Chapter 6: Depressive and Bipolar Disorders

learned helplessness

The perception, based on past experiencesthat one has no control over the reinforcements in one's life.

symptoms of mania

The symptoms of mania span the same areas of functioning -emotional , motivational , behavioral, cognitive, and physical-as those of depression, but mania affects those areas in an opposite way .

cognitive triad

The three forms of negative thinking that Aaron Beck theorizes lead people to feel depressed. The triad consists of a negative view of one's experiences, oneself, and the future.

suicide due to bipolar disorders

"Approximately 10 to 15 percent of them eventually end their own lives, usually out of a sense of hopelessness"

Unipolar depression

"People with unipolar depression suffer from depression only. The various disorders characterized by unipolar depression are called depressive disorders. The symptoms of depression span five areas of functioning: emotional, motivational, behavioral, cognitive, and physical. Women are at least twice as likely as men to experience severe unipolar depression. According to the biological view, low activity of two neurotransmitters, norepinephrine and serotonin, are linked to depression. Hormonal factors, the result of an HPA stress pathway that is overly reactive to stress, may also be at work. Research has also tied depression to abnormalities in a circuit of brain structures, including the prefrontal cortex, hippocampus, amygdala, and subgenual cingulate. Most biological treatments for unipolar depression consist of antidepressant drugs, but several brain stimulation techniques are also used. According to the psychodynamic view, certain people who experience real or imagined losses may regress to an earlier stage of development, fuse with the person they have lost, and eventually become depressed. Psychodynamic therapists try to help depressed persons recognize and work through their losses and excessive dependence on others. The cognitive-behavioral view features explanations of depression that are primarily behavioral, primarily cognitive, or a combination of behavioral and cognitive principles. On the behavioral side, the model says that when people experience a large reduction in their positive rewards in life, they become more and more likely to become depressed. On the cognitive side, Beck's theory of negative thinking holds that maladaptive attitudes, the cognitive triad, errors in thinking, and automatic thoughts help produce unipolar depression. Also, according to Seligman's learned helplessness theory, people become depressed when they believe that they have lost control over the reinforcements in their lives and when they attribute this loss to causes that are internal, global, and stable. Cognitive-behavioral therapists reintroduce clients to pleasurable events, reinforce nondepressive behaviors, teach interpersonal skills, and further help the clients change their dysfunctional cognitions. Sociocultural theories propose that unipolar depression is influenced by social and cultural factors. Family-social theorists point, for example, to a low level of social support. Correspondingly, interpersonal psychotherapy and couple therapy are often helpful in cases of depression. Multicultural theories have noted that the character and prevalence of depression may vary by gender and culture, an issue that culture-sensitive therapies for depression seek to address. The developmental psychopathology perspective contends that unipolar depression is caused by a combination of the factors cited by the various models and that these factors unfold and intersect in a developmental sequence."

persistent depressive disorder

A chronic form of unipolar depression marked by ongoing and repeated symptoms of either major or depression

cyclothymic disorder

A disorder marked by numerous periods of hypomanic symptoms and mild depressive symptoms.

premenstrual dysphoric disorder

A disorder marked by repeated episodes of significant depression and related symptoms during the week before menstruation

rumination theory

A final explanation for the gender differences found in depression is the rumination theory. As you read earlier, rumination is related to depression. Research reveals that women are more likely than men to ruminate when their mood darkens , perhaps making them more vulnerable to the onset of clinical depression.

selective serotonin reuptake inhibitors (SSRI)

A group of second generation antidepressant drugs that affecting other neurotransmitters

lithium

A metallic element that occurs in nature as a mineral salt and is an effective treatment for bipolar disorders.

norepinephrine

A neurotransmitter whose abnormal activity is linked to depression and panic disorder.

serotonin

A neurotransmitter whose abnormal activity is linked to depression, obsessive-compulsive disorder and eating disorders.

major depressive disorder

A severe pattern of depression that is disabling and not caused by such factors as drugs or a general medical condition.

cognitive therapy

A therapy developed by Aaron Beck that helps people identify and change the maladaptive assumptions and ways of thinking that help cause their psychological disorders.

behavioral activation

A therapy for depression in which the therapist works systematically to increase the number of constructive and pleasurable activities and events in a client's life.

couple therapy

A therapy format in which the therapist works with two people who share a long-term relationship.

deep brain stimulation (DBS)

A treatment for depression in which a pacemaker powers electrodes that have been implanted in subgenuar cingutate, thus stimulating that brain area.

