Term
Mood Disorders
(intro card) |
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Definition
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Term
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Definition
| a low, sad state marked by lack of energy, low self-worth, guilt, or related symptoms |
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Term
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Definition
| - a state or episode of euphoria or frenzied activity in which people may have an exaggerated belief that the world it theirs for the taking |
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Term
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Definition
| - depression without a history of mania |
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Term
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Definition
| disorder marked by alternating or intermixed periods of mania and depression |
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Term
Unipolar Depression
(intro) |
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Definition
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Term
| how common is unipolar depression |
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Definition
-almost 7% in any given year
-5% suffer from mild forms
-around 17% in lifetime
*prevalance rates similar in Canada,England, France, and many other countries
-women are at least twice as likely than men to experience (26% vs 12%)
-about half of people recover within 6 weeks and 90% recover within a year |
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Term
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Definition
| -may vary from person to person but span five areas of functioning: emotional, motivational, behavioral, cognitive, physical |
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Term
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Definition
| -most people feel sad and dejected, lose sense of humor, get little pleasure from anything (or even anhedonia- inability to experience any pleasure at all), some may feel anxiety, anger, or agitation, also crying spells |
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Term
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Definition
-lose desire to pursue usual activities, report lack of drive, initiative, and spontaneity, social withdrawal
-about 6-15% of people who suffer from severe depression commit suicide |
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Term
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Definition
| -less active, less productive, spend more time alone, may lie in bed for several hours, move and speak more slowly |
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Term
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Definition
| -hold extremely negative views of self, blame selves, rarely credit selves, pessimistic, intellectual ability is poor- confused, unable to remember things, easily distracted, unable to solve problems (in lab studies- depressed people do tend to perform more poorly than nondepressed on some tasks of memory, attention, and reasoning) |
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Term
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Definition
| -physical ailments (headaches, indigestion, constipation, dizzy spells, and general pain)- many depressions are misdiagnosed as medical problems at first-, disturbances in sleep and appetite are common- most eat and sleep less but some do so excessively |
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Term
*psych watch*
post-partnum depression |
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Definition
-10-30% of new mothers, 25-50% chance of developing it again with subsequent birth
-hormonal changes may trigger the depression, but also may be genetically predisposed, psychological and sociocultural factors may influence |
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Term
DSM-IV checklist:
major depressive episode |
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Definition
1. The presence of at least five of the following symptoms during the same two-week period: -depressed mood most of the day nearly every day – markedly diminish interest or pleasure in almost all activities most of the day nearly every day – significant weight loss or gain or decrease or increase in appetite nearly every day – insomnia or hypersomnia nearly every day – psychomotor agitation or retardation nearly every day – fatigue or loss of energy nearly every day – feelings of worthlessness or excessive guilt nearly every day – reduced ability to think or concentrate, or indecisiveness nearly every day – recurrent thoughts of death of suicide, a suicide attempt, or a specific plan for committing suicide
2. Significant distress or impairment |
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Term
DSM-IV checklist:
major depressive disorder |
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Definition
1. the presence of a major depressive episode
2. No history or maniac or hypomania episode |
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Term
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Definition
| ...may include psychotic symptoms (loss of contact with reality- delusions- bizarre ideas without foundation or hallucinations- perceptions of things that are not actually present |
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Term
| major depressive disorder |
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Definition
| - severe pattern of depression that is disabling and is not caused by such factors as drugs or general medical condition |
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Term
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Definition
- mood disorder that is similar to but longer-lasting and less disabling than a major depressive disorder
--when dysthymic disorder leads to major depressive disorder it’s called double depression |
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Term
| stress and unipolar depression |
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Definition
-episodes seem to be triggered by stressful events
– research has found that depressed people experience greater number of stressful life events during the month just before the onset of their disorder than do other people during the same period of time
-stressful life events also precede other psychological disorders but depressed people often report more such events than anybody else |
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Term
reactive (exogenous) depression
VS endogenous depression |
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Definition
- follows a clear-cut stressful event
- seems to be a response to internal factors
– but hard to distinguish |
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Term
| table 7-2: Mood Disorders Profile |
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Definition
1 yr prev; f:m; onset age; prev among 1-degree relatives ;% currently seeking treatment
Major Depressive Disoder 7% 2:1 24-29 elevated 32.9%
Dysthymic Disorder 1.5-5% between 3:2 and 2:1 10-25 elevated 36.8%
Bipolar 1 Disorder 1.6% 1:6 15-44 elevated 33.8%
Bipolar 2 Disorder 1% 1:1 15-44 elevated 33.8%
Cyclothymic Disorder .4% 1:1 15-25 elevated unknown |
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Term
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Definition
