Module 49
cycle of depressed thinking
1) negative/stressful events interpreted through 2) a pessimistic explanatory style create 3) a hopeless/depressed state that 4) hampers the way the person thinks and acts which in turn fuels 1) negative, stressful experiences like rejection.
how many people worldwide have major depressive disorder?
350 million
in a decade between 1994 and 2003 bipolar diagnoses in Americans under age 20 revealed an astonishing
40 fold increase- from an estimated 20,000 to 800,000
what is the estimated heritability for major depressive disorder?
40%
Bipolar I vs Bipolar II
Bipolar I: All that is required for Dx is 1 Manic Episode (No depresive episode needed). Bipolar II: Requires at least one depressive episode and a Hypomanic Episode
Bipolar cycling
Some people with bipolar disorder cycle between extreme highs and lows of emotion and energy that last for days, weeks, or even months
Disruptive Mood Dysregulation Disorder
a childhood disorder marked by severe recurrent temper outbursts along with a persistent irritable or angry mood
major depressive disorder
a disorder in which a person experiences, in the absence of drugs or another medical condition, two or more weeks with five or more symptoms, at least one of which must be either (1) depressed mood or (2) loss of interest or pleasure
bipolar disorder
a group of disorders in which a person alternates between hopelessness and lethargy of depression and the overexcited state of mania
mania
a hyperactive, wildly optimistic state in which dangerously poor judgement is common
explanatory style
a person's habitual way of explaining events, typically assessed along three dimensions: internal/external, stable/unstable, and global/specific
bipolar diagnosis has risen amongst
adolescents
how many neurotransmitter systems are at work during the periods of brain inactivity and hyperactivity that accompany major depressive disorder and bipolar disorder?
at least two
depression can cause the brain's reward centers to
become less active
staying focused on a problem
can be adpative
if one identical twin is diagnosed with major depressive disorder
chances are 1 in 2 that at some time the other twin will be too
rumination
compulsive fretting; overthinking about our problems and their causes
what altered brain structures have neuroscientists discovered in people with bipolar disorder?
decreased white matter (myelinated axons) and enlarged fluid filled ventricles
behavioral and cognitive changes accompany
depression
excessive alcohol use correlates with depression partly because
depression can increase alcohol use, but mostly because alcohol misuse leads to depression
Mediterranean diet
diet that focuses on fish, veggies, whole grains, and olive oil. those who have this diet have a lower risk of developing heart disease, stroke, late life cognitive decline, and depression
many studies have found __________ brain activity during slowed down depressive states and ____________ brain activity during periods of mania
diminished, more
Relentless, self-focused rumination can
distract us, increase negative emotion, and disrupt daily activities
people in the throes of depression are at high risk for
divorce, job loss, and other stressful life events
globally, women's risk for major depressive disorder is ______________ men's
double
childhood abuse
doubles a person's risk of adult depression
drugs that relieve depression tend to
increase norepinethrine or serotonin supplies by blocking either their reuptake or their chemical breakdown
women experience more situations that
increase their risk for depression (e.g. receiving less pay for equal work, juggling multiple roles, caring for children and elderly family members)
the risk of being diagnosed with major depressive disorder or bipolar disorder ____________if your parent or sibling has it
increases
moving to a new culture also
increases the risk for depression, especially among young people who have not yet formed their identities
genes associated with high creativity ____________ the likelihood of bipolar disorder and risk factors for developing bipolar disorder predict___________ creativity
increases, greater
women are generally more vulnerable to disorders involving
internal states (depression, anxiety, inhibited sexual desire)
how does repetitive exercise reduce depression?
it increases serotonin
depression resembles a sort of psychic hibernation
it slows us down, prompting us, when losing a relationship or blocked from a goal, to conserve energy
self defeating beliefs may arise from
learned helplessness
those who rely on precision and logic such as architects, designers, and journalists suffer from bipolar disorder ___________ often than those who rely on emotional expression and vivid imagery.
