Depression
Abnormal Psychology
Mood Disorders
Depressive disorders
z Most of us have periods when we feel sad
z Relatively common
z About 17% of people have an episode of
severe depression
z Major depression (Unipolar depression)
z Dysthymia
Depression
Usually persists for months.
Person experiences little:
z
z
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"I was seized with an unspeakable physical
weariness. There was a tired feeling in the muscles
unlike anything I had ever experienced. My nights
were sleepless. I lay with dry, staring eyes gazing
into space. I had a fear that some terrible calamity
was about to happen. I grew afraid to be alone. The
most trivial duty became a formidable task. Finally,
mental and physical exercises became impossible.
My general feeling might be summed up in the
familiar saying "what's the use" I had tried so hard
to make something of myself, but the struggle
seemed useless. Life seemed utterly futile."
Symptoms, 5 or more (including #1 or #2)
within 2 week period
1. Sad, depressed mood.
2. Loss of interest or pleasure in all activities
z 3. Appetite and weight change.
z 4. Difficulties in sleeping
z 5. Loss of energy, great fatigue or activity
z 6. Negative self-concept, guilt, worthlessness.
z 7. Difficulty in concentrating.
z 8. Recurrent thoughts of death or suicide.
z
z
The Vicious Cycle of
Depression
interest in anything
pleasure
motivation to be productive
Loss of interest in food & sex are common
Sleep abnormalities are associated with depression
Person has feelings of worthlessness, guilt and
powerlessness over life
z
May attempt suicide
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Depression: Age of First Onset
Events That Precipitate
Depression
Severe losses early in life increase
vulnerability to depression later in life.
Lack of social support also increases
vulnerability to depression
Person’s interpretation of negative
event influences their degree of
depression.
The way people think about their lives
and the course of the events may also
play a role
Bipolar Disorders
Manic-depression
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Cycles between depression and mania
Relatively rare
2% of population
Mania
z
z
z
z
z
Periods of very high energy
Rushed speech
Often overly confident
Make grandiose plans
Little need for sleep
Cyclothymia
„ Rapid mood swings are shown in brain activity
Therapist says to client " Well, you seem pretty
happy today"
Client "Happy! Happy! You certainly are a master of
understatement. You rogue! Why I'm ecstatic. I'm
leaving for the West Coast today, on my daughter's
bicycle. Only 3100 miles. That's nothing, you know,
I could probably walk...but, I want to be there by
next week. And along the way I plan to contact a lot
of people about investing in my fish equipment. I'll
get to know more people that way--you know doc,
"know" in the biblical sense (leers at the therapist).
Oh, God, how good it feels. It's almost like a
nonstop orgasm"
Suicide
• Depression & bi-polar
can lead to suicide
• Suicide rates vary
significantly with age,
race, and sex
• Men are more likely to
commit suicide than
women
• Whites are more likely
to commit suicide
than blacks
©1999 Prentice Hall
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Sex Diffs in Depression
Sex Diffs in Depression
Equally common in boys and girls
before puberty
Hormonal Diffs?
Afterwards, women are twice as likely to
experience depression as men
Coping Style Diffs?
Why the sex diff after puberty?
Understanding Mood
Disorders
Biological factors
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Tendency to develop mood disorders is heritable
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Particularly bipolar disorder
Genetic role in depressive disorders not as clear
Women experience more rapid hormonal changes than
men do (menstrual cycles, pregnancy, childbirth and
menopause)
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Men generally try to distract themselves when they are
feeling depressed,
z
Women tend to dwell on their feelings more.
z Ruminating may not be useful for coping and may make
the person feel worse.
