Psychological Disorders PowerPoint® Presentation by Jim Foley © 2013 Worth Publishers Module 49: Mood Disorders Mood Disorders Major depressive disorder [MDD] is: more than just feeling “down.” more than just feeling sad about something. Bipolar disorder is: more than “mood swings.” depression plus the problematic overly “up” mood called “mania.” Criteria of Major Depressive Disorders Major depressive disorder is not just one of these symptoms. It is one or both of the first two, PLUS three or more of the rest. Depressed mood most of the day, and/or Markedly diminished interest or pleasure in activities Significant increase or decrease in appetite or weight Insomnia, sleeping too much, or disrupted sleep Lethargy, or physical agitation Fatigue or loss of energy nearly every day Worthlessness, or excessive/inappropriate guilt Daily problems in thinking, concentrating, and/or making decisions Recurring thoughts of death and suicide Major Depression: Not Just a Depressive Reaction Some people make an unfair criticism of themselves or others with major depression: “There is nothing to be depressed about.” If someone with asthma has an attack, do we say, “what do you have to be gasping about?” It is bad enough to have MDD that persists even under “good” circumstances. Don’t add criticism by implying the depression is an exaggerated response. Depression is Everywhere Depression shows up in people seeking treatment: Phobias are the most common (frequently experienced) disorder, but depression is the #1 reason people seek mental health services. Depression appears worldwide: Per year, depressive episodes happen to about 6 percent of men and about 9 percent of women. Over the course of a lifetime, 12 percent of Canadians and 17 percent of Americans experience depression. Depression: The “Common Cold” of Disorders? Although both are “common” (occurring frequently and pervasively), comparing depression to a cold doesn’t work. Depression: is more dangerous because of suicide risk. has fewer observable symptoms. is more lasting than a cold, and is less likely to go away just with time. is much less contagious. And…depressive pain is beyond sniffles. Seasonal Affective Disorder [SAD] Seasonal affective disorder is more than simply disliking winter. Seasonal affective disorder involves a recurring seasonal pattern of depression, usually during winter’s short, dark, cold days. Survey: “Have you cried today”? Result: More people answer “yes” in winter. Percentage who cried Men Women August 4 7 December 8 21 Amanda’s therapist suggests that her depression results from mistakenly blaming herself rather than a slumping economy for her recent job loss. Her therapist’s suggestion best illustrates a: A. B. C. D. DSM V diagnosis. psychoanalytic perspective. medical model. social-cognitive perspective. Elaine feels that her life is empty. She has lost all interest in her career and hobbies, and wonders if she would be better off dead. She is most likely suffering from: A. B. C. D. a dissociative identity disorder. a generalized anxiety disorder. an antisocial personality disorder. a mood disorder. Which of the following is TRUE? A. Compared to all other nations, the U.S. has the highest rate of suicide. B. Men commit suicide more often than women do. C. Suicide rates in the U.S. are lowest among the elderly. D. African Americans commit suicide more often than do whites. Bipolar Disorder Bipolar disorder was once called “manic-depressive disorder.” Bipolar disorder’s two polar opposite moods are depression and mania. Mania refers to a period of hyper-elevated mood that is euphoric, giddy, easily irritated, hyperactive, impulsive, overly optimistic, and even grandiose. Contrasting Symptoms Depressed mood: stuck feeling Mania: euphoric, giddy, easily “down,” with: irritated, with: exaggerated pessimism exaggerated optimism social withdrawal hypersociality and sexuality lack of felt pleasure delight in everything inactivity and no initiative impulsivity and overactivity difficulty focusing racing thoughts; the mind fatigue and excessive desire to won’t settle down sleep little desire for sleep Bipolar Disorder and Creative Success Many famous and successful people have lived with the ups and downs of bipolar disorder. Some speculate that the depressive periods gave them ideas, and the manic episodes gave them creative energy. Any evidence of mood swings here? Bipolar Disorder in Children and Adolescents Does bipolar disorder show up before adulthood, and even before puberty? Many young people have cycles from depression to extended rage rather than mania. The DSM-V may have a new diagnosis for these kids: disruptive mood dysregulation disorder. Understanding Mood Disorders Why are mood disorders so pervasive, and more common among the young, and especially among women? Why Does Depression Have so Many Symptoms? Understanding Mood Disorders Can we explain… why does depression often go away on its own? the course/development of reactive depression? Often, time heals a mood disorder, especially when the mood issue is in reaction to a stressful event. However, a significant proportion of people with major depressive disorder do not automatically or easily get better with time. Suicide and Self-Injury Every year, 1 million people commit suicide, giving up on the process of trying to cope and improve their emotional well-being. This can happen when people feel frustrated, trapped, isolated, ineffective, and see no end to these feelings. Non-suicidal self-injury has other functions such as sending a message, or self-punishment. Those with alcohol dependence are roughly 100 times more likely to commit suicide; some 3 percent of them do. Suicide rates are much higher among the rich, the nonreligious, and those who are single, widowed, or divorced Understanding Mood Disorders Biological aspects and explanations Social-cognitive aspects and explanations Evolutionary Genetic Brain /Body Negative thoughts and negative mood Explanatory style The vicious cycle An Evolutionary Perspective on the Biology of Depression Depression, in its milder, nondisordered form, may have had survival value. Under stress, depression is social-emotional hibernation. It allows humans to: conserve energy. avoid conflicts and other risks. let go of unattainable goals. take time to contemplate. Biology of Depression: Genetics Evidence of genetic influence on depression: 1. DNA linkage analysis reveals depressed gene regions 2. twin/adoption heritability studies Biology of Depression: The Brain Brain activity is diminished in depression and increased in mania. Brain structure: smaller frontal lobes in depression and fewer axons in bipolar disorder Brain cell communication (neurotransmitters): more norepinephrine (arousing) in mania, less in depression reduced serotonin in depression Preventing or Reducing Depression: Using Knowledge of the Biology of Depression 1. Adjust neurotransmitters with medication. 2. Increase serotonin levels with exercise. 3. Reduce brain inflammation with a healthy diet (especially olive and fish oils). 4. Prevent excessive alcohol use . Understanding Mood Disorders: The Social-Cognitive Perspective Low SelfEsteem Discounting positive information and assuming the worst about self, situation, and the future Self-defeating beliefs such as assuming that one (self) is Learned unable to cope, Helplessness improve, achieve, or be happy Depression is associated with: Depressive Explanatory Style Rumination Stuck focusing on what’s bad Depressive Explanatory Style How we analyze bad news predicts mood. Problematic event: Assumptions about the problem The problem is: The problem is: The problem is: Mood/result that goes along with these views: Depression’s Vicious Cycle A depressed mood may develop when a person with a negative outlook experiences repeated stress. The depressed mood changes a person’s style of thinking and interacting in a way that makes stressful experience more likely. Brandy, who tends to have a pessimistic explanatory style, learns that she earned a poor grade on her psychology exam. Which attribution is most likely to help her cope without becoming depressed? A. “I’ll always be a poor student.” B. “The teacher gave a particularly hard exam this time.” C. “Of course my grade is bad, since I can’t do anything right.” D. “Once again I proved that I just don’t know how to study.”