Mood Disorders

I. Major Depressive Disorder: a severe mood disorder characterized by major depressive episodes in the absence of mania or hypomania.

Symptoms must persist consistently for at least 2 weeks.

A year a more is rare as this disorder occurs in waves or recurring episodes.

Genetic factors and the presence of other disorders increase the likelihood of recurring episodes.

Major depression often occurs with anxiety as depression and anxiety can impact each other.

Percentage of persons 12 years of age and older reporting difficulty with their work, home, and social activities by sex and depression severity. Depression affects people in many ways. Most people (55.1% with mild depression; 79.7% with moderate or severe depression) report difficulties with work, home, or social activities.

A. Why women more than men?

1) Women are more likely than men to seek out opportunities to discuss their problems with people than keeping it bottled up inside.

2) Women experience more rapid hormonal changes than men do (things like menstrual cycles, pregnancy, childbirth and menopause).

3) Cognitively, women are more likely to ruminate over problems (sometimes obsessively) than are men.

4) Women are more likely to be subjected to abuse and sexism.

5) Our culture promotes lower self-esteem among women relative to men via the media and its messages about appearance and beauty.

B. People with an increased risk of a Major Depressive Disorder diagnosis are...

1) Women.

2) People of lower socioeconomic status.

3) People who are separated or divorced.

4) Having close biological relatives who were diagnosed with depression increases your chances of becoming depressed.

5) Having adoptive relatives who were depressed also increases your chances, but not as much.

6) The probability is especially high if your biological relatives were diagnosed with depression before age 30.

C. Postpartum Depression: persistent and severe mood changes that occur after childbirth.

It’s often accompanied by disturbances in appetite and sleep, low self-esteem, and difficulties in maintaining concentration or attention.

Interestingly, it begins before birth in about 50% of women who develop it.

Both nature and nurture contribute to its development, such as genetic predispositions and an abusive home environment.

D. Postpartum Psychosis: irrational thoughts, hallucinations, and delusions that can occur after childbirth.

E. Premenstrual Syndrome (PMS): symptoms of physical discomfort and emotional tension during the one to two weeks before a menstrual period.

Physical Symptoms…fatigue, headaches, swelling and tenderness of

breasts, bloating, nausea, cramps Psychological Symptoms...

irritability, grouchiness, moodiness, acting demanding, aggressiveness, hostility

 About 85% of all women have at least one symptom of PMS.

F. Premenstrual Dysphoric Disorder (PMDD): a disorder characterized by physical and mood-related symptoms occurring during the woman’s premenstrual period.

Psychological symptoms manifest one to two weeks before menstruation and improve within a few days following the onset of menstruation.

Symptoms are associated with significant emotional distress or interference with the woman’s ability to function.

Estimates put this disorder around 5% of all women.

G. Seasonal Affective Disorder (SAD): repeatedly become depressed during a particular season of the year.

1) Light Therapy: the depressed person sits in front of a bright and safe artificial light for a few hours each day during the time of the year they typically experience SAD.

II. Persistent Depressive Disorder: a persistent depressive disorder that is either chronic major depressive disorder or a chronic but milder form of depression called Dysthymia.

It often begins in childhood or adolescence and continues on through adulthood.

About 90% of people with Dysthymia eventually develop Major Depressive Disorder.

A. Double Depression: those who have a major depressive episode superimposed on a longer-standing dysthymic disorder.

III. Bipolar Disorder: a psychological disorder characterized by mood swings between states of extreme elation and depression.

Affects 1% of the population.

Average age of onset is 20 years old.

Equal prevalence among men and women for Bipolar I Disorder.

1) Typically involves extreme mood swings between manic episodes and major depression.

2) It is possible for bipolar I disorder to apply to those who have only experienced mania without ever having a major depressive episode.

3) Manic Episode: a period of unrealistically heightened euphoria, extreme restlessness, and excessive activity characterized by disorganized behavior and impaired judgment.

A. Bipolar I Disorder: applies to people who have had at least one full manic episode at some point in their lives.

B. Bipolar II Disorder: applies to people who have had hypomanic episodes AND at least one major depressive episode (without ever having a full-blown manic episode).

1) Hypomanic Episode: episodes that are less severe than manic episodes and are not accompanied by the social or occupational problems associated with full-blown mania.

During a hypomanic episode, a person might:feel unusually charged with energy.show a heightened level of activity.have an inflated sense of self-esteem.be more irritable than usual.experience little fatigue or need for sleep.

