Psychopathology: Mood Disorders Lecture Notes

Flashcards covering key vocabulary and concepts related to mood disorders and their treatment.

Mood Disorders

Involve severe alterations in mood that are intense, persistent, and maladaptive, leading to serious problems.

For something to be considered a mood disorder, it must be…

clinically significant & significantly deviate from the individual’s base line or ordinary emotional state; persistent enough to BE maladaptive

True or False: Everyone will suffer from at least some form of a “depressive episode” at a point in their lifetime

True

Depressive disorder:

involves periods of symptoms in which an individual
experiences an unusually intense sad mood

The essential element of depressive disorders involving an unusually elevated sad mood is known as…

dysphoria

Clinical depressive disorder

A mood disorder characterized by persistent feelings of sadness, hopelessness, and a loss of interest in activities, affecting daily functioning

Clinical depressive disorders involve a massive deficiency in NTs that are…

mood enhancers; on a regular basis, you’re always getting far less mood-enhancing NTs than you need (ex: serotonin, dopamine, endorphins, oxytocin)

What are the 2 primary examples of clinical depressive disorders discussed in class?

Major depressive disorder (MDD), persistent depressive disorder (PDD)

What are the 2 key moods of mood disorders?

Dysphoria & euphoria

Dysphoria (depressive)

An unusually elevated sad mood characterized by feelings of extraordinary sadness and dejection

Euphoric mood (mania):

A mood characterized by intense, unrealistic feelings of excitement and joy.

Mixed Features (mixed episode of euphoria & dysphoria):

characterized by symptoms of both mania or hypomania w/ depressive features

Hypomanic episodes:

involves milder versions of euphoria but must last at least 4 days; same symptoms but less impairment, no need for hospitalization

Major Depressive Disorder (MDD)

clinical depressive disorder where individual chronically experiences short, intense episodes of depressive symptoms

Major Depressive Episode

A period during which an individual experiences intense psychological and physical symptoms, accompanying feelings of overwhelming sadness

What are the symptoms of MDD?

- lose all motivation, no desire to do anything, everything suddenly requires energy
- may lead to excess or deficit in eating / sleeping
- major sleep, appetite, hygiene, & energy disturbances

What is the criteria for MDD?

•  >=2 episodes within an interval of 2 consecutive months

Must experience dysphoria most of the day & nearly every day for >=2 weeks
(but episodes can last up to months)

Why does MDD only become diagnosable after 2 weeks of dysphoria?

Bc you may have smth else that affects you so greatly for a good week, like a breakup, losing a job, or failing a class

If untreated, MDD can last for…

6-9 months on average & will likely recur

Persistent Depressive Disorder (PDD) (dysthymia)

chronic mood disturbance in which the individual suffers from a persistent blue mood w/o experiencing a major depressive episode

Fill in the blanks: PDD is (temporary or chronic?) & happens to be a (less or more?) severe mood disturbance than MDD

chronic; less severe
(symptoms of PDD are mild / moderate in comparison to MDD, but last much longer)

The most important characteristic in distinguishing PDD from MDD is…

the intermittent, short-lived normal mood swings existing in PDD

Periods of “normal moods” occur briefly in PDD; they only last for how long?

a few days to a weeks, (max: 2 months)

PDD must be experienced for how long to be diagnosed?

1 year in children/adolescents, 2 years for adults

The average duration of having PDD is how long?

4-5 years (but can last for over 20 years at max.)

Seasonal Affective Disorder (SAD)

A mood disorder where episodes of depression typically occur during fall and winter, subsiding in spring

SAD can occur across any gender or latitude, but it is most common among…

women & those who live in northern latitudes

What seasonal factors put ppl at risk for SAD?

• Lack of vitamin D in colder seasons like the winter
  affects NT production
  (esp. feel-good NTs like serotonin & dopamine)
  

• Less socialization in colder seasons → also affects
  NT production since you stay indoors
  (note: lower mood baseline can lead to greater depression risk, since by then it takes less to send mood below threshold for depression)

• Classical conditioning (remember Pavlov’s dogs?)

