Psychopathology: Mood Disorders

Symptoms of depression

unhappy mood

loss of interests/reduced energy

changes in appetite

disrupted sleep patterns

difficulty in concentration

restless agitation or torpor

pessimism and thoughts of death

Why is prevalence of mental illness greater in women?

patterns of seeking help

gender differences in endocrine physiology (related to reproductive cycle)

Increased activation in which parts of the brain for depression?

prefrontal cortex during cognitively demanding tasks

amygdala during emotional processing

Decreased activity in which parts of the brain for depression?

hippocampus (decreased volume)

anterior cingulate cortex

The ______ is dysfunctional in people with depression

habenula

Stimulation of the habenula (increases/reduces) depressive behavior

reduces

Pharmacological treatment for depression

monoamine oxidase (MAO) inhibitors

MAO

enzyme that inactivates monoamines (norepinephrine

MAO inhibitors raise the level of _______ at the synapses

monoamines

______ led to monoamine hypothesis of depression

efficacy

Monoamine hypothesis of depression

depression is due to reduced monoamine activity

Tricyclics (2nd generation of antidepressants)

inhibit reuptake of monoamines

Selective serotonin reuptake inhibitors (SSRIs)

block reuptake of serotonin

SNRIs

taget serotonin and norepinephrine

Problems with reuptake inhibitors (1)

SSRI benefits are often not much different than placebo

Problems with reuptake inhibitors (2)

not everyone responds to SSRIs

Problems with reuptake inhibitors (3)

Problems with reuptake inhibitors (4)

SSRIs can increased risk of suicide

Problems with reuptake inhibitors (5)

anti-depressant discontinuation syndrome

Non-traditional pharmacological treatments for depression

ketamine and psychedelic drugs (effects can be immediate and long-lasting from single dose)

Ketamine

NMDA receptor antagonist

can be administered via inhaler in ER

rapid reduction in suicide ideation

Psychedelic drugs

target 5-HT2a

psilocybin

LSD

Non-pharmacological treatments for depression

electroconvulsive shock therapy (ECT)

repetitive transcranial magnetic stimulation (rTMS)

deep brain stimulation (DBS)

cognitive behavioral therapy (CBT)

exercise

ECT

strong electrical current is passed through the brain, causing a seizure

rTMS

alters cortical electrical activity

DBS

through a surgically implanted electrode

CBT

changing perception

-behaviors (what we do affects how we think and feel)

-feelings (what we feel affects how we think and act)

-thoughts (what we think affects how we feel and act)

Effectiveness of CBT

can be as effective as SSRIs, and when used together are more effective than either alone

Bipolar depression and mania

characterized by alternating periods of mania and depression

mania symptoms

expansive mood

excessive talkativeness

grandiosity

increased energy/reduced sleep

Rapid-cycling

four or more cycles per year

Who is more affected by bipolar disorder?

men and women are equally affected

Brain changes akin to those with what disorder?

schizophrenia (enlarged ventricles and reduced grey matter)

Which element is an effective treatment for bipolar disorder?

lithium

Effects of lithium for bipolar disorder

affects serotonin and dopamine activity

increases grey matter in brain

Toxic side effects of lithium for bipolar disorder

tremor

weight gain

flattened mood

cognitive impairment