Presentation on Mood Disorders: Major Depressive Disorder, Bipolar I Disorder, etc.
Presentation for doctoral program class at Saybrook University, San Francisco. Fall 2009
Presentation on Mood Disorders: Major Depressive Disorder, Bipolar I Disorder, etc.
Presentation for doctoral program class at Saybrook University, San Francisco. Fall 2009
Disclaimer: This a project for a high school AP Psychology course. This is a fictionalized account of having a psychological ailment. For questions about this blog project or its content please email the teacher, Laura Astorian: laura.astorian@cobbk12.org
This a project for a high school AP Psychology course. This is a fictionalized account of having a psychological ailment. For questions about this blog project or its content please email the teacher, Laura Astorian: laura.astorian@cobbk12.org
Depression
Background
Pathophysiology
• The monoamine theory of depression is that it results from a central deficit in the monoamine neurotransmitters serotonin (5-HT) and norepinephrine.
• Other reported physiological features include ↑cortisol and a blunted TSH response.
• However, there is no widely accepted and definitively proven biological model of depression.
Epidemiology
• Time course: for most it is an episodic illness, but for other it follows a more chronic course.
• Incidence: 5% annual risk, 20% lifetime risk.
Presentation
DSM and NICE criteria
These are based on DSM-4, though DSM-5 does not significantly differ.
Major depressive disorder is ≥2 weeks of low mood and/or anhedonia, and at least 4 symptoms out of:
• ↓Energy or fatigue.
• ↓Concentration
• ↓Weight/appetite.
• Disturbed sleep, which commonly includes early waking. Diurnal pattern to symptoms also seen, with symptoms often worse in the morning.
• Slowing of thought and movements (psychomotor slowing) or agitation.
• Ideas of worthlessness or guilt.
• Recurrent thoughts of death or suicide.
• All but the last 2 are considered 'biological' symptoms.
Suffering from Major Depressive DisorderRachelVira
This a project for a high school AP Psychology course. This is a fictionalized account of having a psychological ailment. For questions about this blog project or its content please email the teacher, Laura Astorian: laura.astorian@cobbk12.org
An unusually high percentage of famous writers, poets, composers and artists have suffered from bipolar mood disorder. This presentation goes in depth.
Disclaimer: This a project for a high school AP Psychology course. This is a fictionalized account of having a psychological ailment. For questions about this blog project or its content please email the teacher, Laura Astorian: laura.astorian@cobbk12.org
This a project for a high school AP Psychology course. This is a fictionalized account of having a psychological ailment. For questions about this blog project or its content please email the teacher, Laura Astorian: laura.astorian@cobbk12.org
Depression
Background
Pathophysiology
• The monoamine theory of depression is that it results from a central deficit in the monoamine neurotransmitters serotonin (5-HT) and norepinephrine.
• Other reported physiological features include ↑cortisol and a blunted TSH response.
• However, there is no widely accepted and definitively proven biological model of depression.
Epidemiology
• Time course: for most it is an episodic illness, but for other it follows a more chronic course.
• Incidence: 5% annual risk, 20% lifetime risk.
Presentation
DSM and NICE criteria
These are based on DSM-4, though DSM-5 does not significantly differ.
Major depressive disorder is ≥2 weeks of low mood and/or anhedonia, and at least 4 symptoms out of:
• ↓Energy or fatigue.
• ↓Concentration
• ↓Weight/appetite.
• Disturbed sleep, which commonly includes early waking. Diurnal pattern to symptoms also seen, with symptoms often worse in the morning.
• Slowing of thought and movements (psychomotor slowing) or agitation.
• Ideas of worthlessness or guilt.
• Recurrent thoughts of death or suicide.
• All but the last 2 are considered 'biological' symptoms.
Suffering from Major Depressive DisorderRachelVira
This a project for a high school AP Psychology course. This is a fictionalized account of having a psychological ailment. For questions about this blog project or its content please email the teacher, Laura Astorian: laura.astorian@cobbk12.org
An unusually high percentage of famous writers, poets, composers and artists have suffered from bipolar mood disorder. This presentation goes in depth.
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Bipolar disorder, also known as bipolar affective disorder (and originally called manic-depressive illness), is a mental disorder characterized by periods of elevated mood and periods of depression. The elevated mood is significant and is known as mania or hypomania depending on the severity or whether there is psychosis.
The cornerstone of someone's mental health is how they think, feel, and behave. Mental health specialists can help people with disorders like addiction, bipolar disorder, depression, and anxiety.
Mental health can have an effect on daily life, interpersonal connections, and physical health.
This connection, nevertheless, also functions the opposite way around. Personal circumstances, social ties, and physical ailments can all have an impact on mental illness. Maintaining
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The cornerstone of someone’s mental health is how they think, feel, and behave. Mental health specialists can help people with disorders like addiction, bipolar disorder, depression, and anxiety.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
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the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
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3. Mood Disorders Characterised by disturbances in emotion and mood. Can be relatively mild or extreme Most cases negative, but can also be dangerously positive – manic state During manic episodes, people feel excessively happy and believe they can do anything.
