Unipolar Mood Disorders

Major Depressive Disorder, Persistent Depressive Disorder, Youth Depression | Week 3 @ PSYC 238 UIUC

MDD Prevalence: General Population

Prevalence: 21%

PDD Prevalence: General Population

Prevalence: 3%

Youth Depression Prevalence: 18-

Prevalence: 11%

Anxiety Disorders

Unipolar Mood Disorders comorbid with-

Risk Factors for Unipolar Mood Disorders

• AFAB 2x as likely

  • deviation begins at 13, jumps at 15

• SES: chronic unemployment increases risk

• SES: lower income increases risk

Culture: Depression

is generally a universal experience

Sadness and MDD

an emotion; insufficient AND unnecessary for a diagnosis

MDD Diagnosis Questions

1. INTENSITY: what is the DISTRESS level?

2. DURATION: length of episode; individual or recurring episodes?

3. IMPAIRMENT: how is the person’s life IMPACTed?

KEY two symptoms of MDD:

1. Depressed Mood

2. Anhedonia

Anhedonia

diminished interest or pleasure in all/most activities for most of the day

(at least two weeks, nearly every day, most of the day)

No. of additional symptoms needed for MDD diagnosis

3

Heterogeneity

the chance that there are two people with the same diagnosis and no overlapping symptoms

Not Otherwise Specified (NOS):

• subthreshold or slightly varying presentation of a disorder

• term used for convincing insurance companies to allow customers treatment

MDD Specifiers

1. Severity: MILD, MODERATE OR SEVERE

2. Remission Status: PARTIAL or FULL remission

3. Episodic (2+ WEEK remission) or Chronic (continuous duration with minimal peaks and dips)

dysthymic mood

sub-threshold depressive mood

Persistent Depressive Disorder: Alternative Name

Dysthymia

PDD: Key Symptom

dysthymic mood

• 2+ other symptoms

PDD-Exclusive Symptoms:

low self-esteem and hopelessness

Duration of PDD:

Adults: 2 years, without a break of more than 2 months

Children: 1 year with no break

Double Depression:

Comorbid PDD and MDD

Typic Onset Age Range of Youth Depression

adolescence

difficulties in diagnosing YDD:

• distinguishing between personality and symptomatology

• children struggle to define feelings

• symptoms are typically more externalizing than adult depression

• reliance on gatekeeper (child professionals)

• parental involvement in therapy may discourage child vulnerability

Process of SSRIs:

increase levels of serotonin in synapse (to be absorbed by new dendrites) by blocking their reuptake into previous axon terminal vesicles

Neurotransmitters of TCAs

serotonin and norepinephrine

Full name of TCA

Tricyclic Antidepressants

Full name of MAOIs

Monoamine Oxidase Inhibitors

Neurotransmitters involved in MAOIs

serotonin, norepinephrine and dopamine

Process of MAOIs

blocks monoamine oxidase from breaking down neurotransmitters to increase their absorption into new dendrites

Effectiveness of Unipolar MD Medications:

50-60% effectiveness

Disadvantages of relying on medications for Unipolar Disorders

• high relapse rate

Logic of Cognitive Behavioral Therapy (CBT)

Goal: change maladaptive thoughts to make them more realistic/positive

Logic: negative thoughts => behavior enforcing thoughts => depression

Logic of Interpersonal Psychotherapy (IPT)

Goal: improve current relationships

Logic: interpersonal stress/lack of support => depression

Unipolar MD Psychotherapies

Cognitive Behavioral Therapy (CBT) and Interpersonal Psychotherapy (IPT)

Effectiveness Comparison to UMD Treatments

Therapies and Medications are EQUALLY EFFECTIVE at DIFFERENT RATES

Dialectical Behavioral Therapy

Goal: improve adaptation and acceptance skills

Financial POV of UMD Treatment

Therapy: consistently expensive

Medications: increase with time, effected by economy