(uncond. stimulus evokes uncond. response)

(so uncond. stimulus is paired w/ neutral stimulus, making the neutral stimulus lead to a cond. response that equals the uncond. response)
→ neutral stimulus becomes cond. stimulus

(similarly, ppl w/ SAD can be cond.’ed to have SAD during any certain time of year)

In a personal story of SAD, Dr. Herman’s mom lost her son & many others in the winter. This caused her to associate winter with grief—what was the unconditional stimulus, uncond. response, neutral stimulus, and cond. response?

Unconditional stimulus: loss of family
Uncond. response: grief
Neutral / cond. stimulus: winter
Cond. response: association of winter w/ grief

How did Dr. Herman manage to curb her mom’s SAD?

she used classical cond.’ing

(made a big deal out of Christmas whenever it hit Dec. 1st;
she would make many ornaments, go Christmas shopping for gifts, bake cookies & sweets, etc.)

Eventually, Dr. Herman’s mom associated Dec. 1st w/
fun festivities instead of depression

(not SAD, but story about how classical cond.’ing in envir.’s can affect grief)

Dr. Herman knew a lady who always felt depressed in areas crowded w/ trees, she said she got depressed when she went to Maine bc she felt claustrophobic.

What is the uncond. stimulus, uncond. response, neutral stimulus, & cond. response?

uncond. stimulus: tightly enclosed areas
uncond. response: claustrophobia & intense sadness
neutral stimulus: state of Maine (esp. w/ its trees)
cond. response: association of Maine w/ claustrophobia &
intense sadness

Dr. Herman’s brother passed from COVID. Her whole life w/ him was spent in a certain village home that she struggles to go back to bc it’s a reminder of loss. This emphasizes how, in classical cond.’ing…

Certain places can trigger us to be sad, not just seasons

How could Dr. Herman come closer to overcoming her feelings of grief triggered by the village home thru classical cond.’ing?

having fun events w/ family at village home,
associating it w/ joy & nostalgia rather than grief

What is the biological explanation for why
exercise helps w/ mild depression?

Bc as you exercise, you produce mood enhancers
(e.g. endorphins, serotonin, dopamine)

Positive thinking / explanatory styles
→ also boosts mood enhancers!

Unspecified Mood Disorder (UMD):

individual suffers from symptoms characteristic of a depressive disorder, causing them clinically significant distress or impairment in social, occupational, or other important areas of functioning

(but their symptoms do not meet the criteria for a depressive or bipolar disorder diagnosis)

Ex: If a person has mood swings that don’t meet the bipolar or depressive disorder criteria…
→ chances are they’re going to be diagnosed w/ UMD

Disruptive mood dysregulation disorder (DMDD):

a depressive disorder in children who exhibit chronic,
severe irritability & have frequent temper outbursts

DMDD occurs at what frequency?

Occurs 3+ times/week on avg. in 1 year, must be in 2+ consistent settings
Ex:
- at home & school
- at a friend's house & a relatives' home
- at club meetings & sports practice

Diagnosis of DMDD is strictly for children between what ages, & when is the latest the onset can happen?

Diagnosis strictly for children between ages 6 to 18
(at 18+, you cannot have DMDD)

Onset of DMDD must be before the age of 10

Why must the onset of DMDD have occurred by the age of 10?

to ensure outbursts are not puberty-related,
bc plenty of emotional dysregulation occurs during puberty

Example story of DMDD, Dr. Herman had a kid in her practice who she worked w/ for years. What fueled his full-blown temper tantrums?

fueled by inner anxiety & frustration rather than
outward anger/rage

Ex:
If he got test results back, he wasn't screaming, like, “I want 100!”
It was more like him screaming bc “oh my gosh, I can’t believe I didn't get a good grade.” even if he scored a 95

Ex: If he ever got overstimulated or overwhelmed at a friend’s fun birthday’s party, he’d start screaming & pulling at his own hair

When Dr. Herman was helping the kid w/ his DMDD, she found that he was quick to…

see everything negatively
(always assumed ill-intent to what other kids were doing or saying, so he took everything personally & would get very upset)

Dr. Herman found that the kid w/ DMDD who perceived everything negatively also had…

reactive attachment disorder (RAD) - withdrawn, prefers solitude, resistant to comfort

(he had a hard time getting close to anyone, which exacerbated his feeling that everyone was out to get him)

DMDD is not about throwing spoiled rotten tantrums at all.
Instead, the temper tantrums of DMDD usually mean what about a child’s mood regulation?

that they struggle to regulate their moods whenever
frustrated, overstimulated, or disappointed

(ex: the kid w/ DMDD who Dr. Herman helped)

Premenstrual dysphoric disorder (PMDD):

a disorder that involves depressed mood or changes in mood, irritability, dysphoria, & anxiety during the premenstrual phase

(premenstrual phase: 1-2 weeks before menstruation at 30 days)

(severely affects daily life; only subsides after menstrual period begins for most cycles of the preceding year)

What are the “good news” and “bad news” of facing PMDD?

