Exam II- Mood Disorders

What are the five areas of functioning that may be affected by depression?

1. Emotional Symptoms

2. Motivational Symptoms

3. Behavioral Symptoms

4. Cognitive Symptoms

5. Physical Symptoms

Emotional symptoms of depression

feeling miserable, empty

Motivational symptoms of depression

• Losing motivation to pursue typical activities

• Lack of drive / initiative

Behavioral symptoms of depression

• speaking and moving more slowly

• being less physically active and productive

Cognitive symptoms of depression

• thinking that you are inadequate or undesirable

• being excessively pessimistic

• having difficulty focusing

Physical symptoms of depression

• headache

• constipation

• dizzy spells

• general pain

• difficulty eating / sleeping

Symptoms of a depressive episode

• depressed mood most of the day, nearly everyday

• anhedonia

• weight or appetite disturbance

• sleep disturbance

• fatigue or loss of energy

• worthlessness / guilt

• inability to concentrate / indecisiveness

• suicidal ideation

Anhedonia

a lack of pleasure in activities that an individual used to enjoy or an inability to take pleasure in anything

How long do depressive symptoms need to last for before we can classify an individual as experiencing a major depressive episode?

2 weeks

How long do depressive symptoms need to last for before we can diagnose an individual with a persistent depressive disorder?

at least 2 years

What is the lifetime prevalence of severe unipolar depression?

around 20%

Peripartum Depression

10-20% of new mothers experience clinical depression during pregnancy or within four weeks following birth. Can last for months / years without treatment. Therapy, and sometimes medication, are often forms of treatment.

Baby Blues

Up to 80% of new mothers experience sadness, mood swings, and tearfulness 2-3 days post-birth. Typically treated with support and rest, and lasts up to 2 weeks

Does the risk for unipolar depression change for males and females during different developmental periods?

• Children: no differences

• Adolescence: females are more likely

• Adulthood: Women are at least 2x more likely to suffer from depression than men

What are the potential explanations for gender differences in depression?

• The Life Stress Theory

• The Body Dissatisfaction Theory

• The Rumination Theory

• The Lack of Control Theory

The Life Stress Theory

the idea that women in our society tend to experience more stress than men

• Ex: more likely to live in poverty, face more discrimination, work in unskilled jobs

The Body Dissatisfaction Theory

Suggests that the pressure society places on people to look a certain way leads to higher body dissatisfaction among women compared to men. This is b/c women are more likely to internalize unrealistic beauty standards, leading to negative self-perceptions and emotional distress

The Rumination Theory

Proposes that people who are prone to depression tend to ruminate when sad

The Lack of Control Theory

suggests that women experience higher rates of depression because they are more likely to feel a lack of control over their lives due to societal factors like discrimination, lower social status, and greater exposure to stressors. This sense of helplessness can lead to increased vulnerability to depression

What is the biological explanation for unipolar depression?

• Neurotransmitters: Low activity levels of serotonin and norepinephrine are associated with depression

• Hormones: ppl. w/ depression have abnormal levels of cortisol & melatonin

• There is a small genetic factor

For depressed individuals, what two hormones do we often find abnormal levels of?

cortisol and melatonin

How does the psychodynamic view explain depression?

Freud noted similarities b/w clinical depression and grief in ppl. who lose loved ones. He explained depression as a symbolic or imaged loss

How does the behavioral view explain depression?

depression results from changes in rewards and punishments people receive in their lives

The behavioral view explains that ____ rewards and the availability of ___ ___are especially important.

social; social support

Examples of social rewards

• Receiving a compliment from a friend

• Being asked to hangout

Depression has been repeatedly tied to ____ of social support and ____ social rewards

unavailability; fewer

Beck’s Cognitive Model of Depression

Beck theorizes four interrelated cognitive components combine to produce unipolar depression: (1) maladaptive attitudes, (2) cognitive triad, (3) errors in thinking, (4) automatic thoughts

