at least some relief with this mood stabilizer Potentially serious side effect Lithium toxicity Suicide ideation thoughts of killing oneself Suicide attempt behavior intended to kill oneself Suicide death from deliberate self injury Non suicidal self injury behaviors intended to injure oneself without intent to kill oneself Being divorced or widowed elevates suicide risk four or fivefold The suicide rate increases in old age The highest rates of suicide in the United States are for white males over age 50 Men more likely to commit suicide effectively The rates of suicide for adolescents and children in the United States are increasing dramatically CBT Mood Disorders Cognitive Behavioral Therapy Utilizes a directive action oriented approach that teaches a person to explore identify and analyze dysfunctional patterns of thinking and behaving The client learns how to challenge and restructure their thinking and behavior Cognitive vs Interpersonal Therapy Interpersonal Therapy is short term and focuses on relationships with others CBT more self exploratory Habituation Explain that with repeated exposures anxiety gradually decreases Automatic Thoughts Cognitions that stream rapidly through our minds when we are in the midst of a situation or recalling events Schemas Core beliefs that act as a template or underlying rule for assessing information Cognitive Errors These are inaccurate or irrational automatic thoughts All or Nothing Thinking black and white thinking Judgments about oneself personal experiences or other are all good or all bad a total success or a total failure completely perfect or completely flawed Overgeneralization You see a single negative event as a never ending pattern that negative events will keep happening to you Mental Filter A conclusion is drawn after looking at only a small portion of the available information Salient data is ignored in order to confirm the person s biased view of the situation Disqualifying the Positive positive experiences are rejected by insisting they don t count for some reason or another In this way a negative belief can be maintained Jumping to Conclusions A negative interpretation is made even though there are no definite facts to convincingly support this conclusion Magnification Minimization The significance of an attribute event or sensation is exaggerated or minimized Catastrophizing Focus is on the most extreme negative consequences of a given situation Emotional Reasoning What someone feels determines what they think It is assumed that negative emotions reflect what the way things really are Must Should or Never Statements These are inflexible rules for behaviour that are learned or are expectations that one must live up to Personalization Excessive responsibility or blame is taken for negative events Thought Record There are 10 steps to a thought record The first six steps help you understand your negative thinking The next four steps help you develop healthier thinking and incorporate it into your life Chapter 6 Anxiety Anxiety vs Fear Apprehension about a future threat Response to an immediate threat Sympathetic nervous system fight or flight Adaptive Specific Phobias High comorbidity of specific phobias Symptoms persist for at least 6 months Social Anxiety Disorder Causes more life disruption than other phobias More intense and extensive than shyness 33 also diagnosed with Avoidant Personality Disorder Overlap in genetic vulnerability for both disorders Symptoms persist for at least 6 months Panic Disorder You have Panic Attacks Sudden intense episode of apprehension terror feelings of impending doom intense urge to flee and symptoms reach peak intensity within 10 minutes unrelated to specific situations Uncued attacks vs Cued attacks Cued Attacks aren t usually called Panic Disorder more likely
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