Mood Disorders: Depressive and Bipolar Disorders

Vocabulary practice flashcards covering depressive disorders, bipolar and related disorders, diagnostic criteria, clinical etiologies, neurocircuitry, and pharmacological/psychotherapeutic treatments.

Persistent Depressive Disorder (PDD)

A continuous, chronic form of unipolar depression combining dysthymia and chronic major depression; requires experiencing a depressed mood for most of the day, more days than not, for at least $2$ years ($1$ year in children/adolescents), accompanied by at least $2$ additional depressive symptoms, with no symptom-free period lasting longer than $2$ months.

Major Depressive Disorder (MDD)

A depressive disorder characterized by discrete episodes lasting at least $2$ weeks with changes in affect, cognition, and neurovegetative functions; diagnosis requires at least $5$ symptoms present for most of the day nearly every day, with at least one symptom being depressed mood or anhedonia.

Premenstrual Dysphoric Disorder (PMDD)

A treatment-responsive depressive disorder occurring during the majority of menstrual cycles, where at least $5$ symptoms appear in the final week before menses, start to improve within a few days after onset, and become minimal or absent in the week post-menses.

Disruptive Mood Dysregulation Disorder (DMDD)

A depressive disorder diagnosed in children up to $12$ years of age, characterized by frequent episodes of extreme behavioral outbursts and dyscontrol, designed to reduce the potential overdiagnosis and treatment of bipolar disorder in pediatric populations.

Anhedonia

A core emotional symptom of depression characterized by a marked loss of interest or pleasure in all, or almost all, previously enjoyable activities for most of the day, nearly every day.

Psychomotor Agitation or Retardation

Purposeless physical movement (such as pacing the room, tapping toes, or general restlessness) or slowed physical movements of the body observed during depressive episodes.

Bipolar I Disorder

A mood disorder diagnosed when an individual experiences at least one full manic episode; the episode can be preceded or followed by hypomanic or major depressive episodes, but only a manic episode is required for diagnosis.

Bipolar II Disorder

A mood disorder characterized by a history of at least one hypomanic episode and at least one current or past major depressive episode, with no history of a full manic episode.

Manic Episode

A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally increased goal-directed activity or energy, lasting at least $1$ week and present all day, every day.

Mood Lability

Rapid, unpredictable shifts in emotional state and mood seen during manic episodes.

Hypomanic Episode

A period of persistently elevated, expansive, or irritable mood and increased energy lasting for at least $4$ consecutive days, sharing symptoms with mania but lacking the extreme functional impairment or psychotic features of a manic episode.

Cyclothymic Disorder

A mood disorder characterized by numerous periods with hypomanic symptoms and mild depressive symptoms that do not meet full criteria for a hypomanic or major depressive episode, which can eventually develop into Bipolar I or Bipolar II disorder.

Suicidality in Mood Disorders

The risk of suicide associated with mood disorders: MDD conveys an estimated $17\text{-fold}$ increased risk of suicide, and approximately $15\%\text{ to }20\%$ of individuals with bipolar disorder die by suicide.

5-HTT Gene

A gene located on chromosome $17$ that is implicated in the biological vulnerability to depression.

Biochemical Theory of Mood Disorders

The model proposing that depressive episodes are associated with low activity levels of norepinephrine and serotonin, whereas manic episodes involve low serotonin coupled with high norepinephrine activity.

Learned Helplessness

A cognitive model derived from animal shock experiments demonstrating that repeated exposure to uncontrollable negative stressors leads organisms to believe they are unable to escape or exert control, even when escape becomes possible.

Attributional Style

The cognitive pattern by which individuals explain life outcomes: a negative attributional style attributes negative events to internal, stable, and global factors (linked to depression), whereas a positive style attributes events to external, unstable, and specific factors.

Cognitive Triad

A cognitive model proposed by Aaron Beck describing how individuals with depression consistently maintain automatic, negative thoughts about their experiences, themselves, and their futures.

Lewinsohn's Behavioral Theory of Depression

Peter Lewinsohn's behavioral formulation stating that depression develops when individuals experience a significant reduction in the rate of positive rewards and reinforcements in their lives.

Artifact Theory

A gender-difference theory suggesting that the higher observed prevalence of depression in women is an artifact of diagnostic tools and clinicians being more sensitive to identifying depressive symptoms in women than in men.

Rumination Theory

A cognitive theory proposing that women have higher rates of depression than men because they are more likely to ruminate, focusing repetitively and intently on their depressive symptoms and the implications of their distress.