Good news: there's medication for it

Bad news: you have to know your cycle, you must have a regular cycle bc you have to take that medication at the right time

(if you miss the period, it's too late & you're going to experience the dysphoria/depressive state)

PMDD has many factors & causes, incl.’ing:

• biological factors

• neurochemical factors

• psycholo. causes

• neuroticism

  • involves temperamental sensitivity to negative stimuli

  • ppl w/ greater neuroticism:

    • things bother them more; they need to have more control over life to not feel anxious

    • they are more prone to
      experiencing a broader range of negative moods

Neuroticism is defined as…

the primary personality variable that serves as a
vulnerability factor for depression and anxiety
(neuroticism strongly correlated w/ depression & anxiety)

Learned Helplessness

A psychological condition in which an individual feels they have no control over the outcomes in their life, leading to feelings of helplessness & depression

Learned helplessness model of depression:

when perceived lack of control is present, helplessness may result in depression

People make attributions that are central to whether they experience depression / how they handle depression. What are these 3 critical dimensions of explanatory styles?

And what is the pessimistic attribution style in each dimension?

1. Internal OR External

2. Global OR Specific

3. Stable OR Unstable

Pessimistic attribution style → internal, global, stable
(most vulnerable to depression)

Internal VS External

Internal: it is all your fault; it is bc of you personally that smth bad occurred (ex: it’s my fault I didn’t get the job, I’m a bad applicant)

External: acknowledging factors apart from yourself that led to an outcome (the application was very selective since there were tons of applicants & only a few would get in; doesn’t make me inferior)

Global VS Specific

Global: thinking that one mistake/tragic event shows you failed in every aspect of your life
(ex: got a bad grade in a class, this makes me stupid)

Specific: understanding that this one area of your life causing you sadness is just ONE area

(ex: I do well in many other classes, just that this one needs work; needing a bit of improvement doesn’t make me dumb)

Stable VS Unstable

Stable: thinking that smth negative in your life will continue forever
(this pain is permanent, I’m never gonna get better)

Unstable: knowing that smth negative in your life is temporary
(my pain is temporary, I’ll feel better once I get thru this!)

Bipolar Disorder

A mood disorder characterized by episodes of euphoric mood alternating with major depressive episodes.

Cyclothymic Disorder

A more chronic but less severe version of bipolar disorder involving numerous periods of hypomania and depression.

Cognitive Therapy

A type of therapy aimed at changing negative thinking patterns to alleviate depression.

Suicide Ideation

The process of thinking about ending one's life, often a precursor to more serious suicide attempts.

Negative Explanatory Style

A pattern of thinking that attributes negative outcomes to oneself, and sees problems as global and stable.

Neuroticism

A personality trait involving sensitivity to negative stimuli, often linked to increased levels of anxiety and depression.

Positive Psychology

The study and application of principles to promote resilience and well-being in individuals.

Antidepressants

Medications used to treat depression, often by altering neurotransmitter levels in the brain.

Electroconvulsive Therapy (ECT)

A medical treatment for severe depression that involves electrical stimulation of the brain.

Transcranial Magnetic Stimulation (TMS)

A noninvasive procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression.

Pharmacotherapy

The treatment of mood disorders with medications to manage symptoms effectively.

Self-Harm

Engaging in behaviors that intentionally damage one's own body without the intent of ending one's life.

Disruptive Mood Dysregulation Disorder (DMDD)

A disorder in children characterized by chronic, severe irritability and temper outbursts.

Premenstrual Dysphoric Disorder (PMDD)

A severe form of premenstrual syndrome that causes significant mood changes and is often treated with medication.

Substance-Induced Mood Disorder

A mood disorder resulting from the direct physiological effects of a substance, such as drug abuse.

Risk Factors for Depression

Includes genetics, neurochemical factors, stress, and early adversity that can predispose individuals to mood disorders.