Maladaptive attitudes

• self-defeating attitudes develop during childhood

• upsetting situations later in life can trigger an extended round of negative thinking

Define Cognitive Triad

an extended round of negative thinking

What is the Cognitive Triad?

individuals repeatedly interpret their experiences, themselves, and their futures in negative ways — leading to depression

Errors in thinking

Depressed ppl. make general errors in their thinking, including:

• Arbitrary inferences

• Minimization of positive

• Magnification of the negative

Arbitrary inferences

coming to a negative conclusion based on very little info

Examples of errors in thinking:

1. All or none thinking: looking at things in black and white

2. Overgeneralization: coming to a general conclusion based on a single incident

3. Jumping to Conclusions

Automatic Thoughts

a steady train of unpleasant thoughts that inadequacy and hopelessness

• Ex: “I’m worthless. I’m stupid.”

What is learned helplessness?

This theory suggests that people become depressed when they think that:

1. they not longer have control over the good and bad in their lives

2. they themselves are responsible for this state

What does it mean to make internal, stable, and global attributions? How are they related to depression?

• These are recent versions of the learned helplessness theory

• Internal attributions that are global and stable lead to greater feelings of helplessness and possibly depression

What is an example of someone making internal, stable, and global attributions?

In reaction to a breakup:

“It’s all my fault (internal). I ruin everything I touch (global) and I always will (stable)”

What is mania characterized by?

• dramatic and inappropriate rises in mood

• a state of euphoria

Symptoms of a manic episode:

• abnormally high or irritable mood

• increased activity or energy

• inflated self-esteem or grandiosity

• decreased need for sleep

• increased talkativeness

• distracted

• flight of ideas

• increase in goal-directed activity

• excessive involvement in dangerous activities

How long do manic episodes last?

at least a week

Hypomanic episode

• when symptoms are less severe than a manic episode

• never requires hospitalization

• shorter in duration

What are the five areas of functioning that may be affected by mania?

• Emotional Symptoms

• Motivational Symptoms

• Behavioral Symptoms

• Cognitive Symptoms

• Physical Symptoms

Emotional symptoms of a manic episode:

euphoria or irritability

Motivational symptoms of a manic episode:

a need for constant excitement, involvement, and companionship

Behavioral symptoms of a manic episode:

• very active

• moving quickly

• talking loudly or rapidly

Cognitive symptoms of a manic episode:

• show poor judgement or planning

• may hold an inflated opinion of themselves

• may have trouble remaining in touch with reality

Physical symptoms of a manic episode:

a high energy level, often with little or no rest

What is the primary difference between Bipolar I and Bipolar II disorder?

Those with Bipolar I disorder alternate between full manic and major depressive episodes, while those with Bipolar II disorder alternate between hypomanic episodes and major depressive episodes

Rapid Cycling

the term given to those who experience four or more manic/depressive episodes in a year

Cyclothymic Disorder

• when a person experiences numerous periods of hypomania and mild depressive symptoms for two or more years

• symptoms are less severe than Bipolar I or II

What is the biological model’s explanation for bipolar disorders?

• Neurotransmitters: science isn’t sure which ones

• Brain structure: Basal ganglia and cerebellum tend to be smaller

• Genes: family pedigrees support this theory

What is the controversy regarding diagnosing children with bipolar disorder?

• Experts feared that children and adolescents were being over diagnosed with Bipolar Disorder

• They believe that it has become a clinical “catchall” that is being applied to almost every explosive, aggressive child

• Many children diagnosed with Bipolar Disorder do not display symptoms of mania

• Children were receiving adult medications that weren’t specifically tested for children

What alternate diagnosis was proposed for children experiencing “bipolar disorder”?

Disruptive Mood Dysregulation Disorder

Symptoms of Disruptive Mood Dysregulation Disorder:

• severe recurrent temper outbursts that are inconsistent with developmental level

• mood between temper outbursts is persistently irritable

• present in at least two settings (home, school, peers)

• cannot be diagnosed before age 6 or after age 18