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30 Cards in this Set
- Front
- Back
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Major Depressive Disorder (MDD) |
Extremely depressed mood state, nothing in life is fun, thoughts of death and suicide. It's hard to think clearly, can't make decisions. Feeling unhappy most of the day every day, feeling worthless. Duration of 2 weeks up to 9 months. Very common with relapses. |
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Persistent Depressive Disorder
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A depression that never seem to go away, and lasts for at least 2 years without more than 2 months of feeling better. It's similar to MDD, but more chronic and severe. Much less responsive to treatment and higher mortality rate. |
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Anhedonia |
Loss of pleasure/interest, affecting many or most areas of life. |
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Overview of Mania |
Maniac episodes includes severe mood disturbances. Must last for 2 weeks, and can last 2-6 months if it's untreated. - Inflated self-esteem and grandiosity. - Thoughts are racing, flight of ideas. - Distractibility. - Often includes a psychosis. - Doesn't have the same need for sleep. - Keeps talking, feeling pressure to keep talking. - Psychomotor agitation (moves limbs purposeless or unintentional) - Excessive involvement in pleasurable activities.
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Bipolar 1 Disorder |
- Alternates from pole to pole, full MANIA and major depressive episodes, and meets criteria for both at each state. - May show evidence for psychosis. - Very high suicide rate. - Normally begins around 18 years old. - Chronic. |
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Bipolar 2 Disorder |
- Alternates between HYPOMANIC (not as severe mania) and major depressive disorder. - May include psychosis. - Very high suicide rate. - Normally begins around 22 years old. - Chronic. - 10-13 % tend to continue to Bipolar 1. |
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What kind of feelings does one feel when one is experiencing mania? |
- Have lots of energy |
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Cyclothymic Disorder |
- More chronic, but much less severe version of bipolar disorder. - Hypomanic (less severe than mania) episodes what alternates with depressive episodes (less severe than MDD). Never bad enough for hospitalization. - Is in one mood state or the other for many years with relatively few periods of neutral mood. - The alternations between those episodes happens either more often than in BP1/2, or alternates every few years. - Should be treated, so they don't develop CD to a bipolar disorder. - Can't be symptom free for more than 2 months at a time. - Subtypes: predominance of mild depressive symptoms, predominance of hypomanic symptoms, equal distribution of both mild depressive symptoms and hypomanic symptoms. |
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(Persistent Depressive Disorder) Dysthymia |
Less severe than depression, but lasts longer. (Earlier called "Depressive Personality.") At least 2 years, up to 20-30 years or more. |
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Premenstrual Dysphoric Disorder (PMDD) |
- 2-5 % of all women get this disorder. - Symptoms must be present final week before the onset of menses, start to improve within a few days after onset and then minimal or absent. - Severe mood swings, anxiety, anger, depression, tension, decreased interest in normal activities, difficulties in concentration, hyper/insomnia + classic PMS symptoms. - Must be present for majority of cycles for 1 year. |
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Disruptive Mood Dysregulation Disorder |
- Children disorder (6-18 yrs). Looks like ADHD, and is therefore often misdiagnosed. - Not age appropriate. - Rages, physical aggression that is out of proportion in intensity, temper outbursts >3 times per week. - Extreme difficulty controlling emotions. - Severe relationship difficulties. |
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Depressive disorders with additional symptoms (specifiers): Psychotic features specifiers |
- Hallucinations (hearing or seeing). - Somatic (physical) delusions (ex believing that their bodies are rotting). |
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Depressive disorders with additional symptoms: Anxious distress specifier |
- The presence and severity of accompanying anxiety, whether in the form of comorbid anxiety disorders (meeting full criteria or not). - Most important, since anxiety indicates a more severe condition that makes suicidal thought and completed suicide more likely and predicts poorer outcome from treatment. |
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Depressive disorders with additional symptoms: Mixed features specifier |
Predominantly depressive episodes that have several symptoms of mania (at least 3). |
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Depressive disorders with additional symptoms: Melancholic features specifier |
Applies only if the full criteria for a major depressive episode have been met, whether in the context of a persistent depressive disorder or not. - Somatic (physical) symptoms: early-morning awakenings, weight loss, loss of libido, guilt, anhedonia. |
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Depressive disorders with additional symptoms: Catatonic features specifier |
