Mood disorders and suicide

Research on Cognitions and Depression

Depressed people do show higher levels of distorted or dysfunctional thinking than non-depressed controls. People with bipolar disorder tend to show higher levels of dysfunction in thinking than non-patient controls. Dysfunctional attitudes (above a certain threshold) increase vulnerability to depression in the face of negative life events.

Persistent Depressive Disorder

Forms of persistent depressive disorder: Chronic major depressive disorder Chronic but milder form of depression called dysthymia

Cognitive Theories

focus on the ways in which people see themselves and the world around them. Beck's Cognitive Triad of Depression 1.negative view of oneself 2.negative view of the environment 3.negative view of the future

Risk factors in major depression

1.Age:young adults 2.Socioeconomic status: low SES at greater risk 3.Mariral status-separated or divorced people have higher rates of MDD than married or never-married people

Common Features of Depression

1.changes in emotional states 2.changes in motivation 3.changes in functioning and motor behavior 4.cognitive changes

report on suicide

1.eight leading cause of death in Americans 2.suicide because cancer, aids, hivs, 3.more man attempts suicide 4.40-54 more people attempt suicide 5.many people have suicide ideation

Antidepressant drugs

1.tricyclic antidepressants(TCAs) 2.monoamine oxidase (MAO) inhibitors 3.selective serotonin-reuptake inhibitors (SSRI3) 4.serotonin-norephinphrine reuptake inhibitors (SNRIs)

Learned Helplessness (Attributional) Theory

A behavior pattern characterized by passivity and perceptions of lack of control Explanations or attributions for good or bad events can differ on these dimensions: 1.Internal versus external cause Locus of control 2.Stable versus unstable cause Permanent vs. temporary 3.Global versus specific cause Affecting many aspects of one's life vs. just a specific domain

Manic episode

A period of unrealistically heightened euphoria, extreme restlessness, and excessive activity characterized by disorganized behavior and impaired judgment. (other people recognize the sudden shift in mood to be excessive in the light of the person's circumstances)

Bipolar Disorder

A psychological disorder characterized by mood swings between states of extreme elation and depression. The first episode may be either manic or depressive. Manic episodes are generally shorter in duration (weeks to months) and end more abruptly than major depressive episodes.

Major Depressive Disorder

A severe mood disorder characterized by major depressive episodes in the absence of mania or hypomania. Mania - A state of unusual elation, energy, and activity. Hypomania -relative mild than mania

Cognitive distortions

All-or-nothing thinking Overgeneralization Mental filter Disqualifying the positive Jumping to conclusions Magnification and minimization Emotional reasoning "Should" statements Labeling and mislabeling Personalization

Bipolar disorders vary in terms of severity

Bipolar disorder Cyclothymic disorder (cyclothymia)

Treating Depression

Depressive disorders are typically treated with: Psychotherapy psychodynamic therapy cognitive therapy behavior therapy interpersonal psychotherapy (IPT) (lose social support) Biomedical approaches antidepressant medication electroconvulsive therapy (ECT) Sometimes a combination of treatment approaches is used.

Interactional Theory

Difficulties in social interactions may help explain the lack of positive reinforcement. Interactional theory proposes that the adjustment to living with a depressed person can become so stressful that the partner or family member becomes progressively less reinforcing. Based on the concept of reciprocal interaction

Double Depression

Double depression - applies to those who have a major depressive episode superimposed on a longer-standing dysthymic disorder

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

Cognitive Therapy

Focus on distorted thinking (cognitive distortions)(when something bad happens, i should give up) Depressed people typically focus on how they are feeling rather than on the thoughts that may underlie their feeling states. work to identify and change thoughts that may trigger or maintain their depressed moods.

Seasonal Affective Disorder(SAD)

For some people, the changing of the seasons from summer into fall and winter leads to a type of major depression called seasonal affective (mood) disorder (SAD). Not its own diagnostic category in the DSM-5 Is a specifier or subcategory of mood disorder involving major depression

Causal Factors in Bipolar Disorders

Genetic component - concordance rate much higher among MZ twins (43%) than DZ twins (6%). Not purely genetic MZ twin of someone with bipolar disorder does not always develop the disorder Diathesis-stress model

Predicting Suicide

Hopelessness about the future is a key predictor of suicidal thinking and suicide attempts. People who commit suicide tend to signal their intentions, often quite explicitly, such as by telling others about their suicidal thoughts. Most people who commit suicide actually make contact beforehand with a healthcare provider.

Two major types of depressive disorders

Major Depressive Disorder Persistent Depressive Disorder

Gender and Ethnic/Racial Differences

More women attempt suicide, but more men "succeed." 4 male suicides for every female suicide Men tend to choose quicker-acting and more lethal means, such as handguns. Suicides are more common among (non-Hispanic) White Americans and Native Americans than African Americans, Asian Americans, or Hispanic Americans.

