Mood Disorders (a)

8/22/2019 Mood Disorders (a)

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CYCLING MOOD DISORDERS

BIPOLAR DISORDERS

Jack L. Bodden, Ph.D.



DISTINGUISHING BIPOLAR FROM

UNIPOLAR DEPRESSION

Bipolar or cycling mood disorders are distinguished from unipolardisorders by the presence of manic or hypomanic episodes orsymptoms.

Hypomanic episodes are less intense than the manic episode

described earlier. In hypomanic episodes the person experiencesabnormally elevated, expansive or irritable mood for at least 4days and at least three symptoms characteristic of a manicepisode but to a lesser degree.



Cyclothymic Disorder



BIPOLAR (I & II) DISORDERS



BIPOLAR DISORDER I

• Bipolar I Disorders are different from Major depression in that theperson has at least one manic or Mixed episode (Sx of both mania

and major depression for at least 1 week). Even though the personmay not exhibit depressive Sx it is assumed that they have occurredor eventually will occur.

•There are no “Unipolar” Manic or Hypomanic counterpartsto Dysthymia or Major Depression.



BIPOLAR II DISORDERS

In Bipolar II Disorders the person does not experiencefull-blown manic episodes but has experienced clear-cuthypomanic episodes as in Bipolar I Disorder.

Bipolar II Disorders appear to be somewhat more commonthan Type I.



FEATURES OF BIPOLAR DISORDERS

Prevalence rates of about 3%

No sex differences

Usually occurs first in adolescence or young adulthood Bipolar disorders can also have a seasonal component

The depressive phase sx are generally indistinguishablefrom those seen in major depression

Bipolar Disorders are often misdiagnosed





CAUSAL FACTORS IN BIPOLAR DISORDER

Genetic influences are fairly significant (more so thanwith unipolar disorders)

Neurotransmitter imbalance (norepinephrine increase & dpoamine increase in manic and hypomanic episodes)

Neurological factors – blood flow to prefrontal cortex isreduced during depression but during mania it isreduced in right frontal and temporal regions. Blood

flow across the two hemispheres is equal during normalmood states.

Disturbed biological and circadian rhythms



Do Psychological Factors Play a

Role?

They probably play a role in precipitating manic as wellas depressive episodes, and they may be important inrelapses; however, they probably don’t play asimportant a role as do biological factors.

There are significant differences in rates of BipolarDisorder across cultures (e.g. very high in US but lowin Korea (could be differences are due to culturalfactors or maybe differences in diagnosis).



Treatments for Mood Disorders

Medications play an especially important role in the Rx of BipolarDisorders (antidepressants, mood stabilizes and antipsychotics).

Medications (SSRI and other antidepressants) play a moderatelyimportant role in RX of Unipolar Depression.

ECT is sometimes used with severe, stubborn major depression. Psychological treatment, especially CBT plays a very significant role

in the RX of Unipolar Depression. CBT appears to work as well asmedication, but works differently (not as fast but longer lastingeffects). Traditional psychotherapy is somewhat helpful. Marital Rxmay be helpful in a subset of depressed patients.

Psychotherapy with Bipolar Disorders is not terribly effective.

Light therapy and Transcranial Magnetic Stimulation show promisein treating some forms of depression.

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Mood Disorders (a)

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