Term
Biological theories of depression
-history |
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Definition
Early biological theories of depression included the wandering womb and the idea that women were predisposed to mental illness.
1800s: women beleived to have overaction/excitable nervous systems. Menstruation/reproductive system and the brain compete for blood. Periods deprive the brain of blood leading to cognative impairment. Tx was the "rest cure" which involved isolation and a sedentary life style which we now know are two of the worst things to do.
No one had a clue as to the cause of depression until the 1950s |
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Term
Biological theories of depression
1950s- Resperpin |
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Definition
| Resperpin was a medication prescribed in the 1950s for high blood pressure. It caused severe depression. Lab tests were conducted and found that Resperpine depletes serotonin and norepinephrine in the synapses |
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Term
Biological theories of depression
1950s- Lepronizid |
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Definition
lepronizid used to be used to treat TB in the 1950s. Many patients with depression improved. It was an MAOI and helped break down the serotonin by reducing the affect ability of MAO and having the effect of increasing seratonin levels in the brain
The positive side effect of lepronizid and the negative effect of Resperpin led to new theories about the biological causes of depression |
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Term
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Definition
Monoamine Ozadase Inhibitor.
Monoamine Ozaadase is an enzyme that breaks down serotonin.
MAOIs such as lepronizid inhibit MAO and has the effect of increasing serotonin levels in the brain |
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Term
Biological theories of depression
-Monoamine Hypothesis- |
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Definition
the Monoamine Hypothesis of depression posits that depression is caused by an imbalance of serotonin and norepinephrine neurotransmitters in the synapses.
MAOIs such as prozac, paxil, lepronizis all raise serotonin and norepinephrine levels in the synapses
The frontal lobe has a lot of serotonin and norepinephrine. Both neruotransmitters are heavily involved in sleep, moods and appetite all of which are altered by depression |
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Term
Biological theories of depression
-Neuroendocrine theory- |
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Definition
The neuroendocrine theory of depression posits that chronically elevated CORTISOL levels lead to depression.
chronically elevated cortisol levels can damage and kill nerves in the brain (in extreme cases). On a less extreme level, cortisol levels regulate neurotransmitter function.
50% of people with Major Depressive Disorder (MDD) have elivated cortisol levels.
Theory is that chronic exposure to early life stress affects the development of the hormonal system causing an overly sensitive response throughout life.
Counter evidence: some studies shoe that people who are chronically exposed to stress in childhood HYPO secrete cortisol (under respond)
Hypersensitivity can develop in utero. Cortisol can cross the placents. Diet during pregnancy can help counter cortisol and stress. Most of the research was done on pregnant rats- later in life pups had heightened stress responses |
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Term
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Definition
Primary component of the neuroendocrine theory of depression
Cortisol is a hormone that is secreted from the adrenal gland just above the kidney.
Cortisol regulates blood glucose levels.
Cortisol is a powerful immune suppressor (in a good way usually, it keeps the immune system from over reacting- it brings the reaction down after a necessary immune response )
Under stress, people produce cortisol- this is normal. only problem occurs with overproduction |
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Term
Biological theories of depression
-Immune System Theory- |
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Definition
IL6 Interukin -6 levels are frequently elevated in depressed people. IL6 is a PROINFLAMMATORY CYTOKINE- many depressed people have increased levels of proinflammatory cytokines. Depressed people have increased levels of immune activity which an affect neurotransmitter function and affects reuptake and receptors.
The immune system theory is a variation on the MAOI theory. Just a different way that neurotransmitters are regulated.
TX: eat anti inflamatory foods to lower inflamation, exercise and take in Omega 3 fatty acids.
Studies what people were injected with cytokine IL6 made people report feeling sad and tired immediately after-
rats injected with IL6 exhibited "SICKNESS BEHAVIORS" slowed down, withdrawn, stopped grooming, did poorly at tasks, looked and acted sick |
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Term
| Pro Inflammatory Cytokines |
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Definition
| Proinflamatory cytokines are proteins produced by the immune cells. While some immune cells are designed to destroy, Pro Inflammatory Cytokines are designed to help the immune cells remember and help- they are coordinators and act as communication vehicles coordinating immune response |
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Term
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Definition
| There are tons of serotonin neurotransmitters in the gut- beginning anti depressants can cause GI issues |
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Term
| Role of COGNITION in development of depression |
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Definition
| Aaron Beck 1960's believed that depressed patients made a lot of negative interpretations of events,had a negative outlook and self blaming behaviors. They overgeneralized their failures into universals- COGNITIVE ERRORS lead to or perpetuate depression. |
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Term
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Definition
began theory of cognitive role in development of depression in the 60s
Cognitive Errors- Beck beleived cognitive errors caused people to become depressed and kept depressed people from emerging.
