Study Notes on Mood Disorders and Eating Disorders

Overview of Mood Disorders

General Mood Fluctuations

  • Typical mood ranges:

    • Two-year period of mood elevation and depression.

    • More days in a lower mood state.

    • Occasional major depressive episodes may occur.

Persistent Depressive Disorder (Dysthymia)

  • Definition: Chronic low mood for more than two years.

  • Excludes periods of major depressive episodes.

Bipolar Disorders

Bipolar I Disorder

  • Definition: Characterized by at least one manic episode.

  • Manic Episode Criteria:

    • Elevated or irritable mood lasting at least one week or requiring hospitalization.

    • May have depressive episodes but is not required for diagnosis.

Bipolar II Disorder

  • Definition: At least one major depressive episode and at least one hypomanic episode.

  • Hypomania: Less severe than full mania and does not lead to hospitalization.

Mixed Episodes

  • Definition: Experience symptoms of both mania and depression simultaneously within a short period.

Assessment Considerations

  • Importance of accurate self-reporting for diagnoses.

  • Oxymoron: Difficulty in seeking treatment due to symptoms.

Terminology and Historical Context

Transition from Manic Depressive to Bipolar Disorder

  • Previous terminology used: Manic depressive illness.

  • Shift to using 'bipolar' in modern diagnostics (DSM).

Comorbidity with Borderline Personality Disorder

  • Both conditions involve mood cycling.

  • Important to distinguish between bipolar disorder and borderline personality disorder.

Creativity and Bipolar Disorder

Touched by Fire by Kay Redfield Jamison

  • Exploration: Connection between bipolar disorder and creativity.

Key Thesis

  • Many famous creatives (writers, actors) had bipolar disorder.

  • Contrast between high moods (creativity) and low moods (mental health struggles).

Quotes from the Book

"The fiery aspects of thought and feeling that initially compel the artistic voyage, fierce energy, high mood, and quick intelligence…"

  • Suggests link between high mood states and creative outputs.

Overview of Medication for Mood Disorders

Historical Medications

  • Barbiturates: Early drugs used for sedation and mood stabilization.

  • Benzodiazepines: Highly addictive with risk of physical dependence.

Modern Pharmacological Treatments

Antidepressants

  • Often prescribed for anxiety and depressive symptoms.

  • Includes:

    • SSRIs (Selective Serotonin Reuptake Inhibitors)

    • Tricyclics

MAO Inhibitors (MAOIs)

  • Function: Slows the production of monoamine oxidase in the brain.

  • Dietary restrictions required:

    • Avoid aged cheeses, improperly stored meats, alcohol, fermented products, and certain beans.

  • Efficacy: Around 50% of patients see improvement.

Lithium for Bipolar Disorder

  • Effective in stabilizing mood and treating mania.

  • Risk of toxicity: Requires careful dosage management.

New Treatments

  • Ketamine and its FDA approved variant, Spravato.

  • Emerging as a treatment for medication-resistant depression.

Eating Disorders

Anorexia Nervosa

DSM Criteria

  1. Restriction of energy intake, leading to significantly low body weight.

  2. Intense fear of gaining weight or behavior interfering with weight gain.

  3. Disturbance in body image.

Types of Anorexia

  • Restricting Type: No binge eating or purging in the last three months.

  • Binge Eating/Purging Type: Episodes of binge eating followed by purging behaviors.

Onset and Patterns

  • Common onset age: 14 to 20, primarily in females.

  • Often begins with dieting or following a stressful life event.

  • Cognitive/Behavioral Perspective: Obsession with body image, food, and the process of restricting.

Bulimia Nervosa

DSM Criteria

  1. Recurrent episodes of binge eating (within a discrete time period).

  2. Sense of lack of control during binges.

  3. Compensatory behavior to prevent weight gain (purging, excessive exercise).

Onset and Patterns

  • Onset age: 15 to 20, primarily in females.

  • Can begin with dieting and may morph from bulimia to anorexia.

Diagnostic Considerations

  • Challenges with strict parameters for diagnosis can prevent individuals from seeking help.

  • Recognition of eating disorders as spectrum disorders rather than strictly categorical.

Comorbidities and Implications

Substance Use Disorders

  • High comorbidity between eating disorders and substance misuse.

  • Use of stimulants to manage weight is a common factor.

Awareness and Advocacy

  • Increased recognition of eating disorders across genders, ages, and ethnicities, not limited to traditional representations in media.

  • Historical context: Notably in figures like Karen Carpenter, Lily Collins, and Princess Diana.

Final Thoughts on Eating Disorders and Society

  • Encourage recognition of varying presentations and experiences across genders.

  • Emotional disturbances surrounding body image can manifest in a wide array of behaviors, calling for ongoing education, understanding, and compassion in treatment and societal perception.

Conclusion

  • Importance of recognizing the complexities of mood disorders and eating disorders.

  • The necessity for continuous research and adaptive approaches in treatment and understanding of these conditions.