| *caption: regular exercise can help prevent or reduce feelings of depression as well as other psychological symptoms |
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Term
| The Biological Model of Unipolar Depression |
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Definition
| -genetic, biochemical, brain anatomy and brain circuits ... |
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Term
Genetic factors
(biological model) |
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Definition
| -family pedigree, twin, and molecular biology gene studies suggest some people inherit a predisposition |
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Term
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Definition
- select people with unipolar depression, examine their relatives, and see whether depression also afflicts other members of family – if a predisposition is inherited relatives should have a higher rate of depression
– found that 20% of those relatives are depressed compared with fewer than 10% of general population |
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Term
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Definition
| 46% MZ concordance, 20% DZ concordance |
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Term
| molecular biology gene studies |
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Definition
| -found that genes on chromosomes may be linked to unipolar depression, may have an abnormality on 5-HTT gene (responsible for serotonin activity) |
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Term
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Definition
low activity of serotonin and norepinephrine have been strongly linked to unipolar depression
-endocrine system may also play a role- release hormones: high levels of cortisol (a stress hormone released by adrenal gland), melatonin (Dracula hormone- sleep hormone secreted in the dark)
-depression may be tied more closely to what happens within neurons than to the chemicals that carry the messages |
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Term
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Definition
| light therapy may help compensate for winter’s decrease in sunlight and in turn hold off the winter blues |
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Term
| Brain anatomy and brain circuits |
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Definition
| prefrontal cortex, hippocampus, amygdala, Brodmann Area 25 ... |
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Term
prefrontal cortex
(brain anat and circuits) |
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Definition
| - located within frontal cortex of brain; studies have shown lower activity and blood flow in depressed individuals, but other studies have shown increased activity during depression- so believed that it plays a critical role in depression that has yet to be determined |
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Term
hippocampus
(brain anat and circuits) |
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Definition
| - strong neural connections to prefrontal cortex; produces new neurons throughout adulthood (neurogenesis), studies show decreased genesis during depression, and some imaging studies have shown size reduction |
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Term
amygdala
(brain anat and circuits) |
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Definition
| seems to be involved with expression of negative emotions and memories, activity and blood flow 50% more active in depressed brains |
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Term
Brodmann Area 25
(brain anat and circuits) |
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Definition
| located just under the brain part called cingulated cortex; tends to be smaller in depressed brains, significantly more active in depressed brains |
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Term
| biological treatments for unipolar depression |
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Definition
| -antidepressant drugs, but for those who don’t respond electroconvulsive therapy or brain stimulation ... |
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Term
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Definition
| monoamine oxidase inhibitors and tricyclics and second-generation antidepressants ... |
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Term
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Definition
- antidepressant drug that prevents the action of the enzyme monoamine oxidase
- slows the body’s production of enzyme monoamine oxidase which breaks down norepinephrine (MAO inhibitors stop the destruction which results in a rise in nore. activity
-approximately half of depressed patients helped, but experience a dangerous rise in blood pressure if eat foods containing tyramine (cheeses, bananas, and certain wines) so must stick to rigid diet |
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Term
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Definition
- antidepressant drug such as imipramine that has three rings in its molecular structure
– act on neurotransmitter reuptake mechanisms blocking the reuptake process thus increasing neurotransmitter activity
- 60-65% improve but meds must be taken for at least 10 days before improvements take hold, high relapse rates within the first year of stoppage- so put on maintenance therapy- kept on drugs until depression-symptom free for 5 months |
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Term
selective serotonin reuptake inhibitors
(ADMs)
(tx) |
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Definition
- group of second-generation antidepressant drugs that increase serotonin activity specifically, without affecting other neurotransmitters
-about as effective as tricyclics, but preferred because harder to overdose and don’t pose dietary problems and other side effects, but still have their own side effects… |
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Term
figure 7-2: reuptake and antidepressants
(tx) |
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Definition
after neuron releases neurotransmitters into synaptic space it activates a pumplike reuptake mechanism to recapture excess neurotransmitters
- in depression this reuptake process is too active removing too many NTs before they can bind to a receiving neuron- tricyclic and most second-generation antidepressants block this reuptake process enabling them to bind |
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Term
Electroconvulsive therapy (ECT)
(tx) |
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Definition
| - treatment for depression in which electrodes attached to a person’s head send an electrical current through the brain, causing a convulsion |
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Term
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Definition
-65-140 volts of electricity passed through the brain for .5 sec or less resulting in a brain seizure lasting 25secs-few minutes
-muscle relaxants are given to minimize convulsions as well as anesthetics (barbiturates) to put patients to sleep |
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Term
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Definition
– after 6-12 treatments over 2-4 weeks most patients feel less depressed
