Chapter 7 - Mood Disorders and Suicide

According to the text, the average length of a major depressive episode if left untreated is:

9 months

Hanna has just been diagnosed with depression. How long will her depressive episodes likely last?

9 months

Electroconvulsive therapy (ECT)

Biological treatment for severe, chronic depression involving the application of electrical impulses through the brain to produce seizures. The reasons for its effectiveness are unknown.

How does the REM sleep of depressed people differ from that of non-depressed people?

Depressed people begin REM sleep earlier than do non-depressed people

Ayana has had some mood disorder problems in the past, although some days she's better than others. Many days it seems like she has fallen into a rut. Although she manages to get by, she has trouble making decisions because she doesn't trust herself.

Dysthymic disorder

Suicidal attempts

Efforts made to kill oneself.

The controversial but somewhat successful treatment involving the production of seizures through electrical current to the brain.

Electroconvulsive therapy

Integrated grief

Grief that evolves from acute grief into a condition in which the individual accepts the finality of a death and adjusts to the loss.

Mood disorders

Group of disorders involving severe and enduring disturbances in emotionality ranging from elation to severe depression.

Neurohormones

Hormones that affect the brain and are increasingly the focus of study in psychopathology

Wendy usually says, "It's all my fault" when anything goes wrong. Which dimension of the depressive attributional style is she reflecting?

Internal

Major depressive episode

Most common and severe experience of depression, including feelings of worthlessness, disturbances in bodily activities such as sleep, loss of interest, and the inability to experience pleasure, persisting at least two weeks.

How long does the average untreated depressive episode last?

Nine months

Psychological Autopsy

Post-mortem psychological profile of a suicide victim constructed from interviews with people who knew the person before death.

Richard, who has not responded well to medication, experiences six or more manic and depressive cycles in a year. He has been diagnosed with bipolar disorder. What is Richard displaying?

Rapid cycling pattern

Ms. Barr experienced the death of a close friend three months ago. She is so depressed that she has no appetite or energy, and she is suicidal. What would most mental health professionals conclude that Ms. Barr is experiencing?

She is experiencing pathological/complicated grief

Isaac has bipolar 1 disorder and does not take medication. He has just started a manic episode. How long will the episode likely last?

2 to 6 months

Premenstrual dysphoric disorder (PMDD)

A disorder of mood whose symptoms include physical symptoms, severe mood swings, and anxiety that cause incapacitation during most menstrual cycles, starting in the final week before the onset of menses, improving within a few days after the onset of menses, and becoming absent in the week post-menses.

What is the MOST common experience of depression?

A major depressive episode

Antidepressant

A medications used to treat depressive disorders, such as tricyclic antidepressants, monoamine oxidase (MAO) inhibitors, and selective serotonin reuptake inhibitors.

Seasonal affective disorder (SAD)

A mood disorder involving a cycling of episodes corresponding to the seasons of the year, typically with depression occurring during the winter.

Major depressive disorder

A mood disorder involving one (single episode) or more (separated by at least two months without depression, recurrent) major depressive episodes.

Persistent depressive disorder (dysthymia)

A mood disorder involving persistently depressed mood, with low self-esteem, withdrawal, pessimism, or despair; present for at least two years, with no absence of symptoms for more than two months.

(Depressive) Cognitive triad

Aaron T. Beck's theory that depression may result from a tendency to think negatively about three areas: oneself, one's immediate world, and one's future.

Depressive cognitive triad

Aaron T. Beck's theory that depression may result from a tendency to think negatively about three areas: oneself, one's immediate world, and one's future.

Bipolar I disorder

Alternation of major depressive episodes with full manic episodes.

Bipolar II disorder

Alternation of major depressive episodes with hypomanic episodes (not full manic episodes).

These come in three main types (tricyclics, MAO inhibitors, and SSRIs) and are often prescribed but have numerous side effects.

Antidepressants

Mack almost always draws conclusions that emphasize the negative rather than the positive. What is Mack exemplifying?

Arbitrary inference

Which of the following puts you at the greatest risk for committing suicide if you are an Inuit in Nunavut? a. being male b. being between 24 and 36 c. being female d. a history of criminal behaviour

Being male

Jason had cyclothymia and was not treated for it. He now has been diagnosed with another, more serious disorder. What disorder is that most likely to be?

Bipolar I

Jerry experienced a manic episode six months ago, which was followed by a major depressive episode. What would he most likely be diagnosed with?

Bipolar I

Last week, as he does about every three months, Ryan went out with his friends, buying rounds of drinks, socializing until early morning, and feeling on top of the world. Today Ryan will not even get out of bed to go to work, see his friends, or even turn on the lights.

Bipolar I disorder

What is the only country that has a higher suicide rate for women than for men?