vagus nerve stimulation

A treatment for depression in which an implanted pulse generator sends regular electrical signals to a person's vagus nerve; the nerve then stimulates the brain.

electroconvulsive therapy (ECT )

A treatment for depression in which electrodes attached to a patient's head send an electrical current through the brain, causing a convulsion .

interpersonal psychotherapy (IPT)

A treatment for unipolar depression that is based on the belief that changing ones interpersonal problems helps lead to recovery.

transcranial magnetic stimulation (TMS)

A treatment in which an electromagnetic coil which is placed on or above a patient's head, sends a current into the individual's brain.

bipolar I disorder

A type of bipolar disorder marked by full manic and major depressive episodes.

bipolar II disorder

A type of bipolar disorder marked by mildly manic (hypomanic) episodes and major depressive episodes.

symbolic loss

According to Freudian theory, the loss of valued object (for example, a loss of employment ) that is unconsciously interpreted as the loss of a loved oneAlso called imagined loss.

tricyclic

An antidepressant drug such as imipramine that has three rings in its molecular structure.

MAO Inhibitor

An antidepressant drug that prevents the action of the enzyme oxidase.

brain stimulation

Biological treatments that directly or indirectly stimulate certain areas of the brain.

BIPOLAR DISORDERS

In bipolar disorders, episodes of mania alternate or intermix with episodes of depression. These disorders are much less common than unipolar depression. They may take the form of bipolar I, bipolar II, or cyclothymic disorder. Mania may be related to improper neurotransmitter activity, improper transport of ions, or abnormalities in key brain structures. Genetic studies suggest that people may inherit a predisposition to these biological abnormalities. Lithium and other mood stabilizing drugs have proved to be effective in the treatment of bipolar disorders. Patients tend to fare better when mood stabilizing and/or other psychotropic drugs are combined with adjunctive psychotherapy."

mood stabilizing drugs

Psychotropic drugs that help stabilize the moods of people suffering from bipolar disorder. Also known as antibipolar drugs

body dissatisfaction explanation

The body dissatisfaction explanation states that females in Western society are taught, almost from birth, but particularly during adolescence, to seek a low body weight and slender body shapegoals that are unreasonable, unhealthy, and often unattainable. Research finds that, as adolescence unfolds, girls do become more and more dissatisfied with their weight and body and, on average, display an increased rate of depression . However , it is not clear that eating and weight concerns actually cause depression ; they may instead be the result of depression .

immune system

The immune system is the body's network of activities and body cells that fight off bacteria, viruses, and other foreign invaders. There is a growing belief among some researchers that immune system dysregulation of this kind helps produce depression.

lack -of-control theory

The lack -of-control theory, which draws on the learned helplessness research, proposes that women may be more prone to depression because they feel less control than men over their lives. It has been found that victimization of any kind, from discrimination to burglary to rape, often produces a sense of helplessness and increases the symptoms of depression women in our society are on average, more likely than men to be victims across various domains.

life stress theory

The life stress theory suggests that women in our society are subject to more stress than men. On average they face poverty, more jobs, less adequate housing, and more discrimination than men - that have been linked to depression. And in many homes, women disproportionate share of responsibility for child care and housework.

lymphocytes

When people are under intense stress for a while, their immune systems may become dysregulated , leading to slower functioning of important white blood cells called lymphocytes and to increased production of C-reactive protein (CRP ), a protein that spreads throughout the body and causes inflammation and various illnesses.

Ion Activity

While neurotransmitters play a significant role in the communication between neurons, ions seem to play a critical role in relaying messages within a neuron. That is, ions help transmit messages down the axon to the nerve endings . Positively charged sodium ions (Na^ + ) sit on both sides of a neuron's cell membrane. When the neuron is at rest, more sodium ions sit outside the membrane . When the neuron receives an incoming message at its receptor sites, pores in the cell membrane open, allowing the sodium ions to flow to the inside of the membrane , thus increasing the positive charge inside the neuron. This starts a wave of electrical activity that travels down the length of the neuron and results in its " firing."

culture sensitive therapies

culture sensitive therapies are designed to address the unique issues faced by members of cultural minority groups. such approaches , therapists typically have special cultural training and a heightened awareness of their clients cultural values and the culture related stressors , prejudices , and stereotypes that their clients face . They make an effort to help clients develop a comfortable for them ) bicultural balance and to recognize the impact of their own culture and the dominant culture on their views of themselves and on their behaviors