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