-effective in treating unipolar depression- 60-80% of patients improve; particularly effective in severe cases of depression that includes delusions; about 50,000 patients a year are believed to receive ECT
-patients often have difficulty remembering events immediately before and after their treatments and some experience gaps in more distance memory (which can be permanent) |
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Term
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Definition
- vagus nerve stimulation, transcranial magnetic stimulation, deep brain stimulation (for people who don’t respond to anything else)
... |
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Term
vagus nerve stimulation
(brain stim)
(tx) |
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Definition
- we have one vagus nerve on each side of our body that runs from brain stem through neck down to the chest and abdomen (longest nerve in body)
- surgeon implants pulse generator under skin of chest and guides a wire up to neck and attaches to left vagus nerve- electrical signals periodically travel from pulse generator through wire to vagus nerve which delivers electrical signals to brain
- as many as 40% improve significantly |
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Term
transcranial magnetic stimulation
(brain stim)
(tx) |
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Definition
- electromagnetic coil placed on or above head which sends a current to prefrontal cortex
-appears to increase neuron ativity when administered daily for 2-4 weeks- but not yet FDA-approved |
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Term
deep brain stimulation
(brain stim)
(tx) |
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Definition
- drill tiny holes in skull and implant electrodes to Brodmann’a Area 25, electrodes connected to a battery or pacemaker that’s implanted in chest or stomach which sends stream of low-voltage electricity
- 4 of 6 severely depressed patients became almost symptom free within months |
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Term
| Psychological Models of Unipolar Depression |
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Definition
| -most widely accepted are psychodynamic, behavioral, and cognitive models ... |
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Term
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Definition
-noticed how people become depressed after using a loved one (a series of unconscious processes is set in motion and person regresses to oral stage), and Freud extended the model for those who don’t lose a loved one but get depressed-symbolic (imagined) loss …
-less than 10% of all people who experience major losses become depressed… |
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Term
symbolic (imagined) loss
(psychodynamic) |
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Definition
| - according to Freudian theory, the loss of a valued object (ex employment) that is unconsciously interpreted as the loss of a loved one – not widely accepted today, but does influence object relations theorists (emphasize relationships; propose that depression results when people’s relationships leave them feeling unsafe and insecure) |
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Term
| psychodynamic treatments for unipolar depression |
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Definition
-free association, interpret (associations, dreams, displays of resistance and transference), and help review past events and feelings – but is only occasionally helpful…
-patients may be too passive to fully participate, may stop treatment too early when this long-term approach doesn’t bring quick results |
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Term
| those who lost parents as children ... |
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Definition
| those who lost parents as children have increased likelihood of experiencing depression as adults |
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Term
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Definition
| even monkeys get attached to significant figures in life |
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Term
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Definition
-positive rewards dwindle for some people leading them to perform fewer constructive behaviors- although many fill lives with other forms of gratification some do not and so the positive aspects of their lives decrease even more and leads to depression
-studies show that the number of rewards a person receives(especially social rewards) is related to depression: the mood of those who were depressed and received rewards improved; strong relationship between positive life events and feelings of life satisfaction and happiness |
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Term
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Definition
-help increase positive behaviors: adding pleasurable activities to lives, correctly rewarding (or not) other behaviors, social skill training
-techniques work best when at least two are applied together; effective especially for mild depression
-also combined with cognitive… |
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Term
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Definition
| -negative perceptions lead to depression (theory of learned helplessness and theory of negative thinking) ... |
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Term
learned helplessness
(cog) |
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Definition
- perception based on past experiences that one has no control over one’s reinforcements
-thinking 1) no longer have control over reinforcements and 2)they themselves are responsible for this helpless state leads to depression |
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Term
| lab dogs study: even dogs can learn helplessness |
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Definition
| even dogs can learn helplessness (shocking, shuttle box, jumping over barrier…) –many studies of humans and animals show how a participant can learn helplessness |
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Term
attribution-helplessness theory- revised theory
(learned helplessness)
(cog) |
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Definition
-when people view events as beyond their control they ask themselves why: attribute to internal, global, stable causes then may experience depression (as opposed to external, specific, unstable)
-hundreds of studies support attribution theory |
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Term
limitations
(learned helplessness)
(cog) |
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Definition
| research relies on animals- can’t be sure if it directly translates to humans |
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Term
| victims of spouse abuse ... |
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Definition
| victims of spouse abuse often develop feelings of helplessness in turn developing depression, low self-esteem, and self-blame |
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Term
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Definition
-lies at the heart of depression: maladaptive attitudes, cognitive triad, errors in thinking, automatic thoughts combine to produce ...