Selective Serotonin Reuptake Inhibitors (SSRIs)

A first-line class of antidepressant medications that selectively block the reuptake of serotonin to increase its synaptic availability, generally having fewer side effects than older classes (common side effects include nausea, insomnia, and reduced sexual drive).

Tricyclic Antidepressants

An older antidepressant class that blocks the reuptake of serotonin and norepinephrine; effective but prescribed less often due to side effects like dry mouth, blurred vision, constipation, sexual dysfunction, memory issues, and cardiac complications.

Monoamine Oxidase Inhibitors (MAOIs)

Antidepressants that inhibit the monoamine oxidase enzyme responsible for degrading serotonin, norepinephrine, and dopamine; effective but carry risks of hypertensive crisis and require strict dietary restrictions.

Four Phases of CBT for Depression

The step-by-step cognitive-behavioral treatment protocol consisting of: 1) Increasing pleasurable activities, 2) Challenging automatic thoughts, 3) Identifying negative thoughts, and 4) Changing negative thoughts.

Behavioral Activation (BA)

A therapeutic approach for depression focused on modifying behavior to improve mood by systematically increasing rewarding and pleasurable activities while decreasing avoidance, excessive sleeping, and social withdrawal.

Interpersonal Therapy (IPT)

A structured psychotherapy addressing current interpersonal relationships and life events, organized around four primary problem domains: grief/bereavement, role disputes, role transitions, and interpersonal difficulties.

Mood Stabilizers

The first-line pharmacological treatment for bipolar disorder (including medications like lithium and Depakote) that treat both manic and depressive phases without inducing manic switches.

Medication Adherence in Bipolar Disorder

The primary clinical challenge in long-term bipolar care, where individuals frequently discontinue maintenance medications upon feeling better, making psychoeducation and psychotherapy critical adjuncts.

Default Mode Network (DMN)

A brain circuit involved in emotional regulation, social cognition, future-oriented thinking, and autobiographical memory; dysfunction in this network impairs an individual's ability to understand their place in the surrounding world.

Central Executive Network (CEN)

The brain network serving as the seat of executive functioning; its dysfunction in mood disorders leads to executive deficits, cognitive difficulties, and excessive emotionality.

Salience Network

A brain network responsible for detecting prominent internal and external stimuli to guide behavior; dysfunction within this circuit results in altered states of physiological and emotional arousal.

Neuroplasticity in Depression

The biological process wherein chronic stress suppresses neurogenesis and decreases synaptic plasticity within the hippocampus and prefrontal cortex, a deficit that can be reversed through antidepressant pharmacotherapy and physical exercise.

Persistent Depressive Disorder (PDD)

A continuous, chronic form of depression uniting the diagnostic categories of dysthymia and chronic major depression, requiring a depressed mood for most of the day, more days than not, for at least $2\text{ years}$ without being symptom-free for more than $2\text{ months}$.

Major Depressive Disorder (MDD)

A depressive disorder marked by discrete episodes lasting at least $2\text{ weeks}$ that cause significant distress or impairment, requiring at least $5$ symptoms with at least one being either a depressed mood or a loss of interest or pleasure (anhedonia).

Premenstrual Dysphoric Disorder (PMDD)

A depressive disorder where at least $5$ symptoms are present in the final week before the onset of menses, begin improving as menses begins, and become negligible in the week post-menses across the majority of menstrual cycles.

Disruptive Mood Dysregulation Disorder (DMDD)

A diagnosis designated for children up to $12\text{ years}$ old experiencing frequent episodes of extreme behavioral dyscontrol, created to curb potential overdiagnosis and treatment of pediatric bipolar disorder.

Anhedonia

A core mood disturbance symptom of depression characterized by a marked loss of interest or pleasure in all or most previously enjoyed activities.

Psychomotor Agitation or Retardation

Physical symptoms of depression characterized either by purposeless, restless movements (such as pacing the room or toe-tapping) or noticeably slowed physical movement of the body.

Bipolar I Disorder

A mood disorder diagnosed by the presence of at least one manic episode; it may be preceded or followed by hypomanic or major depressive episodes, though only a manic episode is necessary for criteria.

Bipolar II Disorder

A mood disorder characterized by a history of at least one hypomanic episode and at least one current or past major depressive episode, without any full manic episodes.

Manic Episode

A distinct period of abnormally, persistently elevated, expansive, or irritable mood and increased activity lasting all day, every day for at least $1\text{ week}$, accompanied by symptoms such as grandiosity, decreased need for sleep, flight of ideas, and high distractibility.

