Abnormal Psych Exam 2 Study Guide Chapter 5 Mood Disorders CASE STUDIES o Cathy Attorney 31 One of the brightest most promising members of her firm Blamed herself on things that were beyond her control Felt lethargic all the time appetite disappeared didn t feel like doing anything anymore classified as a depressive disorder because she experienced at least one episode of major depression and she never had a manic episode o Debbie Manic 21 Energy level was up felt renewed confidence in herself and relationships One day was feeling particularly exhilarated and impulsively quit her job without backup plan sign judgment impaired Trouble sleeping but still bursting with energy Returned to parents home and argued consistently Went to party and had intercourse with 3 men she didn t know Although her speech was coherent it was rapid and pressured Experienced periods of inexplicable and unbounded joy euphoria THERE ARE TWO TYPES OF MOOD DISORDERS o Bipolar disorder o Depressive disorver Major depression is the leading cause of disability worldwide o Accounts for 10 of all disability Affect pattern of observable behaviors associated with subjective feelings o EX facial expression pitch of voice body movements Mood a pervasive and sustained emotional response that can color perception Depression behavioral symptoms can refer to a mood OR to a clinical syndrome a combination of emotional cognitive and People who are manic feel like their thoughts are being sped up Bipolar mood disorders episodes of depression and mania Emotional symptoms o Depressed or dysphoric unpleasant mood o Euphoria periods of inexplicable unbounded joy Somatic symptoms physical symptoms o Loss of sleep and appetite o Loss of interest in pleasurable activities Diagnosis o Bipolar Disorder 2 year period Presence of psychotic features Hallucinations or delusions Given birth in past 4 weeks Depressive disorders o Average age of onset is 32 Cyclothymia Chronic but less severe form of bipolar disorder Cyclo cycle experiences numerous hypomanic and depressive episodes during a Postpartum onset women who become manic or depressed following pregnancy o Length of episodes vary widely must have a minimum duration of 2 weeks To meet this you need two episodes of major depression with no other periods of psychological disturbance Relapse a return of active symptoms o Approximately half of depressive patients recover in 6 months Frequency o People born after WWII seem to be more likely to develop mood disorders than people from previous generations Increased in recent years think social media people become depressed over their lives because they see what may seem like perfect lives portrayed on social media etc Gender differences o Women are 2 3 times more vulnerable to depression than men Women ATTEMPT suicide more than men but men commit suicide more than women Antidepressant medications 4 general categories o Selective Serotonin Reuptake Inhibitors SSRIs Most frequently used few side effects o Tricyclics TCAs o Monoamine Oxidase Inhibitors MOAIs More side effects less effective than the other two o Other Bipolar Disorder Treatment o Lithium for years was the most comment treatment of bipolar o COMBINATION OF THERAPY AND MEDICINE typically most effective o Electroconvulsive Therapy ECT sends shocks into brain Seasonal Mood disorder Suicide o Depression in winter recovery in spring most typical o Highest rate in US is among white males over the age of 50 o Men who have been occupationally successful are more likely to commit suicide especially if that success is threatened o 1 5 people with mood disorders will eventually kill themselves o Deliberate self harm without desire for suicide Cutting burning scratching skin most typical in borderline personality disorder o Suicide in US mility increased dramatically after combats in Iraq Afghanistan Chapter 6 Anxiety Disorders and Obsessive Compulsive Disorder CASE STUDIES o Johanna writer panic attack Vertigo couldn t catch breath calm down Remembering old episodes brought on new ones Could possibly be due to the stress of her new job and moving to NYC o Ed OCD 38 year old lawyer Afraid of axes Avoided writing whenever possible 2 lined letters not touching made him think of an image of a decapitated head and loop letters gave images of suffocation One frightening experience that seemed to trigger the pervasive anxiety was when he smoked pot at age 17 and panic took over Caused him to become preoccupied with a fear of accidentally ingesting any kind of mind altering drug especially LSD Felt compelled to wash his hands repeatedly compulsive cleaning ritual Had temptations to shout obscenities aloud at church Began to think if he might be a pathological killer TREATMENT Psychiatrist gave him clomipramine antidepressant Weekly psychotherapy sessions Exposure session for fear of axes o Amber Skin picker 24 year old grad student Face covered with rough scars Would zone out and without warning would become aware of herself standing in front of a mirror with face bleeding openly FEAR immediate danger whereas ANXIETY events that might happen in the future Panic attack sometimes called a false alarm Anxiety associated with the anticipation of future problems o 18 of adults suffer from at least one type of anxiety disorder on any given year o Excessive worry Symptoms of Anxiety Disorders o Anxious mood is associated with pessimistic thoughts or feelings o Difference in fear and anxiety Fear occurs appropriately in the face of real danger future threats or danger Worriers are preoccupied with self talk A relatively uncontrollable sequence of negative emotional thoughts that are concerned with possible o People who worry excessively usually say their worries are not realistic o Panic Attacks Panic is more intense than anxiety has a SUDDEN onset o Why is a panic attack sometimes called a false alarm Some think of panic as a normal fear response that is triggered at an inappropriate time Cued Panic attacks Unexpected Panic attacks o Expected or occurring only in the presence of a particular stimulus o Appear without warning or expectation as if out of the blue Phobias persistence irrational narrowly defined fears that are associated with a specific object or situation o Fear of Heights acrophobia think acro batics heights o Fear of being in places where escape may be difficult agoraphobia Fear of the marketplace public places Typical situations crowded streets and shops public transportation o Fear
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