Psych 111 Class 19 - Mood Disorders

Building blocks of mood disorders

• mania

• hypomania

• euthymia

• dysthymia

• major depression

Mood

varies over time

episode

consistent mood (most of the day, nearly every day) for a specified duration

disorder

• specified set of current or historical mood episodes

• distress, impairment, or danger

Building blocks of major depression

• Core symptoms

  • depressed or low mood

  • anhedonia (inability to enjoy things)

• Behavioral symptoms

  • sleep problems

  • low energy/fatigue

• Cognitive symptoms

  • thoughts of death/suicide

  • poor concentration

Major depression requisites

• needs to be at least one core symptoms

• at least five total symptoms

• major depressive episode that lasts at least two weeks

Depression Models and Correlates

• Cognitive

• Behavioral

• Interpersonal

• Biological

Major depression - cognitive correlates

• focusing on negatives

• thinking of death and dying

• thinking traps

Major depression - behavioral correlates

• social withdrawal

• decreased activity

• fatigue and low energy

• changes in sleep patterns

• appetite and weight changes

• poor self care

• slowed or reduced speech

• increased crying or tearfulness

Major depression - Learned Helplessness Study

• Martin Seligman, 1970

• Shuttle box

• low wall - dog jumps over when floor is electrified

• high wall - dog cannot escape

• Dogs separated into three groups:

  • escape group: dogs received shocks but could stop them by pressing a panel with their nose

  • yoked group: dogs received shocks at the same time and duration as the first group but had no control over stopping them

  • control group: no shocks were administered

• Phase 2: all dogs were placed in a new box with two compartments separated by a low barrier - shocks were administered, but now all dogs could escape simply by jumping over the barrier

• Findings: escape and control group dogs quickly learned to jump the wall to avoid shocks but yoked group dogs did not try to escape even though they had the ability to do so. They just laid down and whined.

• Conclusion: The dogs in the yoked group had learned helplessness - they had learned in the first phase that their actions didn’t affect outcomes, so they stopped trying

Learned helplessness study relevance to depression

individuals feel helpless to improve their lives due to repeated exposure to stress, failure, or uncontrollable events - leading to passivity, hopelessness, and withdrawal

Major depression - interpersonal correlates

• poor social skills

• poor communication skills

• insecure attachment style

Major depression - biological correlates

• monoamine hypothesis

  • suggests that depression is caused by a deficiency or imbalance of certain neurotransmitters called monoamines, specifically serotonin, norepinephrine, and dopamine

• neuroplasticity hypothesis

  • proposes that the brain's ability to adapt and change its structure and function throughout life is a key factor in various mental and neurological conditions

Dysthymia

• one core depression symptom

• two total depression symptoms

• cognitive style is pessimistic rather than self-critical

Euthymia

• Eu - “good”

• Thymia - “mood”

• Most people are in this state most of the time

Mania

• mood

  • elevated, expansive, or irritable

• behavior

  • less sleep

  • more talking

  • more goal-directed activity

• Cognition

  • racing thoughts

  • grandiosity

  • distractibility

Mania Requisites

• requisites

  • elevated, expansive or irritable mood

  • three total symptoms (four if mood is only irritable)

  • clear change from baseline

  • marked impairment in daily living

• episode

  • lasts at least one week

  • or psychosis

  • or hospitalization

Hypomania

same criteria as mania but episode is four days and no marked impairment

mixed episode

• depressive, hypomanic or manic episode

• at least three symptoms or opposite polarity

Mood Disorders

• Bipolar I disorder

• Bipolar II disorder

• Major depressive disorder

• Cyclothymic disorder

• Dysthymic disorder

Bipolar I

• Diagnosis

  • one manic (or mixed episode)

• Lifetime prevalence

  • 1%

• Note

  • most have depressive episodes as well

Bipolar II

• Diagnosis

  • one hypomanic episode

  • one major depressive episode

• Lifetime Prevalence

  • 1%

Major depressive disorder

• Diagnosis

  • one major depressive episode

• Lifetime prevalence

  • 28%

  • more common in females

• Note

  • many have recurrent depressive episodes

Cyclothymic disorder

• diagnosis

  • multiple periods of hypomania and dysthymia (not major depression) over two years

• lifetime prevalence

  • <1%

• Note

  • mania, hypomania, and major depression can show up after two years

Dysthymic disorder (persistent depressive disorder)

• disorder

  • dysthymic mood most of the day nearly every day for two years

• Lifetime Prevalence

  • 2-3%