Transcript a severe mood disorder characterized by major depressive

Mood Disorders
I. Major Depressive Disorder: a severe mood
disorder characterized by major depressive
episodes in the absence of mania or
hypomania.
Symptoms must persist consistently for at least 2 weeks.
A year a more is rare as this disorder occurs in waves or
recurring episodes.
Genetic factors and the presence of other disorders
increase the likelihood of recurring episodes.
Major depression often occurs with anxiety as depression
and anxiety can impact each other.
Percentage of persons 12 years of age and older reporting difficulty with their work, home, and social
activities by sex and depression severity. Depression affects people in many ways. Most people (55.1% with mild
depression; 79.7% with moderate or severe depression) report difficulties with work, home, or social activities.
A. Why women more than men?
1) Women are more likely than men to seek out
opportunities to discuss their problems with people
than keeping it bottled up inside.
2) Women experience more rapid hormonal changes
than men do (things like menstrual cycles, pregnancy,
childbirth and menopause).
3) Cognitively, women are more likely to ruminate over
problems (sometimes obsessively) than are men.
4) Women are more likely to be subjected to abuse and
sexism.
5) Our culture promotes lower self-esteem among
women relative to men via the media and its messages
about appearance and beauty.
B. People with an increased risk of a Major Depressive
Disorder diagnosis are...
1) Women.
2) People of lower socioeconomic status.
3) People who are separated or divorced.
4) Having close biological relatives who were diagnosed
with depression increases your chances of becoming
depressed.
5) Having adoptive relatives who were depressed also
increases your chances, but not as much.
6) The probability is especially high if your biological
relatives were diagnosed with depression before age 30.
C. Postpartum Depression: persistent and severe mood
changes that occur after childbirth.
It’s often accompanied by disturbances in appetite and sleep,
low self-esteem, and difficulties in maintaining concentration
or attention.
Interestingly, it begins before birth in about 50% of women
who develop it.
Both nature and nurture contribute to its development, such
as genetic predispositions and an abusive home
environment.
D. Postpartum Psychosis: irrational thoughts, hallucinations,
and delusions that can occur after childbirth.
E. Premenstrual Syndrome (PMS): symptoms of physical
discomfort and emotional tension during the one to two weeks
before a menstrual period.
Physical Symptoms…
fatigue, headaches, swelling and tenderness of
breasts, bloating, nausea, cramps
Psychological Symptoms...
irritability, grouchiness, moodiness, acting demanding,
aggressiveness, hostility
About 85% of all women have at least one symptom of PMS.
F. Premenstrual Dysphoric Disorder (PMDD): a disorder
characterized by physical and mood-related symptoms
occurring during the woman’s premenstrual period.
Psychological symptoms manifest one to two weeks before
menstruation and improve within a few days following the
onset of menstruation.
Symptoms are associated with significant emotional distress
or interference with the woman’s ability to function.
Estimates put this disorder around 5% of all women.
G. Seasonal Affective Disorder (SAD): repeatedly become
depressed during a particular season of the year.
1) Light Therapy: the depressed person sits in front of a
bright and safe artificial light for a few hours each day during
the time of the year they typically experience SAD.
II. Persistent Depressive Disorder: a
persistent depressive disorder that is either
chronic major depressive disorder or a chronic
but milder form of depression called Dysthymia.
It often begins in childhood or adolescence and continues
on through adulthood.
About 90% of people with Dysthymia eventually develop
Major Depressive Disorder.
A. Double Depression: those who have a major depressive
episode superimposed on a longer-standing dysthymic disorder.
III. Bipolar Disorder: a psychological disorder
characterized by mood swings between states
of extreme elation and depression.
Affects 1% of the population.
Average age of onset is 20 years old.
Equal prevalence among men and women for Bipolar I
Disorder.
A. Bipolar I Disorder: applies to people who have had at least
one full manic episode at some point in their lives.
1) Typically involves extreme mood swings between
manic episodes and major depression.
2) It is possible for bipolar I disorder to apply to those
who have only experienced mania without ever having a
major depressive episode.
3) Manic Episode: a period of unrealistically heightened
euphoria, extreme restlessness, and excessive activity
characterized by disorganized behavior and impaired
judgment.
B. Bipolar II Disorder: applies to people who have had
hypomanic episodes AND at least one major depressive
episode (without ever having a full-blown manic episode).
1) Hypomanic Episode: episodes that are less severe than
manic episodes and are not accompanied by the social or
occupational problems associated with full-blown mania.
During a hypomanic episode, a person might:
feel unusually charged with energy.
show a heightened level of activity.
have an inflated sense of self-esteem.
be more irritable than usual.
experience little fatigue or need for sleep.