Mood Lability

Rapid, pronounced shifts in mood that are frequently observed in individuals during a manic episode.

Hypomanic Episode

A mood episode marked by persistently elevated, expansive, or irritable mood and energy lasting at least $4\text{ days}$, whose behavioral disturbances are noticeable but not severe enough to cause the extreme impairment seen in full mania.

Cyclothymic Disorder

A chronic mood disturbance characterized by numerous periods with hypomanic symptoms and mild depressive symptoms that do not meet full criteria for an episode, which may eventually develop into Bipolar I or II.

5-HTT Gene

A gene located on chromosome $17$ that has been linked by biological research to the development of depressive disorders.

Twin Concordance in Depression

The genetic finding showing identical twins have a $46\%$ chance of both developing the disorder, compared to a $20\%$ chance in fraternal twins, demonstrating a strong biological link.

Learned Helplessness

A cognitive etiology model derived from dog shock experiments demonstrating that individuals acquire depression when they are conditioned to believe they are entirely unable to escape negative conditions, even when escape options are made available.

Negative Attributional Style

A cognitive vulnerability where an individual attributes daily negative life events to internal, stable, and global factors while attributing positive events to external, unstable, and specific factors.

Cognitive Triad

A triad of maladaptive thoughts characteristic of depression comprising recurring negative evaluations about oneself, one's experiences, and one's future.

Lewinsohn's Behavioral Model of Depression

The framework developed by Peter Lewinsohn positing that depression occurs as a result of a decline in positive rewards and reinforcements, causing individuals to stop engaging in adaptive behaviors.

Artifact Theory

A sociocultural theory suggesting that observed gender disparities in depression occur because diagnostic systems and clinicians are more sensitive to detecting and diagnosing symptoms in women than in men.

Rumination Theory

A cognitive gender-difference theory proposing that women experience higher rates of depression than men because they are more prone to intently and repetitively focus on depressive symptoms.

Selective Serotonin Reuptake Inhibitors (SSRIs)

A first-line class of antidepressant medication that blocks the reabsorption of serotonin to increase its synaptic availability, carrying common side effects such as nausea, insomnia, and reduced sex drive.

Tricyclic Antidepressants

A class of antidepressants that increases serotonin and norepinephrine availability; effective but less commonly prescribed due to serious side effects such as dry mouth, blurred vision, constipation, sexual dysfunction, memory issues, and worsening heart conditions.

Monoamine Oxidase Inhibitors (MAOIs)

Antidepressant medications that prevent the monoamine oxidase enzyme from degrading serotonin, norepinephrine, and dopamine; effective but dangerous due to required dietary restrictions and the risk of hypertensive crisis.

Behavioral Activation (BA)

A depression psychotherapy designed to improve mood by increasing pleasurable, rewarding activities and social skills while decreasing avoidance behaviors, social withdrawal, and excessive sleeping.

Interpersonal Therapy (IPT)

A structured psychotherapeutic approach for depression centered on relationships and current life events, focusing on grief/bereavement, role disputes, role transitions, and interpersonal conflicts.

Mood Stabilizers

The primary pharmacological foundation for Bipolar Disorder (e.g., lithium, depakote) that manages manic and depressive episodes without provoking shifts into mania.

Medication Adherence in Bipolar Disorder

A primary target of adjunctive psychotherapy in Bipolar Disorder, addressing the prevalent issue where patients discontinue medications such as mood stabilizers once they begin feeling better.

Default Mode Network (DMN)

A brain circuit responsible for emotional regulation, social cognition, autobiographical memory, and future-oriented thinking, whose dysfunction causes individuals with depression difficulty understanding their place in the world.

Central Executive Network (CEN)

A brain circuit serving as the control center of executive functioning; dysfunction in this network produces cognitive deficits, executive performance issues, and excessive emotionality in depression.

Salience Network (SN)

A brain circuit that detects salient internal and external stimuli to guide behavior; functional disruptions in this network lead to altered arousal states in depression.

Glutamate Excitotoxicity

A neurochemical mechanism implicated in depression where excessive concentrations of the neurotransmitter glutamate kill off surrounding neurons and disrupt regular brain circuit function.

Reduced Neuroplasticity Hypothesis

The biological model proposing that chronic stress and depression suppress neurogenesis and structural flexibility in the prefrontal cortex and hippocampus, which therapeutic treatments act to restore.