less
hypomanic episode
less severe and less disruptive version of a manic episode that is one of the criteria for several mood disorders
many depressed people suffer from
low self esteem, they have intensely negative perceptions about themselves, their situation, and their future
expecting the worst, depressed people
magnify bad experiences and minimize good ones
comparisons can also feed
misery
people genetically disposed to depression
more often experience depressing events
Norepinephrine
neurotransmitter that increases arousal and boosts mood. Is scarce during depression and overabundant during mania
drugs that decrease mania decrease
norepinephrine
mild sadness can help
people process and recall faces more accurately. they also tend to pay more attention to detail, think more critically, and make better decisions
depression is the number one reason
people seek mental health services
compared with generations past, depression
strikes earlier and more often, with the highest rate among older teens and young adults
bipolar disorder is also a predictor of
suicide
if one identical twin has bipolar disorder
the chances of diagnosis in the other twin in 7 in 10- even those raised apart
An enduring recovery from depression is more likely if:
the first episode strikes later in life, there were no previous episodes, the person experiences minimal physical or psychological stress, and there is ample social support
during positive emotions
the left frontal lobe and adjacent reward center become more active
what feeds depressed people's depression?
their self-defeating beliefs and their negative explanatory style
Though bipolar disorder is much less common than major depressive disorder
they are more dysfunctional claiming twice as many lost workdays yearly
depression is often a response
to past and current stress
depression will be chronic for about
twenty percent of people
When we feel down
we think negatively and remember bad experiences
people with biopolar disorder usually bounce from one emotion to the other
week to week
depression is a
whole body disorder
depression is ___________, with _____________ everywhere at _________________
widespread, women, greater
who is at greatest risk for major depressive disorder?
women
what often precedes depression?
work and relationship stresses
Diagnosing Major Depressive Disorder
5 symptoms in 2+ weeks 1. Depressed mood most of the day, nearly every day 2. Little interest or pleasure in almost all activities 3. Significant changes in weight or appetite 4. Sleeping more or less than usual 5. Agitated or decreased level of activity 6. Fatigue or loss of energy 7. Feelings of worthlessness or inappropriate guilt 8. Diminished ability to think or concentrate 9. Recurrent thoughts of death or suicide
In about _____ percent of the cases, people experiencing depression also exhibit signs of another disorder, such as anxiety or substance use.
50
how many people worldwide have bipolar disorder?
60 million
example of a depressed person's explanatory style
After a breakup: Stable: I'll never get over this Global: without my partner, I can't seem to do anything right. Internal: our breakup was all my fault End Result: Depression
Persistent Depressive Disorder (Dysthymia)
Moderate depression that persists for two years or more
Diet, drugs, stress and other environmental influences lay down ________ ________, molecular genetic tags that can turn certain genes on or off
epigenetic marks
biopolar disorder afflicts men and women
equally
therapy often speeds recovery from depression but
even without professional help, most people recover
Men's disorders tend to be more ____ and include ____.
external, alcohol use disorder and disorders related to antisocial conduct and lack of impulse control
major depressive disorder and bipolar disorder runs in
families
linkage analysis
first geneticists find families where the disorder appears across generations, then they compare DNA from affected and unaffected family members, linkage analysis points them to a chromosome neighborhood
Susan Nolen-Hoeksema
found that people (especially women) who ruminate about their depression, by repetitively focusing on their sad feelings, tend to stay depressed longer than those who distract themselves
Why is depression so common among young Westerners?
rise of individualism and decline of commitment to religion and family
women often get ___________ than men do, men often get _________ than women do
sadder, madder
what offers a window into the brain's activity during depressed and manic states?
scanning devices
serotonin is also ___________ during depression
scare or inactive
some people's depression seem to have a
seasonal pattern, returning each winter when anti-depressant prescriptions increase
The pessimistic, overgeneralized, self-blaming attributions that give rise to learned helplessness are called
self-defeating beliefs
Most major depressive episodes
self-terminate
one publicized study of New Zealand young adults found that the recipe for depression combined two necessary ingredients
significant life stress, and a variation of a serotonin controlling gene
about 1 person in 4 diagnosed with depression has been brought down by
significant loss or trauma, such as a loved one's death, a ruptured marriage, a physical assault, or a lost job
During the manic phase of bipolar disorder, individuals are most likely to
sleep less, have fewer sexual inhibitions, their positive emotions will persist abnormally, their speech is loud, flighty, and hard to interrupt, they find advice irritating, thinking fast will feel good but increases poor risk taking
depressed people explain events in terms that are
stable, global, and internal