Attributions

Negative events: internal, stable, global Positive events: external, unstable, specific

Electroconvulsive therapy

Passing electric current through the brain to trigger seizures (shock therapy) A generally safe and effective treatment for severe depression that does not respond to alternative treatments Controversial

Postpartum Depression

Postpartum depression (PPD) - Persistent and severe mood changes that occur after childbirth Often accompanied by disturbances in appetite and sleep, low self-esteem, and difficulties in maintaining concentration or attention

Premenstrual Dysphoric Disorder(PMDD)

Premenstrual dysphoric disorder (PMDD) a disorder characterized by physical and mood-related symptoms occurring during a woman's premenstrual period Psychological symptoms manifest in the week before menses and improve within a few days following the onset of menses.

Research Evidence

Psychodynamic theorists focus on the role of loss in depression. researchers does show that loss of significant others is often associated with the development of depression Evidence supports the view that a self-focusing style—an inward or self-absorbed focus of attention—is associated with depression, especially in women. (loss someone--need to express the anger)

Psychodynamic Theories

Psychodynamic theory of depression - depression represents anger directed inward rather than against significant others From the psychodynamic viewpoint, bipolar disorder represents shifting dominance of the individual's personality between the ego and superego.

Mood disorders

Psychological disorders characterized by unusually severe or prolonged disturbances of mood. The major forms of mood disorders: depressive disorders bipolar disorders and related disorders

Mood Thermometer

Sever mania-hypomania-normal/balanced mood-mild to moderate depression-severe depression

Genetic Factors

Significant genetic component in determining proneness to mood disorders, including major depression and bipolar disorder. Major depression tends to run in families. Closer genetic relative are more likely to share a disorder. Part of diathesis-stress models of mood disorders

Stress and Depression

Stress plays an important role in determining vulnerability in bipolar disorder and even more strongly in major depression. Source: Loss of loved one Breakup Unemployment(prolonged) Physical illness Economic hardship Pressure at work Exposure to discrimination

Psychological Approaches

Studies of psychological treatments for bipolar disorder are underway. Cognitive-behavioral therapy, interpersonal therapy, and family therapy, may be helpful adjunctive therapies when used along with drug therapy in the treatment of bipolar disorder. Evidence that psychological treatment can improve the level od functioning and adherence to a medication regimen in bipolar patients

Why do people commit suicide?

Suicidal thinking does not necessarily imply loss of touch with reality, deep seated unconscious conflict, or a personality disorder. The risks are greater among people with major depression and bipolar disorder. Suicide is often linked to psychological disorders. Past suicide attempts are an important predictor of future attempts.

Psychodynamic Approaches

Traditional psychoanalysis focuses on understanding ambivalent feelings toward important people (objects) in people's lives they have lost or whose loss was threatened. Work through feelings of anger toward lost objects and turn anger outward instead, people can turn anger outward eg. Through verbal expression of feelings, rather than directing it inward Can take years to uncover and deal with unconscious conflicts. Modern psychoanalytic approaches are more direct, relatively brief, and focus on present as well as past conflicted relationships.

Lithium carbonate

a powdered form of the metallic element lithium, is widely used in treating bipolar disorder. Other mood stabilizers include anticonvulsant drugs such as carbamazepine (Tegretol) and divalproex (Depakote).

Bipolar I Disorder

applies to people who have had at least one full manic episode at some point in their lives extreme mood swings

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)

Learning Theories

emphasize situational factors, such as the loss of positive reinforcement. We perform best when levels of reinforcement reflect our efforts. Changes in the frequency or effectiveness of reinforcement can make life feel unrewarding. Inactivity and social withdrawal reduce opportunities for reinforcement; lack of reinforcement exacerbates withdrawal.

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

Behavioral approaches

focus on developing more effective social or interpersonal skills and increasing their participation in pleasurable or rewarding activities support for behavioral techniques in treating in both adults and adolescents: high remission in severely depressed patines compared to

Theoretical Perspectives on Suicide

inward directed anger that turns murderous (psychodynamic) feelings of alienation (Durkheim) a wish to escape unbearable psychological pain motivated by personal expectancies (social-cognitive) reduced use or availability of serotonin increased risk from mood disorders and parental suicide

lifetime prevalence rates for MDD

moe female

Biochemical Factors and Brain Abnormalities

norepinephrine and serotonin Increase levels of the neurotransmitters norepinephrine and serotonin in the brain often helped relieve depression Brain-imaging studies show lower metabolic activity in the prefrontal cortex of clinically depressed people as compared to healthy controls. Brain abnormalities in people with mood disorders in parts of the brain involved in governing emotions.

Humanistic Theories

people become depressed when they cannot imbue their existence with meaning and make authentic choices that lead to self-fulfillment Focus on the loss of self-esteem resulting from losing significant others or suffering occupational setbacks. Personal identity and self-worth tend to be associated with our social roles as parents, spouses, students, or workers.