Chapter 14 15 Part 2 Mental Illness and Treatment Part 2 Mood Disorders What are Mood Disorders Major Depressive Disorder These are disorders such as depression dysthymia bipolar disorder and cyvlothymia This is a very common disorder characterized by persistent sadness lethargy feelings of guilt and worthlessness and in extreme cases suicidal ideation Depression can be extremely debilitating Usually symptoms must last for over two weeks before a diagnosis is made In severe cases people often neglect basic needs and socially withdrawal Depression has several potential causes many or all of which might interact in a specific person s cases Life events social problems locus of control negative cognitions and biological factors Major losses can lead to periods of depression The latest version of the DSM is the first to acknowledge this Pessimism and depression can further set the stage for responses to challenging events that exacerbate the situation Rejection and social isolation are painful Depression leads to senses of guilt loss of self worth and desire for reassurance This can actually lead to social rejection and hostility which can make depression worse There is a tendency for people with depression to hold negative views of themselves the world and the future This seems to be both a symptom and a cause of depression The cognitive component of CBT targets it Depression seems related to serotonin dopamine and norepinephrine levels Drugs targeting these neurotransmitters can help alleviate depressive symptoms Major Depression Depression Causes Life Events Social Disruption Negative Cognitions Biology Dysthymia Dysthymia is mild persistent depression It is not as serious as major depression but it tends to be more chronic than major depression Could be worse Not sure how but it could be Eeyore from pooh bear Bipolar Disorder Manic Episodes Bipolar disorder used to be called manic depression Most of the time people with bipolar disorder are normal or clinically depressed What distinguishes it from depression are what are known as manic episodes At least one manic episode is required for a diagnosis and manic episodes will often periodically recur without treatment Manic episodes consist of elevated mood decreased need for sleep racing thoughts hypersexuality and illusions of grandeur psychosis irresponsible behavior and inflated self esteem Bipolar Disorder tends to be highly heritable Increased sensitivity to dopamine and decreased sensitivity to serotonin may be at the heart of the disorder It is controlled by medication There is a correlation between risk for bipolar disorder and creativity The exact causes of the link are unclear but many famous artists have suffered from forms of the disorder Causes of Bipolar Disorder Bipolar Disorder and Creativity Cyclothymia Suicide This is the mild form of the disorder Mood disorders are the most common cause of suicide although other disorders also increase risk About 30 000 Americans kill themselves every year Women attempt more often and men succeed more often It is crucial to get help once suicidal ideation has begun People who have made attempts even failed ones are much more likely than even other people with depressed moods to try again Personality and Dissociative Disorder Personality Disorders These tend to be controversial and some of the harder to diagnose disorders When stable inflexible and socially personally disruptive personality traits first appear in adolescence and follow someone from there on out they are said to have a personality disorder Borderline Personality Disorder Affects about 2 to 6 of adult population Mostly affects women but it can affect men as well Borderline Personality is marked by a sense of instability in mood and impulse control There is marked fear of abandonment and acting out in response to that fear May be caused by a proclivity to overreact to stress and an inability to regulate emotions Very heritable Psychopathy Psychopaths The formal diagnosis is Antisocial Personality Disorder However psychopathy as a personality trait doesn t require a history of illegal or irresponsible actions where as a diagnosis typically does Likely genetic More common among men psychopathy is associated with lack of guilt They will lie cheat and steal There are usually charming and personable They are more likely to be criminals however never go that far They DO frequently view people as instrumental Dissociative Disorder Depersonalization Derealization Dissociative Amnesia There are disorders marked my disruptions in conscious sense of self or one s perceptions Most people experience feelings of observing themselves from the outside feeling of the world being unreal every so often When it happens repeatedly and chronically it is considered a disorder This happens when there are gaps in memory surrounding traumatic or stressful events This is not the sort of thing where people are unaware that something happened because people are aware there is a memory gap The existence of the disorder is debated EX Waltz with Bashir Dissociative Identity Disorder There is a disorder characterized by multiple personalities Its existence is also hotly debated It seems to be a culture bound disorder that primarily occurs in the west Like hypnosis it may be shaped by patients beliefs Psychotic Disorders Schizophrenia Psychotic Symptoms Often confused with multiple personalities because the root words for schizophrenia mean split mind However it has nothing to do with personality disorders It is the most severe form of psychosis Causes ADHD These tend to be delusions and hallucinations Delusions are false beliefs Hallucinations are sensory experiences of things that don t really exist In schizophrenia these are usually auditory but they can be olfactory or visual Other Symptoms We also see disorganized and nonsensical speech word salad In some cases people have catatonia These are motor issues that sometimes include people holding positions for hours at a time It is also associated with social withdrawal Schizophrenia is highly heritable It is associated with enlarged ventricles enlarged sulci and smaller temporal lobes There seem to be abnormalities in dopamine receptors and oversensitivity to dopamine in some brain regions can cause psychotic symptoms Diathesis stress models suggest that schizophrenia is caused by genetic predispositions and Cause Diathesis stress stressful events Childhood Disorders Autism Spectrum Disorders