People prone to depression have a negative view of the self, world and events. COGNITIVE SCHEMAS based on prior expereince. When the schemas are negative, they influence the interpretation of events
e.g. someone doesn't say hi- to a depressed person it might feel like a snub (cognitive error), to a non depressed person, they'd think the person just didn't see them
TRIAD- influences and interpretations and perceptions lead to a lot of cognitive errors |
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Term
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Definition
Aaron Beck's theory
All or nothing thinking
e.g. If I don't get an A I'm a failure
Mental Filter- Focus on the negative
e.g. focused on the 5 test questions that were wrong i/o the 95 that were right.
Jumping to conclusions
Self Labeling e.g I'm a loser, I'm a failure- tends to be automatic and subconscious. |
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Term
| Cognitive Therapy for treating depression |
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Definition
| Teach the patients to see their cognitive errors and teach them to stop and dissect such thoughts for accuracy |
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Term
Behavioral Theories for Depression
Peter Lewinson |
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Definition
| 1960s Peter Lewinson believed people became depressed because they didn't have enouhgh positive events in their lives. If you ask them to list the pleasurable activities in their lives, it will be a short list- this lack contributes to depression |
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Term
| Response Contingent Positive Reinforces |
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Definition
Part of Peter Lewinson's theory of behavioral causes for depression (?)
Distinguish between the positive events that just happen and the positive events that the person is responsible for making happen
e.g. A favorite relative randomly drops by vs. the action of calling that fav. relative and inviting them over.
If you initiate your own positive events your positive moods and reactions to them will be stronger.
Tx- teach people reintegrate positive reinforces into their lives and teach skills such as assertiveness to help them bring about change |
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Term
| Cognitive Behavioral Therapy (CBT) |
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Definition
A combined treatment of cognitive and behavioral methods
Start with treating small behaviors rather than cognitions if the person is severely depressed (cognitions take more mental energy)
A combined treatment of medication and CBT works best |
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Term
Bipolar Depression
Unquiet Mind - Ethical Issues |
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Definition
The more advances that are made towards identifying the genetic factors in BPD, the possiblity arises to possibly be able to irradicate the mutation in the future or to develop a medication to correct it early on, or to identify it in utero and leave the option to abort the pregnancy.
One could theoretically wipe out this disorder entirely. Ethical dilemna- would you want to irradicate BPD? What would society be like? SO many creative minds gone: e.g. winston churchill, Linden B. JOhnson, both though to have BPII |
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Term
Bipolar Disorder
Medications |
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Definition
People are constantly going on and off medications regardless of the illness (antibiotics, blood pressure meds etc) To such an extent that we don't even know how well prescriptions even work. Many people start to feel better so stop using them or hate the side effects
In BPD lack of drug adherence is very hard on loved ones. Support groups are found to be important tools to help patients stay on track |
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Term
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Definition
Bipolar I consists of full blown mania and deep depressions (same depressive sx as unipolar major depression)
During depressive episodes, people are frequently misdiagnoses as having unipolar depression
antidepressants can trigger manic episodes which generally leads to the correct diagnosis
Bipolar is a PROGRESSIVE ILLNESS- if left untreated it begins to trigger itself, episodes occur closer together and become more severe
Depression in BPDI is severe and 15% commit suicide |
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Term
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Definition
| Doens't stop all future manic depressive cycles but it makes them less frequent and less intense. |
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Term
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Definition
| People with bipolar disorder who have 4 or more manic/depressive episodes per year |
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Term
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Definition
| Combined mania and depression- major depression coupled with racing depressive thoughts. |
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Term
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Definition
| Bipolar II combines Hypomania (low level mania) with deep depressions |
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Term
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Definition
| Milder dysthymic depressions and hypomanias- the depressions tend to interfere with life more than the hypomanias |
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Term
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Definition
Hypomania is never psychotic, not as intense. The behavior is a watered down version of mania
e.g. full blown mania is talking so fast that you have trouble following, and talking too fast to be able to have a conversation.
vs. hypomania- talking fast but can hold a conversation
e.g. mania- excessive spending to the point of bankrupcy vs hypomania might go on a shopping spree
hypomania involves a change in behavior- more irritable, more energy, more annoying, but not so severe the you know right away- easy to attribute to a personality trait. |
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Term
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Definition
natural soil salt- litium citrate and lithium chloride.
1800s used in medicine to dissolve citric acid in the body. People went to hot springs full of it or drank litho water or litho beer (would need 200,000 gl to get equiv. of 1 pill)
1950s psychiatrist in australia- rural psyc hospital wondered if BPD was caused by toxins in the body so did animal studies, injected urine and lithium into rats, then just injected lithium- the rats became placid and relaxed. Began injecting himself with lithium to test if it was safe then injected it into patients. 10BP patients all improved enough to be released. 6 schizophrenic patients- they became slightly less agitated, 3 majorly depressed patients- showed no change
Study wasn't given much attention but Dr. John Cade wrote up his findings (litium had a bad rap at the time)
Dr. Morgens Shou read the study and started taking lithium and giving it to his family (all BP) then ran a double blind study |
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