Mood Disorders: Outline
Know symptoms, prevalence, & onset of unipolar & bipolar disorder
Be familiar with the theories for unipolar & bipolar disorders
Understand the treatments available through the different paradigms for these disorders
Be familiar with terminology
Terminology
Unipolar Depression
Reactive depression
Endogenous depression
Anaclitic depression
Dysthymia
Double depression
Seasonal depression
Postpartum depression
Bipolar Disorder
Bipolar I
Bipolar II
Cyclothymia
Unipolar Depression: Symptoms
The presence of at least five of the following symptoms during the same two-week
period:
Depressed mood
Markedly diminished interest or pleasure in almost all activities
Significant weight change (or appetite change)
Insomnia or hypersomnia
Psychomotor agitation or retardation
Fatigue or loss of energy
Feelings of worthlessness or excessive guilt
Problems concentrating & indecisiveness
Recurrent thoughts of death or suicide
Suicide attempt or suicidal ideation
Significant distress or impairment
No history of mania or hypomania
Unipolar Depression
Lifetime prevalence: 17 %
Sex Ratio: women 2: 1 men
Age of onset: any age (common around 20s)
Ethnic: middle age white Americans higher rate than middle age African Americans
Bipolar Disorder
Bipolar I: full manic & major depressive episodes
Bipolar II: mild mania & major dep. episodes
Cyclothymic
disorder: numerous mild manic & depressive episodes (2 or more yrs)
Presence of current or past manic episode, defined by
A) Period of elevated, expansive or irritable mood lasting at least 1 week
B) Altered mood is accompanied by at least 3 of the following:
Symptoms (con)
1. Inflated self-esteem
2. Decreased need for sleep
3. More talkative or pressured speech
4. Flight of ideas or racing thoughts
5. Distractibility
6. Increase in goal-oriented activity
7. Excessive involvement in pleasurable activities that can have painful consequences
C) Symptoms not due to drugs or meds
D) Symptoms caused marked impairment
Symptoms are not accounted by other disorder
Bipolar (con)
Prevalence: lifetime 1%
Onset: 15-44
Sex-ratio: equal
Unipolar Theories
Behavioral (Lewinsohn): lack of positive reinforcement
Cognitive
(Beck): Theory of Depression
attitudes
Cognitive triad (experience, themselves, future)
Errors in thinking (arbitrary inferences, etc.)
Automatic thoughts
Maladaptive
Cognitive-behavioral
(Seligman) learned helplessness theory of depression
Person feels s/he is losing control of reinforcements
Person believes s/he is responsible for this state
Who is susceptible? Attributional Styles:
Internal, Global, & Stable  Depression
Unipolar theories (con)
Biological
Genetic factors
Family pedigree study
Proband (20%)
Twin studies (46% = MZ; 20% = DZ)
Adoption studies
Catecholamine theory
Indoleamine theory
Unipolar Theories (con)
Psychodynamic: (fixation at oral stage) symbolic loss  person introjects feelings for
lost one onto themselves
Supporting evidence: Anaclitic depression
Sociocultural: depression triggered by outside stressors
Divorce
Oppression
isolation
Theories: Bipolar Disorder
Biological:
neurotransmitters
Na+ ion instability
genetic factors
Effects: Talk Therapy vs. Drug Therapy
Dr. Mayberg's research shows that cognitive behavior therapy (CBT) affects the front
part of the brain, the thinking part (left, blue), while the SSRI anti-depressant Paroxetine
works on a more primitive region at the back of the brain (right, red).