-research supports negative thinking |
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Term
maladaptive attitudes leads to cognitive triad
(neg thinking)
(cog) |
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Definition
| - three forms of negative thinking that Beck theorizes lead people to feel depression; consists of negative view of one’s experiences, oneself, and the future |
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Term
draw arbitrary inferences
(neg thinking)
(cog) |
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Definition
| - negative conclusions based on little evidence; minimize significance of positive events or magnify the negative ones |
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Term
automatic thoughts
(neg thinking)
(cog) |
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Definition
| -numerous unpleasant thoughts that help to cause or maintain depression, anxiety, or other forms of psychological dysfunction |
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Term
ruminative responses ...
(neg thinking) |
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Definition
| - research shows that those who make ruminative responses (repeatedly dwell on their mood without acting to change it) during unhappy moods are more likely to develop clinical depression |
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Term
cognitive treatment
(intro...) |
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Definition
cognitive-behavioral therapy- follows 4 phases and requires fewer than 20 sessions
-research supports |
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Term
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Definition
| increasing activities and elevating mood: encourage to become more active and confident; prepare detailed schedule of hourly activities for coming week (as you become more active, mood is thought to improve) |
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Term
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Definition
| challenging automatic thoughts: educate about negative automatic thoughts; then test reality behind them and often find their groundless |
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Term
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Definition
| identifying negative thinking and biases: show how illogical thinking processes contribute to automatic thoughts; guide patients to see that many of their interpretations have negative bias and help change that negative interpretation style |
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Term
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Definition
| changing primary attitudes: change maladaptive attitudes |
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Term
| new wave therapists don’t agree with discarding negative cognitions: instead acceptance and commitment therapy (ACT |
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Definition
| - guide patients to recognize and accept their negative cognitions simply as streams of thinking that flow through minds rather than valuable guidelines for behaviors and decisions |
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Term
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Definition
| -depression is greatly influenced by social context: family-social perspective and multicultural perspective ... |
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Term
family-social perspective
(soc-cul) |
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Definition
| -depression linked to unavailability of social support (particularly those who are isolated or without intimacy) |
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Term
family-social treatments: interpersonal psychotherapy and couple therapy
(soc-cul) |
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Definition
| -help change how they deal with close relationships in their lives |
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Term
interpersonal psychotherapy
(fam-soc tx)
(soc-cul) |
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Definition
- treatment for unipolar depression that is based on the belief that clarifying and changing one’s interpersonal problems will help lead to recovery (interpersonal loss, interpersonal role dispute, interpersonal role transition, and interpersonal deficits)
-symptoms disappear in 50-60% of clients |
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Term
interpersonal loss:
(interpersonal psychotherapy) |
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Definition
| -loss of a loved one-remember lost person in different ways and seek new relationships |
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Term
interpersonal role dispute:
(interpersonal psychotherapy) |
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Definition
| when two people have different explanations of their relationship and of the role each should play- develop ways of resolving |
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Term
interpersonal role transition:
(interpersonal psychotherapy) |
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Definition
| brought about by major life changes- help develop social supports and skills |
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Term
interpersonal deficits:
(interpersonal psychotherapy) |
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Definition
| personality characteristics that prevent them from having intimate relationships (shyness, social awkwardness)- recognize deficits and teach social skills and assertiveness |
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Term
couple therapy
(fam-soc tx)
(soc-cul) |
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Definition
- therapy format in which the therapist works with two people who share a long-term relationship
-about half of depressed clients may be in a dysfunctional relationship, recovery is slower for people don’t receive support from their spouse
-behavioral marital therapy- teach specific communication and problem-solving skills – pretty effective |
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Term
multicultural perspective
(soc-cul) |
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Definition
