Chapter 7: Depressive and Bipolar Disorders

emotional symptoms of depression

sad, dejected, miserable, empty, humiliated, anxiety, anger, agitation, not feeling pleasure in anything

motivational symptoms of depression

lack of drive and spontaneity. have to force themselves to get out of bed, go to work, eat meals, etc. suicide is the most extreme form

depression and suicide

17x more likely. 6-15% die

behavioral symptoms of depression

less active, less productive, spend more time alone or in bed, move or speak slowly

cognitive symptoms of depression

hold extremely negative views about themselves (inadequate, undesirable, inferior, etc.), blame themselves for every unfortunate event, pessimism, feel confused and have trouble remembering and are easily distracted

physical symptoms of depression

headaches, indigestion, constipation, dizzy spells, general pain, disturbances in appetite or sleep, fatigued

major depressive disorder

a severe pattern of depression that is disabling and not caused by such factors as drugs or a general medical condition

persistent depressive disorder

a chronic form of unipolar depression marked by ongoing and repeated symptoms of either major or mild depression

premenstrual dysphoric disorder

a disorder marked by repeated episodes of significant depression and related symptoms during the week before menstruation

postpartum depression

a disorder in which a major depressive episode typically begins with 4 weeks after delivering a child; many cases actually begin during pregnancy

biological explanations of depression

genetics (unipolar is tied to 2/3 of chromosomes), low activity of norepinephrine and serotonin, overreactive HPA axis, depression-related circuit, dysregulated immune system

MAO inhibitors

antidepressant that prevents the action of the enzyme monoamine oxidase

tricycles

antidepressant that has 3 rings in its molecular structure

selective serotonin reuptake inhibitors

group of antidepressants that increase serotonin activity without affecting other neurotransmitters

ketamine-based drugs

anesthetic antidepressant that brings rapid relief to many people

brain stimulation

interventions that directly or indirectly stimulate the brain in order to bring about psychological improvement

electroconvulsive therapy (ECT)

a biological treatment in which a brain seizure is triggered when an electric current passes through electrodes attached to the patient’s forehead

vagus nerve stimulation (VNS)

treatment for depression in which an implanted pulse generator sends regular electrical signals to the nerve that stimulates the brain

transcranial magnetic stimulation (TMS)

treatment in which an electromagnetic coil, which is placed on or above a patient’s head, sends a current into the individual’s brain

deep brain stimulation (DBS)

a treatment for depression in which a pacemaker powers electrodes that have been implanted in the patient’s subgenual cingulate, thus stimulating that brain area

symbolic or imagined loss

Freud theory where person equates other events with the loss of a loved one

cognitive triad

individual repeatedly interprets their experiences, themselves, and their futures in negative ways, leading to feelings of depression

rumination (Beck)

thinking of something over and over again impacts you negatively)

learned helplessness

the perception, based on past experiences, that one has no control over the reinforcements in one’s life and they themselves are responsible for this helpless state

behavioral activation

therapist works systematically to increase number of constructive and pleasurable activities and events in a client’s life (steps: reintroduce pleasurable events, reward nondepressive behaviors, improve social skills)

cognitive therapy

helps people identify and change their maladaptive assumptions and ways of thinking that help cause their psychological disorders

Beck’s 4 phases of cognitive therapy

1.increase activities and elevate mood

2.challenge automatic thoughts

3.identify negative thinking

4.change primary attitudes

interpersonal psychotherapy (IPT)

address 4 interpersonal problem areas (loss, role disputes, role transitions, deficits)

mania

experience dramatic and inappropriate rises in mood. opposite of depression

emotional symptoms of mania

euphoric joy out of proportion to actual happenings in individual’s life; some are irritable or angry

motivational symptoms of mania

in want of constant excitement, involvement, and companionship. social style may be overwhelming, domineering, or excessive

behavior symptoms of mania

move and talk quickly, flamboyance

cognitive symptoms of mania

poor judgement and planning, filled with optimism, hold inflated opinion about themselves, may lose touch with reality

physical symptoms of mania

remarkable energy, get little sleep yet feel awake

manic episode

at least one week display high or irritable mood, increase activity or energy, and at least 3 other symptoms of mania (less severe is called a hypomaniac episode)

bipolar I disorder

marked by full manic and major depressive episodes

bipolar II disorders

marked by mildly manic episodes and major depressive episodes

cyclothymic disorder

marked by periods of hypomaniac symptoms and mild depressive symptoms (for 2 or more years)

lithium

a metallic element that occurs in nature as a mineral salt and is an effective treatment for bipolar disorders

mood-stabilizing drugs

psychotropic drugs that help stabilize the moods of people with bipolar (aka antibipolar drugs)