PSYCH 211: Mood & Anxiety Disorders

mood disorders general characteristics

disordered feelings: feelings of numbness, emptiness, unworthiness

two types of major affective disorders

• bipolar disorder

• major depressive disorder

bipolar disorder characteristics, hereditability?

cyclical periods of mania (grandiosity) & depression

• often exhibit nonstop speech & motor activity, racing thoughts, little sleep, risky behavior

• 80% hereditable, affects 2% of pop

treatment for bipolar disorder

lithium, can take 1-3 weeks, helps handle manic portion & subsequently depression portion- can’t treat the depression solely (anti-depressants would be used)

• can take lithium in combo w/ antipsychotics, anticonvulsants, antidepressants

major depressive disorder characteristics & hereditability

unremitting or periods of depression, no alteration w/ mania periods

• 40% hereditability

• affects 7% women, 3% men

treatment for major depressive disorder & how well they work

functionality of each drug is very situation-specific

• (SSRIs) serotonin-specific reuptake inhibitors: prozac, zoloft

• serotonin & norepinephrine reuptake inhibitors: effexor

• norepinephrine & dopamine reuptake inhibitors: wellbutrin

• NMDA glutamate receptor antagonists: ketamine

differene between ketamine & other treatments for major depressive disorder

ketamine is known to work within hours, contrasting the inhibitor’s longer duration spent working

direct electrical/magnetic stimulation of brain (cranial nerve)

electroconvulsive therapy (ECT)— inducing seizures

deep brain stimulation, transcranial magnetic stimulation, vagal nerve stimulation

monoamine hypothesis

depression is caused by low levels of monoamine signaling

how electroconvulsive therapy works & how well it works

• most rapid & effective treatment for bipolar disorder & anxiety, also used for schizophrenia

• people given muscle relaxants & put under general anesthesia then brief electrical shocks to head to induce seizure

  • more than 50% of ppl experience complete remission, works within days to show reduced symptoms

evidence against monoamine signaling

issue w/ hypothesis: artificially lowering serotonin signaling in non-depressed individuals rarely causes depression

• demonstrates depressed ppl don’t seem to have lower levels of monoamine signaling

how well does increasing serotonin levels affect the neural network to help alleviate MDD symptoms

lowk we don’t know much abt real mechanisms bc these increased serotonin levels are instant but symptom relief often occurs after several weeks of continuous use

• clearly not a 1-to-1 connection btwn monoamine signaling & depression

what fMRI testing proved for MDD

subgenual anterior cingulate cortex less active after treatment for depression

• further clinical trials couldn’t isolate/prove any more info from this initial study

effects of depression on sleep

tend to have shallow, fragmented sleep

• tend to wake up frequently, especially toward morning

• typically spend more time in stage 1 sleep & less time in deep, slow-wave sleep

  • enter REM much earlier in night than ppl w/o depression

how does total sleep deprivation affect ppl w/ MDD & what does this suggest

immediate antidepressant effect with symptoms of mania too

there could be chemical buildup that gets cleared away during sleep w/ antidepressant properties

what systems are triggered in our body’s classic stress response

involves autonomic & endocrine systems to mobilize body into fight or flight

how does our body’s stress response work?

1. body senses threat

2. stress activate sympathetic branch (autonomic)

   1. spinal nerves connect directly to adrenal glands & trigger them to release epinephrine & norepinephrine into blood

3. stress activates HPA axis (hypothalamic-pituitary-adrenal gland)

   1. hormone signaling cascade that increases glucocorticoid signaling in blood

      1. adrenal gland releases primarily cortisol (HIGH CORTISOL)

body now prepped to react, increased blood pressure/flow & heart rate

chronic stress: causes & effects

caused by acute glucocorticioid signaling, body now deprioritizes "non-survival functions

• immune functions, growth hormone signaling, sex hormone signaling

effects of chronic stress applied onto possible functions

• infertility (lack of sex hormone signaling)

• brain plasticity messed up & reduced body growth (growth hormone signaling deficit)

• steroid diabetes (high cortisol damages pancreas)

• digestive problems (ulcers, IBS, changes in weight)

• infertiliy (sex hormone signaling deficit)

if chronic stress is harmful— why can’t stress response just be blocked pharmacologically

hormones created in signaling needed for survival & regulate numerous physiological functions (cardiovascular function, immune function, skeletal grwoth, reproduction)

• help in circadian rhythm of metabolism & prep body for physical activity

PTSD general characteristics & hereditability, how likelihood of developing relates to # of traumatic events

aftermath of traumatic event, 30% hereditability

• likelihood of developing PTSD increases with # of traumatic events

symptom severity of PTSD correlation with size of brain regions

volume in hippocampus & PFC will get smaller due to reduction in neurons

is PTSD considered an anxiety disorder?

no— its associated w/ emotions (guilt, shame, anger) that lay outside of fear/anxiety spectrum

what neurologically causes PTSD

an overactive sympathetic nervous system & dysregularities in HPA axis (high cortisol)

treatment for PTSD

therapy & SSRIs

generalized anxiety disorder

excessive anxiety & worry when in not aversive/threatening situation

social anxiety disorder

excessive fear of being exposed to scrutiny by others

panic disorder

where panic attacks occur often, often trigger anticipatory anxeity

anticipatory anxiety & effects

fear of having panic attack, can lead to increased risk for developing agoraphobia

when does anxiety usually develop, what % of pop, same for women vs men?

affects 12% of pop, 2x as common for women (mental illnesses generally)

anxiety treatment

lifestyle changes, behavioral therpay (CBT), medications (SSRIs)

obsessive compulsive disorder symptoms & commonality among genders

4 groups

• symmetry: need for patterns, symmetry, etc

• cleanliness— germs, bodily fluids, contaminations

• hoarding— can’t throw things out

• forbidden thoughts— distressing violent, religious, sexual

2x as common in women

treatment for OCD & severe cases

counseling & antidepressants (SSRIs)

• severe cases: cingulotomy— modern version of frontal lobotomy, surgically severs fiber bundle in frontal lobe