Mood Disorders

Bipolar I Disorder

Full manic and major depressive episodes Most sufferers experience an alternation of episodes Some experience mixed episodes

biological treatment: Selective serotonin reuptake inhibitors (SSRIs)

) (Prozac, Zoloft, and Paxil) elevate levels of serotonin by preventing its reuptake

biological treatment: Electroconvulsive Therapy (ECT)

used for severely depressed patients who do not respond to drugs. The patient is anesthetized and given a muscle relaxant. Patients usually get a 100 volt shock that relieves them of depression

Cyclothymic Disorder

A chronic pattern of less-severe mood swings: hypomania and mild depression. May blossom into bipolar I or II disorder

Hypomanic Episode

A less severe version of a manic episode that does not cause marked impairment in social or occupational functioning

Cog treatment: Stress Inoculation Training

A type of self-instructional training focused on altering self-statements an individual routinely makes in stress producing situations. EX: "Relax, the exam may be hard, but it will be hard for everyone else too. I studied harder than most people. Besides, I don't need a perfect score to get a good grade."

mood etiology: sociocultural

Dysfunctional family systems, poverty, high-crime neighborhoods, domestic violence, and other stressful situations Women have a higher chance than men of developing a mood disorder

mood etiology: cognitive

Feelings and behaviors are primarily a function of thoughts. Ruminating response style, self-defeating thoughts, external locus of control, learned helplessness, and pessimistic views of: themselves, the world, the future. RET CBT Aaron Beck stress inoculation

mood etiology: biological

Genetic; runs in families Low serotonin may "open the door" to a mood disorder and permit norepinephrine activity to define the particular form the disorder will take: Low serotonin + Low norepinephrine = Depression Low serotonin + High norepinephrine = Mania. Ions, which are needed to send incoming messages to nerve endings, may be improperly transported through the cells of individuals with bipolar disorder this improper transport may cause neurons to fire too easily (mania) or to resist firing (depression) PET scans show that brain energy consumption rises and falls with manic and depressive episodes. Malfunctions in the body's circadian clock, specifically for SAD.

Bipolar II Disorder

Hypomanic episodes and major depressive episodes

mood etiology: psychodynamic

Link between depression and grief: when a loved one dies, the mourner regresses to the oral stage

Mood disorder

Mood disorders are disturbances of emotions that are severe or prolonged enough to cause impairment of functioning. These conditions are magnifications of our normal reactions. The magnified states in mood disorders are mania and depression. Mania - a period of abnormally high emotion and activity Depression - a period of extreme sadness and helplessness Emotional extremes, which come in two principal forms. Unipolar disorders - experience emotional extremes at just one end of the mood continuum Major depressive disorder Dysthymic disorder Seasonal Affective disorder Bipolar disorders - experience emotional extremes at both ends of the mood continuum - depression and mania

suicide facts

People who are deeply depressed rarely kill themselves until after the depression starts to lift. Ironically, this lifting of depression gives the person the energy to execute a plan developed when depression was so overwhelming that it effectively stopped action. There is a strong link between drug and alcohol use and suicide. The risk of suicide is 100 times greater among alcoholics Suicide rates increase with age. In the U.S., the highest rate of suicide is among the elderly (especially elderly men). Suicide attempts are often help-seeking gestures, not failed efforts to die. Most people who actually commit suicide made no prior attempts In most parts of the world, men are more likely than women to commit suicide. Women, however, are at least twice as likely to attempt suicide. Men succeed more often because their weapon of choice is firearms, which are more lethal than the drug overdoses preferred by women

Seasonal affective disorder

Symptoms Depression on a recurring basis in one season of the year when it gets dark early and light late in the day Treatment Light Therapy - exposure to bright light for a specific length of time The level of light produced must match that of visible light outdoors shortly after sunrise or before sunset

dysthymic disorder

Symptoms Mild but chronic; lies between a blue mood and major depressive disorder Characterized by daily depression lasting two years or more; longer lasting but less disabling When dysthymic disorder leads to major depressive disorder, the sequence is called "double depression"