| – gender and cultural and ethnic background ... |
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Term
-gender: women at least twice as likely to develop depression because…
(mulitcul) |
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Definition
| -artifact theory, hormone explanation, life stress theory, body dissatisfaction explanation, lack-of-control theory, rumination theory ... |
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Term
artifact theory
(gender)
(multicul) |
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Definition
- women and men equally prone to depression but clinicians often fail to diagnose in men (women display more obvious signs? –while men mask behind anger)
–no research support |
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Term
hormone explanation
(gender)
(multicul) |
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Definition
- hormone changes trigger depression in many women (especially around puberty, pregnancy, menopause)
- research says hormones alone aren’t responsible |
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Term
life stress theory
(gender)
(multicul) |
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Definition
| - women experience more stress than men (poverty, menial jobs, less adequate housing, more discrimination) |
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Term
body dissatisfaction explanation
(gender)
(multicul) |
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Definition
| - females pressured to be slender (depression gender differences do indeed first appear in adolescence) |
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Term
lack-of-control theory
(gender)
(multicul) |
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Definition
| - women feel less control over their lives than men, learned helplessness (victimization rates higher) |
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Term
rumination theory
(gender)
(multicul) |
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Definition
| - women more likely than men to ruminate during down moods |
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Term
cultural background and depression
(multicul) |
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Definition
-depression is a world-wide phenomenon (common core symptoms of sadness, joylessness, anxiety, tension, lack of energy, loss of interest, loss of ability to concentrate, ideas of insufficiency, thoughts of suicide)
- but different side symptoms (nonWestern cultures more likely to have physical symptoms while Western cultures more cognitive symptoms)
-few differences in depression of different ethnic or racial groups and no difference in overall rates between minority groups, but sometimes differences when looking at specific ethnic populations living under special circumstances- degree rose with degree poverty, family size, and number of health problems |
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Term
| Saint-John’s-wort (shrub) ... |
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Definition
| Saint-John’s-wort (shrub) plant that is proven to be helpful with mild depression |
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Term
| -figure 7-5 what do people do to improve their mood? |
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Definition
-talk to friends/family: f 63% m 51%
-listen to music: 55% 52%
-pray/meditate: 51% 38%
-help others in need 45% 39%
-take a bath or shower 47% 35%
-play with a pet 38% 30%
-exercis/workout 24% 30%
-go out with friends 29% 27%
-eat 24% 25%
-take a drive in a car 20% 21%
-have sex 18% 25% |
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Term
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Definition
| -those with bipolar disorder experience depression and mania (emotional rollercoaster) |
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Term
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Definition
-dramatic and inappropriate rises in mood
-span same 5 areas of functioning- emotional, motivational, behavioral, cognitive, and physical ... |
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Term
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Definition
| - mania is usually out-of-proportionally joyful; but can also be angry/irritable |
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Term
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Definition
| - want constant excitement, involvement, companionship- little awareness that their social style is overwhelming, domineering, excessive |
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Term
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Definition
| - very active; often flamboyant |
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Term
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Definition
| - poor judgement and planning (feel too good/move too fast to consider consequences); poor listening when filled with optimism; big egos (self-esteem can approach grandiosity); trouble staying in touch with reality |
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Term
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Definition
| - energetic; little sleep and act wide awake and despite missing a lot of sleep their energy is still high |
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Term
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Definition
| - energetic; little sleep and act wide awake and despite missing a lot of sleep their energy is still high |
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Term
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Definition
| -considered to be in full manic episode when display abnormally high/irritable mood for at least one week accompanied with at least 3 other symptoms (may even include delusions or hallucinations); when symptoms less severe (causing little impairment) called hypomanic episode |
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Term
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Definition
- type of bipolar disorder marked by full manic and major depressive episodes
– most experience alternation of episodes (weeks of mania followed by period of wellness, then followed by depression episode; but some have mixed episodes- swinging from manic to depressive episodes in same day) |