China

Cyclothymic disorder

Chronic (at least two years) mood disorder characterized by alternating mood elevation and depression levels that are not as severe as manic or major depressive episodes.

This teaches clients to carefully examine their thought process and recognize depressive styles in thinking.

Cognitive therapy

Maintenance treatment

Combination of continued psychosocial treatment or medication designed to prevent relapse following therapy.

Disruptive mood dysregulation disorder

Condition in which a child has chronic negative moods such as anger and irritability without any accompanying mania.

Mixed features

Condition in which the individual experiences both elation and depression or anxiety at the same time. Also known as dysphoric manic episode or mixed manic episode.

Women are more frequently diagnosed with mood and anxiety disorders than are men. What is one proposed explanation for this difference?

Cultural stereotypes encourage women to develop interpersonal styles of dependency and passivity

Disruptive mood dysregulation disorder, both depressive disorders

Definition: Condition in which a child has chronic negative moods such as anger and irritability without any accompanying mania.

Yu is giving a lecture on depression. She emphasizes that"

Depressive symptoms occur in most people at some point in their lives

What must people understand about depression?

Depressive symptoms occur in most people at some point in their lives.

In the "Hillside Strangler" case, what did Kenneth Bianchi claim to be suffering from?

Dissociative identity disorder

Eusebio is always down and a bit blue, but occasionally he becomes so depressed that nothing pleases him.

Double depression

Jack has experienced recurrent episodes of major depressive disorder. IN the intervals between the episodes, he does not seem to return to "normal". In fact, during those periods, he has been diagnosed as dysthymic. What condition does Jack most likely have?

Double depression

Jenny has experienced long-standing feelings of depression. During the past 20 days, she has experienced a depressed mood, feelings of emptiness, and significant weight loss. Jenny confided in a neighbour that she is considering suicide. What is Jenny MOST likely suffering from?

Double depression

Travis suffers from acute major depressive episodes. He does not respond to therapeutic drugs and has been spotted pacing along the bridge near his home. Travis recently gave his therapist a favourite family heirloom. His psychiatrist is concerned about his suicidal ideation. Considering the ineffectiveness of the current treatment and the severity of Travis's symptoms, which treatment should his psychiatrist consider?

Electroconvulsive shock therapy

Which of the following interpersonal issues is NOT dealt with through interpersonal psychotherapy? a. errors in thinking b. role disputes c. adjustment to loss d. social skills deficit correction

Errors in thinking

How many times greater is the rate of mood disorders among First Nations people in Canada compared to the rate in the general population?

Four times greater

Anne has major depression and her friend Gail is experiencing mania. Both are refusing drug treatment. If both Anna and Gail began feeling symptoms on the same day, what can you predict about when the symptoms will end?

Gail's symptoms will go away first

Lyle is 23 years old. His mother died two weeks ago, and since then he has been so upset he has been unable to eat or sleep. He has been crying a great deal. The death was completely unexpected, and Lyle has been alternating between feeling sad, feeling very anxious, and wanting to deny that his mother is dead. What is Lyle experiencing?

Grief

Complicated grief

Grief characterized by debilitating feelings of loss and emotions so painful that a person has trouble resuming a normal life; designated for further study as a disorder by the DSM-5.

Which of the following factors is MOST likely to contribute to postpartum depression? a. having an infant with a difficult temperament b. having been a professional career woman c. history of marijuana use d. family history of depression

Having an infant with a difficult temperament

This therapy focuses on resolving problems in existing relationships and learning to form new interpersonal relationships.

Interpersonal psychotherapy

Jackie has depression and is having a particularly hard time with anhedonia. What does this mean?

Jackie can't experience pleasure

Which of the following people struggles with depression despite having many successes, but is determined to decrease the high rates of suicide among young people in many Canadian Aboriginal communities? a. Sarah McLachlan b. Zindel Segal c. James Bartleman d. Margaret Trudeau

James Bartleman

Hypomanic episode

Less severe and less disruptive version of a manic episode that is one of the criteria for several mood disorders.

Mike has bipolar I disorder. Which of the following medications has most likely been prescribed for him?

Lithium

This antidepressant must be carefully regulated to avoid illness but has the advantage of affecting manic episodes.

Lithium

Last year, Debbie experiences a three-month period of depressed mood, feelings of worthlessness, difficulty concentrating, recurrent thoughts of death, sleep difficulties, and loss of energy. Four weeks ago, she began to experience the same severe symptoms. What is Debbie's most likely diagnosis?

MDD, recurrent

This is an effort to prevent relapse or recurrence over the long run.

Maintenance treatment

For the past few weeks, Jennifer has been sleeping a lot. She feels worthless, can't get up the energy to leave the house, and has lost a lot of weight. Her problem is the most common and extreme mood disorder.