Major depressive disorder

Symptoms Signs of depression last two weeks or more and are not caused by drugs or medical conditions Signs include: Lethargy and fatigue (takes tremendous effort to get up and get dressed); feelings of worthlessness (tearfulness and weeping; exaggerate minor failings, discount positive events, interpret things that go wrong as evidence that nothing will ever go right); loss of interest in family & friends; recurrent thoughts of death/suicide; loss of interest in activities; depressed most of the day; significant weight gain/loss; insomnia; psychomotor agitation/retardation; concentration difficulties or indecisiveness

Cog treatment: Rational Emotive therapy (RET)

This was developed in the 1950s by Albert Ellis He believed that irrational thoughts lead to negative emotions and that controlling and changing such thoughts is the key to better mental health First, the patient identifies unrealistic and self-defeating thoughts. Then, the therapist uses suggestions, logic, and encouragement to help the client replace such thoughts with more realistic and beneficial ones. depression caused by irrational beliefs that cause us to expect too much of ourselves and lead to feelings of worthlessness . Therapist directly challenges the patient and persuade them to adopt more realistic beliefs. Before RET: "I lost my job because I'm worthless. I'm awful at everything I do and I'll never be successful." After RET: "I lost my job because they had to make budget cuts as a result of the bad economy. I was a hard worker and I did my best. Employers will recognize my efforts and I will find a new job - probably even a better one than the one I lost."

Manic Episode

Three or more symptoms of mania lasting one week or more. During Mania, a person may go long periods without sleeping, experience changeable, racing thoughts, be easily distracted, and set impossible goals.

biological treatment: lithium carbonate

a common salt, has been used to stabilize manic episodes in bipolar disorders. It moderates the levels of norepinephrine and glutamate neurotransmitters

biological treatment: Transcranial Magnetic Stimulation (TMS

a pulsating magnetic coil is placed over prefrontal regions of the brain to treat depression with minimal side effects

Cog treatment: Cognitive Behavioral therapy (CBT)

another insight therapy, combines cognitive therapy (changing self-defeating thoughts) with behavior therapy (changing inappropriate behaviors). With this therapy, people become aware of their irrationally negative thoughts, and are taught to practice a better everyday approach by changing those thoughts and letting the new thoughts guide their behavior. Combine the reversal of self-defeated thinking with efforts to modify behavior. Aims to alter the way people act (behavior therapy) and alter the way they think (cognitive therapy) Patients are also given behavioral "homework assignments" that focus on changing overt behaviors. Before CBT: "I'm no good around the house." Changing thoughts: "I may not be able to do everything, but I can still help out around the house in a worthwhile way." "Homework" assignment from therapist: Tasks such as cleaning out the basement, getting advice on hanging a picture, or cutting the grass. After CBT: Success at accomplishing even one of the homework tasks provides concrete evidence to challenge a false belief, thus helping to reduce it.

Biological treatment: Monoamine Oxidase (MAO) inhibitors

elevate levels of norepinephrine and serotonin by blocking or inhibiting the enzyme that deactivates these NT

biological treatment: Serotonin-norepinephrine inhibitors (SNRIs)

elevate levels of norepinephrine and serotonin by blocking the reuptake of these NT

Bipolar disorder

formerly called manic-depressive disorder An alternation between depression and mania signals bipolar disorder. Depressive symptoms: extreme sadness withdrawn inability to make decisions tired slowness of thought Manic Symptoms: elation euphoria desire for action hyperactive multiple ideas Types: Manic Episode hypomanic episode bipolar I disorder bipolar II disorder Clothymic Disorder

Cog treatment: Aaron Beck's Cognitive theory

proposed that depression and other mood disorders result primarily from negative self-talk and the distorted perceptions of self that result from it. Depressed patients believe that they can never be happy (thinking) and thus associate minor failings (e.g. failing a test [event]) in life as major causes for their depression. depression is caused by errors in thinking. In therapy, clients are taught not only to identify negative, distorted thoughts but also to actually go out and test those negative beliefs Beck believes that cognitions such as "I can never be happy" need to change in order for depressed patients to recover. This change is brought about by gently questioning patients. Used cognitive therapy get people to take off the "dark sunglasses" in which they view their surroundings

biological treatment: psychosurgery

used as a last resort in alleviating psychological disturbances. Psychosurgery is irreversible. Removal of brain tissue changes the mind. Modern methods use stereotactic neurosurgery and radiosurgery that refine older methods of psychosurgery