Understanding Mood
Disorders
Cognitive perspective
z
Cognitive triad
Negative thoughts about the self
Negative view of the future
z Feel unable to improve the situation
z
Neurotransitters: Serotonin, Norepinephrine
Brain damage: left anterior/prefrontal cortex
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z
Attributions
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Cognitive Aspects of
Depression
Explanatory style: a tendency to accept 1 kind of
explanation for success or failure more than
others
z
We’re more consistent in the type of attribution that we use
to explain failures
Causal explanations people make when bad
things happen
Depressive Realism
Bipolar Disorder: Causes
Primarily biological
Not one gene
Gets worse over generations.
Person who blames self for all failures has a
pessimistic explanatory style.
z
z
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“I failed my Psyc test b/c I’m a dumb-ass.”
They view failures as global (consistent over situations) and
stable (consistent over time)
A pessimistic explanatory style is positively associated with
depression
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Dissociative Disorders
What if you feel depressed, if a
roommate or friend seems depressed?
Do not offer a diagnosis.
Talk to someone, get help.
z Talk to someone who knows what they are
talking about.
z
z
Schizophrenia
Group of disorders characterized by severe
personality disorganization, distortion of
reality, and inability to function in everyday
life
z
NOT multiple personalities
Most frequently diagnosed in young adults
Onset is typically sudden, although there are
some markers during childhood
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z
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being “strange”
short attn. span
having few friends
disruptive in class
Common dissociative experiences
z Not recognizing yourself in a mirror: 3%
z Standing next to yourself, watching: 15%
z Finding unfamiliar notes that you must
have made: 25%
z Driving home and not remembering the
trip: 35%
z Being able to ignore pain 65%
Symptoms - for at least
one month
1. Thought Disturbances
2. Disturbances of Perception
and Attention
3. Motor Disturbances.
4. Affective Disturbances
Understanding
Schizophrenia
Heterogeneity
Catatonic- lots or not enough movement.
mutism, echolalia.
Disorganized- disorganized speech,
behavior. Inappropriate or flat affect, no
catatonia
Paranoid- delusions and auditory
hallucinations.
Undifferentiatied- doesn’t fit a category
Residual type- 1 episode, no prominent
positive symptoms. Odd behavior and
beliefs.
Sociogenic hypothesis. Low SES Æ SZ
Mother -- double bind messages from the
mother
Genetic predisposition for schizophrenia
Dopamine
z
z
Too much dopamine in mesolimbic system
Not enough dopamine in prefrontal areas
Social issues
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Role of stress in development or schizophrenia
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Causes: Brain Damage
Brain scans indicate that:
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z
Hippocampus and parts of cerebral cortex
are a little smaller than normal
Schizophrenics have smaller neurons and
fewer synapses in the prefrontal cortex
Causes:
Neurodevelopmental
Hypothesis
Result of nervous system impairments
that develop before or at birth.
Impairments may be due to genetic or
other reasons:
poor prenatal care
z difficult pregnancy and labor
z mother’s exposure to influenza virus
z Urban schizovirus
z
Causes: Brain Damage
• Pair of
identical
twins,
discordant.
• Schizophrenic
had enlarged
ventricles
(see arrows)
compared to
normal sibling
Dissociative Identity
Disorder
Multiple Personality
z
z
Existence in a single
individual of two or more
distinct identities or
personalities that
alternate in controlling
behavior
Alternate personalities
z
Often have
characteristics that are
very different than the
primary identity
z
z
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Hostility
Controlling
Aggressive
Often primary identity is
not aware of “alters”
z
Alters can have different
handwriting styles,
artistic or athletic
abilities, knowledge of a
foreign language
Multiple personalities as
a defense mechanism
z
z
May relieve emotional
pain
Extremely rare disorder
z
May be overdiagnosed
in individuals who are
highly suggestible
Last Word on Behavior
Disorders
There are no behaviors that are absolutely
normal or absolutely bizarre
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Not a dichotomy
Continuum of behavior
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All of us exhibit some behaviors that might be considered
odd or eccentric
This does not mean that we have a behavior disorder
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Normal variability of behavior
In other words, don’t start diagnosing your friends
and family…
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