4. Mild Mood Disorders Dysthymia– Greek for “bad spirit” Moderate depression that lasts for two years or more with intervals of normal moods that never last more than a few weeks or months and is typically a reaction to some external stressor. Cyclothymia – “spirit that moves in circles” Disorder that consists of mood swings from moderate depression to hypomania and lasts two years or more. Both usually begins in childhood or adolescence and includes times of normal feelings that may last less than two months at a time.
5. Extreme/Severe Major Depression. Most common of the diagnosed mood disorders and is about twice as common in women as it is in men (APA, 2000). Possible explanations – hormonal structure of the female system (little support), different social roles played by women in the culture. Degree of differences between sexes is < and non existent in college students and single adults.
6. Major Depressive Disorder Most severe form of depression. Characterised by depressed mood and loss of interest in pleasurable activities (anhedonia). Includes disturbances in appetite, sleep, energy level and concentration, feelings of worthlessness, preoccupied with suicidal thoughts and so fatigued that they sleep day and night or cannot go to work or do chores. Major depressive episodes typically last about five months.
7. Prevalence 1 in 5 Australians experience from depression at some point in their lives At any given time, around 5.1% of Australians suffer from major depression (AIHW, 1999) – about 3.4% of men and 6.8% of women. Vast majority of patients who experience a major depressive episode will have one or more recurrences within 5-15 years. Prevalence decreases as we get older, however, those living in residential care experience twice the level of depressive symptoms as those living in the general community
8. Risk factors Social isolation, unemployment, loss of loved one, breakup of a relationship, school failure. Linked to tobacco use, illicit drug use, alcohol misuse and dependence, eating disorders and obesity (AIHW) In childhood: parents who suffer from depression, loss of a parent, abuse, neglect. Higher rates among Aboriginal and Torres Strait Islander people, those living in rural and remote areas, people with physical illnesses and among veterans and defence services personnel
9. Indigenous Australians Swan and Raphael (1995) highlighted trauma, loss and grief as the most significant problems identified by Indigenous Australians. Problems derived from history of invasion, incarceration, forced separation of children from parents, deaths in custody and a range of other traumas.
10. Bipolar Disorder Characterised by severe mood swings that go all the way from severe depression to manic episodes. Unlike cyclothymia, there is usually no external cause for the extremity of mood. Depressive phases are indistinguishable from major depression, but give way to manic episodes that may last from a few weeks to a few months. During the manic episodes, the person is often restless, irritable, have difficulty sitting still/inactive and seem to have unlimitted energy. Speech may be rapid.
11. ADHD link? Ongoing debate/controversy. Seems to be a connection between ADHD and onset of bipolar in adolescence, but only a small percentage of children with ADHD go on to develop bipolar. Symptoms of irrational thinking and other manic symptoms are not present in ADHD
12. Causes of Mood disorders Psychoanalytic theorists: depression as anger (originally aimed at parents/authority figures) turned inward on the person. The anger is repressed and later displaced to the self in the form of self-blame and self-hate
13. Causes: Cognitive Theory Links depression with learned helplessness. The helplessness theory suggests the way people feel depends on the way they explain events or outcomes to themselves, particularly aversive event. E.g. jilted lover conclude they are unlovable. Depressed people differ in how negative their ideas about themselves and the world are, and the ways they manipulate and use information.
14. Beck’s Negative Triad Theory Outlook on world Cognitive distortions: Cognitive mechanisms by which a depressed person negatively transforms neutral or positive information Mood, motivation, behaviour leading to depressed mood, avoidance, suicidal wishes Outlook on self Outlook on future
15. Consider the following interaction… PATIENT: I can’t go back to school. I’m just not smart enough. THERAPIST: How did you do the last time you were in school? PATIENT: Um… I got mostly As. But that was a long time ago. And what have I ever done career-wise that suggests I could handle being a lawyer? THERAPIST: That’s not really a fair question is it? Don’t you think your low image of yourself has something to do with why you haven’t done anything ‘spectacular’ career-wise? PATIENT: I guess you’re right. I’m as smart as my sister and she’s a lawyer. THERAPIST: Right. PATIENT: But what have I ever done career-wise that says I could handle being a lawyer?
16. Biological Causes Neural Transmission: Effects of brain chemicals such as serotonin, norepinephrine and dopamine; drugs that increase the activity of these neurotransmitters decrease the symptoms of depression. Genetics: Most heritability estimates for major depression are in the range of 30-40%. Twin studies estimates heritability for bipolar disorder to be as high as 84% (Cardno, Marshall et al., 1999). Roughly 80-90% of bipolar patients have a family history of some mood disorder.