C. Rapid Cycling: experiencing two or more full cycles of
mania and depression within a year without any periods of
normal functioning in between.
D. Creativity with Depression and Mania
1) Flow: the mental state of operation in which the person is
fully immersed in what he or she is doing by a feeling of
energized focus, full involvement, and success in the process
of the activity.
2) The experience of Flow includes…
A loss of the feeling of self-consciousness, attention is
directed outwards towards their activity.
Distorted sense of time, one's subjective experience of time
is altered as people become absorbed in their activity.
A sense of personal control over the situation or activity.
The activity is intrinsically rewarding, so there is an
effortlessness stream of action.
IV. Cyclothymic Disorder: a mood disorder
characterized by a chronic pattern of lesssevere mood swings than are found in bipolar
disorder.
V. Causes of Depressive Disorders
A. Psychodynamic Theories
1) Losing a Child
A parent is rarely prepared for this loss.
Generally feels like a cruel and unnatural shock.
Parents may feel they have failed the child & thus guilty.
If marriage is strong, the loss may draw a couple closer.
If marriage is weak, the loss may tear the couple apart.
2) The Three Stages of Grief Work
a) Shock and disbelief.
b) Preoccupation with the memory of the dead person.
c) Resolution.
3) Patterns of Grieving
a) Commonly Expected Pattern: grief pattern in which the mourner
goes from high to low distress.
b) Chronic Grief: grief pattern in which the mourner remains
distressed for an unusually long time and may impact the mourner’s
long term psychological and physical health.
4) Grief Therapy: treatment to help the bereaved cope with
their loss.
5) Ambiguous Loss: a loss that is not clearly defined or
does not bring closure.
B. Humanistic Theories
Transcendence: to step beyond
Self-Actualization, to achieve
Self-Actualization:
higher states of consciousness,
to strive for and
and a cosmic vision of
to achieve one’s
one’s part in the universe.
Aesthetic: creativity,
fullest potential.
beauty, and a sense of order
Cognitive: thought stimulation
and to contemplate one’s existence
Esteem: to like oneself, to see
oneself as competent, and to be liked by others
Attachment: to belong,
to affiliate with others, love, and to be loved
Safety: protection from danger,
for security, comfort, and freedom from fear
Biological: basics such as hunger and thirst;
require satisfaction before other needs can begin operation
C. Learning Theories
1) Interactional Theory: difficulties in social interactions
may help explain the lack of positive reinforcement.
a) Reciprocal Interaction: our behavior influences how other people
respond to us and how they respond to us influences in turn how we
respond to them.
D. Learned Helplessness (Attribution) Theory:
hopelessness and resignation learned when a person
perceives no control over repeated or bad events.
E. Cognitive Theories
1) Cognitive Triad of Depression: the view that depression
derives from adopting negative views of oneself, the
environment or world at large, and the future.
2) Explanatory Style: a tendency to accept one kind of
explanation for success or failure more than others.
F. Biological Factors
Identical twins show a higher concordance rate for
developing depression than fraternal twins.
Antidepressants, which increase levels in the brain of the
neurotransmitters norepinephrine and serotonin, often help
relieve depression.
Brain-imaging studies show lower metabolic activity in the
prefrontal cortex of clinically depressed people as compared
to healthy controls.
There also appears to be lower metabolic activity in the
limbic system which is involved in regulating mood.
VI. Treating Depression
A. Interpersonal Psychotherapy: the therapist and the client
discuss the issues that are causing depression by focusing on
the client’s current relationships.
B. Electroconvulsive Therapy (ECT): a brief electrical
current is administered to the patient’s head that induces a
convulsion similar to an epileptic seizure (a.k.a. shock
therapy).
VII. Causes of Bipolar Disorders
VIII. Treating Bipolar Disorders
A. Lithium: a naturally occurring chemical that is often used
to treat the manic symptoms of bipolar disorder.
IX. Suicide
About 12% - 15% of U.S. adults report having serious suicidal
thoughts with about 5% actually making an attempt at suicide.
About 60% of people who commit suicide suffer from a mood
disorder.
Suicide attempts are more likely to occur during a major
depressive episode.
A. Suicide in Older Adults
B. Sex and Ethnic Differences
Women are more likely to consider suicide.
Men are four times more likely to successfully commit suicide.
This is at least partially due to the fact that men are more
likely to use guns, while women are more likely to ingest
substances, such as sleeping pills.
C. Why Do People Commit Suicide?
1) Social Contagion: the rapid spread of emotions or
behaviors through a crowd or community.
2) Social Proof: we tend to see an action as more
appropriate or correct when others are doing it.