C. Rapid Cycling: experiencing two or more full cycles of mania and depression within a year without any periods of normal functioning in between.

D. Creativity with Depression and Mania

1) Flow: the mental state of operation in which the person is fully immersed in what he or she is doing by a feeling of energized focus, full involvement, and success in the process of the activity.

2) The experience of Flow includes…

A loss of the feeling of self-consciousness, attention is directed outwards towards their activity.

Distorted sense of time, one's subjective experience of time is altered as people become absorbed in their activity.

A sense of personal control over the situation or activity.

The activity is intrinsically rewarding, so there is an effortlessness stream of action.

IV. Cyclothymic Disorder: a mood disorder characterized by a chronic pattern of less-severe mood swings than are found in bipolar disorder.

V. Causes of Depressive Disorders

A. Psychodynamic Theories

1) Losing a Child

A parent is rarely prepared for this loss.Generally feels like a cruel and unnatural shock.Parents may feel they have failed the child & thus guilty.If marriage is strong, the loss may draw a couple closer.If marriage is weak, the loss may tear the couple apart.

2) The Three Stages of Grief Work

a) Shock and disbelief.

b) Preoccupation with the memory of the dead person.

c) Resolution.

3) Patterns of Grieving

a) Commonly Expected Pattern: grief pattern in which the mourner goes from high to low distress.

b) Chronic Grief: grief pattern in which the mourner remains distressed for an unusually long time and may impact the mourner’s long term psychological and physical health.

4) Grief Therapy: treatment to help the bereaved cope with their loss.

5) Ambiguous Loss: a loss that is not clearly defined or does not bring closure.

B. Humanistic Theories

Biological: basics such as hunger and thirst;require satisfaction before other needs can begin operation

Safety: protection from danger, for security, comfort, and freedom from fear

Attachment: to belong,to affiliate with others, love, and to be loved

Esteem: to like oneself, to seeoneself as competent, and to be liked by others

Cognitive: thought stimulation and to contemplate one’s existence

Aesthetic: creativity,beauty, and a sense of order

Self-Actualization:to strive for andto achieve one’sfullest potential.

Transcendence: to step beyondSelf-Actualization, to achieve

higher states of consciousness,and a cosmic vision of

one’s part in the universe.

C. Learning Theories

1) Interactional Theory: difficulties in social interactions may help explain the lack of positive reinforcement.

a) Reciprocal Interaction: our behavior influences how other people respond to us and how they respond to us influences in turn how we respond to them.

D. Learned Helplessness (Attribution) Theory: hopelessness and resignation learned when a person perceives no control over repeated or bad events.

E. Cognitive Theories

1) Cognitive Triad of Depression: the view that depression derives from adopting negative views of oneself, the environment or world at large, and the future.

2) Explanatory Style: a tendency to accept one kind of explanation for success or failure more than others.

F. Biological Factors

Identical twins show a higher concordance rate for developing depression than fraternal twins.

Antidepressants, which increase levels in the brain of the neurotransmitters norepinephrine and serotonin, often help relieve depression.

Brain-imaging studies show lower metabolic activity in the prefrontal cortex of clinically depressed people as compared to healthy controls.

There also appears to be lower metabolic activity in the limbic system which is involved in regulating mood.

VI. Treating Depression

A. Interpersonal Psychotherapy: the therapist and the client discuss the issues that are causing depression by focusing on the client’s current relationships.

B. Electroconvulsive Therapy (ECT): a brief electrical current is administered to the patient’s head that induces a convulsion similar to an epileptic seizure (a.k.a. shock therapy).

VII. Causes of Bipolar Disorders

VIII. Treating Bipolar Disorders

A. Lithium: a naturally occurring chemical that is often used to treat the manic symptoms of bipolar disorder.

IX. Suicide

About 12% - 15% of U.S. adults report having serious suicidal thoughts with about 5% actually making an attempt at suicide.

About 60% of people who commit suicide suffer from a mood disorder.

Suicide attempts are more likely to occur during a major depressive episode.

A. Suicide in Older Adults

B. Sex and Ethnic Differences

Women are more likely to consider suicide.

Men are four times more likely to successfully commit suicide.

This is at least partially due to the fact that men are more likely to use guns, while women are more likely to ingest substances, such as sleeping pills.

C. Why Do People Commit Suicide?

1) Social Contagion: the rapid spread of emotions or behaviors through a crowd or community.

2) Social Proof: we tend to see an action as more appropriate or correct when others are doing it.