Major depressive episode

Bipolar II disorder is characterized by major depressive episodes alternating with hypomanic episodes, while bipolar I disorder is characterized by alternating episodes of major depression and another symptom. What is the other symptom?

Mania

Feeling certain he would win the lottery, Charles went on an all-night shopping spree, maxing out all his credit cards without a worry. We know he's done this several times, feeling abnormally extreme elation, joy, and euphoria.

Mania

Thirty-five-year-old Rick recently formulated an elaborate plan to cure AIDS with vitamin therapy. To provide funding, he withdrew all his money from his bank and purchased thousands of jars of vitamins and small boxes to put them in. When he appeared at a hospital emergency room loudly demanding names of patients with AIDS, Rick was hospitalized for psychiatric observation. What is Rick most likely experiencing?

Manic episode

Interpersonal psychotherapy

Newer brief treatment approach that emphasizes resolution of interpersonal problems and stressors such as role disputes in marital conflict, or forming relationships in marriage or a new job. It has demonstrated effectiveness for such problems as depression.

What distinguishes bipolar I disorder from bipolar II disorder?

Only bipolar I disorder has episodes of mania

If Sarah has a low level of serotonin in her system, will she show symptoms of depression?

Only if the levels are low compared to other neurotransmitters

A student who has been doing very well in class receives a minor critical comment on an essay she wrote. The student thinks, "This is terrible. I'm probably going to fail the course." What is this type of cognitive error in thinking?

Overgeneralization

Mania

Period of abnormally excessive elation or euphoria, associated with some mood disorders.

Ambrose has just been prescribed selective serotonin reuptake inhibitor (SSRI). Which of the following medications may have been prescribed to Ambrose?

Prozac

Learned helplessness theory of depression

Seligman's theory that people become anxious and depressed when they make an attribution that they have no control over the stress in their lives (whether in reality they do or not).

Suicidal ideation

Serious thoughts about committing suicide.

Double depression

Severe mood disorder typified by major depressive episodes superimposed over a background of dysthymic disorder.

Jane is diagnosed with bipolar II disorder. Which of the following can we expect her to experience? a. She will experience hypomanic episodes alternating with mild depressive symptoms b. She will experience manic episodes and major depressive episodes c. She will experience hypomanic episodes and major depressive episodes d. She will experience hypomanic episodes predominantly

She will experience hypomanic episodes and major depressive episodes

Marieke has Persistent Mood Disorder (dysthymia) while Jackie has major depressive disorder. How will Marieke experiences differ from Jackie?

She will have less severe symptoms of depression

Which herbal treatment has recently gained considerable interest as a treatment for depression?

St. John's worrt (hypercium)

Which herbal treatment has recently gained considerable interest as a treatment for depression?

St. John's wort (Hypericum)

What is the focus of mood disorder prevention research?

Teaching social skills and problem-solving skills to adolescents

It can be difficult to diagnose depression in older adults because the presentation of mood disorders is often complicated by another variable. What is that variable?

The presence of medical illnesses and/or symptoms of dementia

Which was dropped as an exclusion for a diagnosis of depression when the DSM-5 was published?

The recent death of a loved on

What do we call the phenomenon where individuals who are biologically vulnerable to depression have a tendency to place themselves in high-risk, stressful environments?

The reciprocal gene-environment model

Which of the following is a stage of interpersonal therapy? a. the greeting stage b. the test stage c. the resolution stage d. the treatment stage

The treatment stage

How are MAO inhibitors and tricyclic antidepressants similar?

They both result in the pooling of neurotransmitters at the synapse

Cognitive therapy

Treatment approach that involves identifying and altering negative thinking styles related to psychological disorders, such as depression and anxiety, and replacing them with more positive beliefs and attitudes and, ultimately, more adaptive behaviour and coping styles.

What is the rapid-cycling specifier added to the diagnosis of bipolar disorder?

When a patient has had at least four episodes within a year

Although electroconvulsive therapy has been a controversial issue for decades, it is an effective treatment for depression. In which of the following cases is it especially effective?

When a patients response to antidepressant medication is poor

Current reasearch into neurotransmitter systems has produced the "permissive hypothesis." What does this hypothesis state?

When serotonin levels are low, other neurotransmitter systems become dysregulated and contribute to mood irregularities.

Which of the following individuals is showing signs of cyclothymic disorder? a. Abe, who alternates between depression and hypomania every three months. b. Ben, who seems to be either depressed or manic but neither his depression nor his manic meet the clinical criteria for a disorder. c. Claire, who alternates between depression and mania with a month of neutral mood in between. d. Diane, who alternates between manic and hypomanic states at irregular intervals.

b. Ben, who seems to be either depressed or manic but neither his depression nor his manic meet the clinical criteria for a disorder.