Transcript Manic episode

MOOD
DISORDERS
CHAPTER 8
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MOOD DISORDER
• Significant disturbance in a person’s emotional state
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DEPRESSIVE DISORDERS
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MAJOR DEPRESSIVE DISORDER
• Acute, but time-limited, periods of depressive
symptoms that are called major depressive
episodes
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TABLE 8.1 - CRITERIA FOR A MAJOR
DEPRESSIVE EPISODE
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MAJOR DEPRESSIVE DISORDER
• Two major categories of major depressive disorder:
• Single episode
• Recurrent
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FIGURE 8.1 - PREVALENCE OF MAJOR
DEPRESSIVE DISORDER IN THE UNITED STATES
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DYSTHYMIC DISORDER
• A mood disorder involving chronic depression
• Less intensity than major depressive disorders
• Chronic, enduring form
• Have symptoms for at least 2 years
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DISORDERS INVOLVING ALTERATIONS
IN MOOD
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BIPOLAR DISORDER
• Manic episodes and very disruptive experiences of
heightened mood, possibly alternating with major
depressive episodes
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CRITERIA FOR A MANIC EPISODE
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Inflated self-esteem or grandiosity
Decreased need for sleep
Pressure to keep talking
Flight of ideas
Distractibility
Increase in goal-directed activity
Excessive involvement in activities that have a high
potential for painful consequences
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BIPOLAR DISORDER
• Manic episode: A period of euphoric mood with
symptoms involving:
• Abnormally heightened levels of thinking, behavior, and
emotionality
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BIPOLAR DISORDER
• Types
• Bipolar I disorder - One or more manic episodes, and
maybe depressive episodes
• Bipolar II disorder - One or more major depressive episodes
and at least one hypomanic episode
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FIGURE 8.2 - RANGE OF MOODS PRESENT IN
PEOPLE WITH BIPOLAR DISORDER
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BIPOLAR DISORDER
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Factors that predict rapid cycling
Earlier onset
Higher depression scores
Higher mania scores
Lower global assessment of functioning
Hypothyroidism
Disturbances in sleep-wake cycles
Antidepressant medications
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CYCLOTHYMIC DISORDER
• Not as intense as bipolar
• Met the criteria for a hypomanic episode
• Chronic condition
• Lasts at least 2 years
• Numerous periods of depressive symptoms
• Never meet the criteria for a major depressive
episode
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THEORIES AND TREATMENT OF MOOD
DISORDERS
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BIOLOGICAL PERSPECTIVES
• First-degree relatives of those with major depression
are two to four times the rates of nonrelatives
• Twin studies
• Altered serotonin functioning
• Brain-derived neurotrophic factor (BDNF)
• Heritability estimated at 60%
• PCLO gene
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BIOLOGICAL PERSPECTIVES
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Antidepressant medication
Treatment for bipolar disorder is lithium carbonate
Pharmacogenetics
Circadian rhythms
Light therapy
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PSYCHOLOGICAL PERSPECTIVES
• Psychodynamic
• Insecure attachment style
• Defensive responses
• Behavioral & cognitive
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Behavioral activation
Role of dysfunctional thoughts as causes
Behavioral contracting combined with self-reinforcement
Pharmacological and psychological interventions
Psychoeducation
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COGNITIVE PERSPECTIVES
• Cognitive triad
• A negative view of:
• Self
• World
• Future
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EXAMPLES OF COGNITIVE
DISTORTIONS
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Overgeneralizing
Selective abstraction
Excessive responsibility
Assuming temporal causality
Making excessive self-references
Catastrophizing
Dichotomous thinking
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PSYCHOLOGICAL PERSPECTIVES
• Interpersonal approaches
• Assessing the magnitude and nature of the individual’s
depression
• Formulating a treatment plan
• Implementation of treatment plan
• Treatment
• Interpersonal and social rhythm therapy
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SOCIOCULTURAL PERSPECTIVE
• Individuals develop depressive disorders in response
to stressful life circumstances
• Exposure to an acute stress
• Exposure to chronic strains
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SUICIDE
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SUICIDE
• Fatal self-inflicted destructive act with explicit or
inferred intent to die
• Suicidal behavior runs from a continuum of thinking
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Ending one’s life
To developing a plan
To nonfatal suicidal behavior
To the actual ending of one’s life
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SUICIDE
• Biopsychosocial perspective
• Biological theories
• Psychological theories
• Sociocultural perspective
• Perspective of positive psychology
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SUICIDE
• Buffering hypothesis of suicidality
• Resilience as separate dimension from risk
• Risk and resilience as bipolar dimensions
• Resilience as a psychological construct
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SUICIDE
• Factors that buffer suicide risk
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Ability to solve problems
High levels of self-esteem
Confidence in one’s problem-solving ability
General feelings of social support and support from family
Secure attachment
Suicide beliefs (not regarding suicide as a personal option)
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BIOPSYCHOSOCIAL PERSPECTIVE
• Disorders involve:
• Disturbances in neurotransmitter functioning
• Cognitive processes
• Sociocultural factors
• Development of evidence-based approaches
allows individuals to:
• Obtain treatment that regulates their moods and lead more
fulfilling lives
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