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Term
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Definition
| - type of bipolar disorder marked by mildly manic (hypomanic) episodes and major depressive episodes |
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Term
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Definition
-between 1-2.6% of all adults suffer from bipolar disorder at any time; equally common F:M; onset usually 15-44 years; if untreated mood swings subside but recur at a later time
-mood episodes recur without treatment, and in most cases depressive episodes outnumber manic |
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Term
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Definition
-1- period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least one week
-2-persistence of at least three of the following: inflated self-esteem or gradiosity, decreased need for sleep, more talkativeness than usual or pressure to keep talking, flight of ideas or the experience that thoughts are racing, distractibility, increase in activity or psychomotor agitation, excessive involvement in pleasurable activities that have a high potential for painful consequences
-3- significant distress or impairment |
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Term
| DSM-IV: bipolar 1 disorder |
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Definition
-1- presence of a manic, hypomanic, or major depressive episode
-2- if currently in a hypomanic or major depressive episode, history of a manic episode
-3- significant distress or impairment |
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Term
| DSM-IV: bipolar 2 disorder |
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Definition
-1- presence of a hypomanic or major depressive episode
-2- if currently in a major depressive episode, history of a hypomanic episode; if currently in a hypomanic episode, history of a major depressive episode; no history of manic episode
-3- significant distress or impairment |
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Term
| What causes bipolar disorder: biological |
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Definition
| -neurotransmitter activity, ion activity, brain structure, genetic factor ... |
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Term
neurotransmitters
(bio causes) |
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Definition
| -over-activity of norepinephrine during mania; low serotonin during mania and depression |
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Term
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Definition
| -neurons firing too easily may lead to mania, or too stubbornly may lead to depression- found neuron defects in those diagnosed with bipolar |
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Term
brain structure
(bio causes) |
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Definition
-abnormal brain structures- basal ganglia and cerebellum tend to be smaller (but not sure if cause or effect)
*caption- higher brain activity during mania, lower during depression |
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Term
genetic factors
(bio causes) |
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Definition
-people inherit biological predisposition- family pedigree studies support; MZ 40% and DZ, siblings, other close relatives 5-10% compared to 1-2.6% in general population
-genetic linkage studies- take families with high rates of disorder and see if it follows a pattern of inheritance; molecular biology- found linkages on various chromosomes
-genetics probably combine to help develop bipolar |
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Term
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Definition
| Lithium and Other Mood Stabilizers ... |
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Term
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Definition
| - a metallic element that occurs in natural as a mineral salt and is an effective treatment for bipolar disorders |
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Term
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Definition
now used more widely because produce fewer side effects or possibly even more effective
( carbamazepine or valproate) |
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Term
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Definition
more than 60% improve and most experience fewer new episodes as long as stay on meds- relapse 28 times greater if stop meds; clients usually on some kind of mood stabilizing drug even after manic episodes subside (for depressive episodes)
-combination of mood stabilizer and antidepressive drugs to treat bipolar; continued doses of mood stabilizers apparently reduce risk of future episodes (manic and depressive) |
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Term
mood stabilizing drugs
(tx) |
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Definition
- change synaptic activity within receiving neurons
- second messengers- chemical changes within a neuron just after the neuron receives a neurotransmitter message and just before it responds (antidepressants affect neurons initial reception) |
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Term
| lithium and mood stabilizers also ... |
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Definition
| -lithium and mood stabilizers also increase the production of neuroprotective proteins (key proteins within certain neurons that prevent cell death) |
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Term
Adjunctive Psychotherapy
(tx) |
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Definition
-psychotherapy rarely effective for bipolar but mood stabilizers not always sufficient; 30% or more may not respond to drugs/receive improper dosage/may relapse and many stop taking meds; so use individual/group/family therapy as an adjunct to meds and emphasize importance of staying on drugs and help solve social problems caused by bipolar
-reduces hospitalization improves social functioning, increases patients ability to obtain and hold a job |
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