Lesson 6: Mood Disorders, Depressive Disorders, Bipolar Disorders

Mood Disorders

More intense and harder to manage than normal feelings of sadness. Primarily affects emotional state, experience long periods of extreme happiness, extreme sadness or both.

Mania

Makes an individual abnormally exaggerated elation, joy, or euphoria. Individuals find extreme pleasure in every activity. Impairment in functioning

D - Distractibility

I - Impulsivity

G - Grandiosity

F - Flight of ideas

A - Activity increases

S - Sleep deficit

T - Talkativeness

Signs and Symptoms of Mania:

Hypomania

Less severe version of a manic episode that does not cause marked impairment in social or occupational functioning.

Anhedonia

loss of energy and inability to engage in pleasurable activity.

Unipolar Mood Disorder

Individuals who suffers either depression or mania

1. Feeling of worhtlessness/hopelessness

2. Insomnia

3. Eating Problems

4. Suicidal ideations

Depressive episode signs/symptoms

Unipolar Depression

Have with depressive episodes but no history of mania, return to a normal or nearly normal mood when their depression lifts. IIlan lang mga symptoms

Bipolar Disorder

Have periods of mania that alternate with periods of depression.

Major Depressive Episode

Most commonly diagnosed and most severe depression. Purely depressive symptoms. Leading to MDD, nagkakasabay-sabay lahat ng symptoms

1. 5 or more symptoms for 2 weeks (out of 9)

2. At least 1 symptoms is either (1) depressed mood or (2) loss of interest or pleasure.

Criteria for Major Depressive Disorder

Puberty

Major Depressive Disorder may first appear at any age, but the likelihood of onset markedly with ____

TRUE

T or F: Depression with earlier age at onset are more familial and more likely to involve personality disturbances

1. Anti-depressant and Psychotherapy

2. Exercise

3. Positive Psychotherapy

4. Interpersonal Therapy

Treatments of MDD

Persistent Depressive Disorder (Dysthymia)

Often has an early and insidious onset and chronic course

Must be in a depressed mood for most of the day for the majority of days over at least 2 years period

Criteria for Persistent Depressive Disorder

Double Depression

Suffers from both MDE and PDD with fewer symptoms

Premenstrual Dysphoric Disorder

5 symptoms, menstrual cycle is done but symptoms are persistent (recurrent per month). At risk to leading Postpartum Depression

Bipolar Disorder I

Mania + MDE + 1 week

Bipolar Disorder I with Psychotic Features

Mania + Hallucination & Delusions + 1 Week

Late adolescence or Early Adulthood

Symptoms of mania in BD1 occur in distinct episodes and typically begin in ____

TRUE

T or F: BD1 is more extreme than BD2 because of extreme mood.

Bipolar Disorder II

Hypomania + MDE + 4 Days; Highly recurrent, also have seasonal variation in mood compared to those with BD1.

Bipolar Disorder II with Psychotic Features

Hypomania + MDE + Hallucinations and Delusions

Low serotonin; High Norepinephrine

Mania may be link to _______ activity accompanied by ______ activity

1. Pharmacological treatment

2. Mood stabilizers

3. Cognitive Behavioral Therapy

4. Psychoeducation

Treatments for BD1 & BD2

Cyclothymic Disorder

Milder but more chronic version of Bipolar Disorder. 2 years episode of hypomanic and depressive experiences which do not meet the full DSM-5 diagnostic criteria for hypomania or MDD; floating, in the middle.

1 Year

In Cyclothymic Disorder, duration is

2 years (Adult) and ____ (Children)

10 years old

Experience of onset of mood symptoms in Cyclothymic Disorder is before _____

Bipolar I

The DSM-5 indicates that risk factors for Cyclothymic Disorder are having a first degree relative with _____

Mood stabilizers (Lithium Carbonate) in conjuction with CBT and support groups

Treatment for Cyclothymic Disorder

1. BD1

2. BD2

3. Cyclothymia

Fill out the blanks

1. Neurotransmitter systems - low serotonin, low dopamine, high cortisol during stressful events

2. Shrinkage in Hippocampus

3. Low hippocampal volume for depressed individual

Biological Dimensions Causes of MDD & BPD

1. Stress and Trauma

2. Learned Helplessness Theory

Psychological Dimensions Causes of MDD and BPD

Biological and Psychological Dimensions

Top 2 causes of MDD and BPD

Learned Helplessness Theory

Anxiety is the first response to stressful situation, depression may follow with hopelessness

1. Anti-depressant medications - SSRIs & Monoamine Oxidase Inhibitors (MAOI)

2. Lithium Carbonate

3. Cognitive Therapy

4. Maintenance Treatment

Treatment Statistics

Selective-Serotonin Reuptake Inhibitors (SSRIs)

Specifically block the presynaptic reuptake of serotonin; Fluxotine (Prozac) best known drug in this class

Monoamine Oxidase Inhibitors (MAOI)

Block the enzyme MAO that breaks down such neurotransmitters as norepinephrine and serotonin.

Lithium Carbonate

Mood stabilizing drug that prevent manic episodes

Cognitive Therapy

Clients are taught to examine carefully their thought processes while they are depressed and to recognize “depressive” errors in thinking

Maintenance Treatment

Prevent relapse or recurrence over the long term. Includes CBT with psychoeducation

TRUE

T or F: Women are twice as likely to have mood disorders as men.

Female

MDD in adolescence is largely a _____ disorder

Death Seeker

Clear intention to end their lives at the time they attempt suicide

Death Initiators

Clearly intent to end their lives but act out of a belief that the process is already under the way and they are simply hastening the process. Pinapahaba or binabagalan muna

Death Ignorers

Do not believe that their self-inflicted death will mean the end of their existence. Walang sense of purpose, naniniwala na walang magbabago kahit mag pakamatay.

Death Darers

Experience mixed feelings or ambivalence about their intent to die.

Suicidal Ideation

Thinking seriously about suicide

Suicidal Plans

Formulation of a specific method for killing oneself

Suicidal Attempts

The person survives from attempts.

1. Altruistic

2. Egoistic

3. Anomic

4. Fatalistic

Emile Durkheim Suicide Types

Altruistic

Dishonor to self, family, or society

Egoistic

Loss of social supports as an important provocation for suicide

Anomic

Result of marked disruptions, such as sudden loss of job

Fatalistic

Loss of control over one’s own destiny

1. Stressful events

2. Mood and thought changes

3. Alcohol and other drug use

4. Mental disorders

5. Modeling

Common triggering factors:

TRUE

T or F: Anyone in the state of doing suicide does not feel anything, cannot think of anything. just blank.