Can be applied to major depressive episodes whether they occur in the context of a depressive disorder or not. - Absence of movement. - Catelepsy (muscles get waxy and semirigid, so a patients arms or legs remain in any position they get placed in). - May involve excessive but random or purposeless movement. - Found in many animals just before they are attacked by a predator. "End state" reaction to feelings. |
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Depressive disorders with additional symptoms: Atypical features specifier |
- Applies to both persistent and non-persistent depressive disorders. - Consistenly oversleep and overeating. - Can react with interest or pleasure to some things, unlike most depressed individuals. - More suicide events, higher rate of comorbid disorders including alcohol abuse. |
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Depressive disorders with additional symptoms: Peripartum onset specifier |
- The period of time just before and just after giving birth. - 13-19 % of all women get this. - More common in after birth than during pregnancy. - Serious thoughts of selfharm, or harming the baby. Mother doesn't understand why she's sad in such a joyous time. - Depression after childbirth can also happen to fathers. |
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Depressive disorders with additional symptoms: Seasonal pattern specifier. Seasonal Affective Disorder (SAD) |
Recurrent major depressive disorder that occur during certain seasons. Most usual in the late fall and ends in the beginning of spring. (Like bipolarity) At least 2 years with no evidence of nonseasonal major depressive episodes during that period. |
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Causes of Mood Disorders |
- Stronger genetic contributions for severe mood disorders. - Greater genetic vulnerability for females. - Serotonin transporter gene: 's' allele associated with vulnerability to depression and brain volume differences. - Some evidence that same genetic factors may contribute to anxiety and depression, and then the environment decides if they get triggered or not.
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Psychological Dimensions in Mood Disorders |
- Stress and trauma are strongly related to the onset and relapse of mood disorders. - Especially severe stress is associated with both depression and bipolar disorder, and it also predicts poorer response to treatment. |
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Beck's Cognitive Theory of Depression |
- Defined as a tendency to interpret life events negatively; causes depressed persons to apply cognitive distortions (errors) to life situations that lead to a negative mood. - The thinking is "all or nothing" with overgeneralization, magnification or castrophizing, jumping to conclusions. The thinking patterns is very negative and highlights the negative parts of life. |
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Gender imbalances and the effect of marriage and divorce on men and women |
- Females are much more likely to have any mood disorder, except for bipolar disorder that is equally between the genders. - Marital dissatisfaction is strongly related to depression. - Men tend to react to divorce more than women. Men has higher depression rate due to divorce. |
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Overview: Mood Disorder Treatments |
Biological treatment: medications, ECT (electro-convulsive treatment, small shocks into the brain, 6-10 treatments). Prozac is most popular, it blocks presynaptic uptake of serotonin. Negative side effects are common, like lower libido etc. About 40-50 % fail to improve, and the effects of the drugs isn't effective for children or elderly. |
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Depressive Disorders Treatment: Antidepressant Medications |
- Tricyclics: Impramine (Tofranil) Amitriptyline (Elavil) Blocks reuptake of norepinephrine and other transmitters. Negative side effects are common. - Monoamine Oxidase (MAO) Inhibitors. Blocks MAO (the enzyme that breaks down serotonin and norephinephrine). It has fewer side effects than tricyclics, but can be fatal when mixed with red wine, beer and cheese, aka all good things in life. |
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Bipolar Disorder: Treatment |
Lithium, which is a common salt in the natural environment and is the primary treatment for bipolar disorders. If the dosage is too small, it won't be effective, but if it's too much is toxic and in worst case lethal. Weight gain is very common, but the biggest advantage is that it distinguishes that it's effective with treating manic episodes because it seems to limit the availability of dopamine and norepinephrine. |
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Suicide rates in Canada |
Highest in Alberta, Quebec, and the Northwest Territories. - Very hight rates among Aboriginal people. - Increasing rates, especially in the young. - Males have higher completion rate than females, might be because they chose often chose more violent ways to do it. Females attempts suicide more often, but doesn't complete them as often. |
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Suicide: Risk Factors |
- If there's someone else in the family who attempted/completed suicide. - If a person has low serotonin levels, which can be genetic. - If there's already a preexisting psychological disorder, like depression or bipolarity. - If the person already attempted suicide earlier. - If there's alcohol use/abuse. - A stressor that is seen as shameful or humiliating. - If there's publicity about suicide, like if a famous people has done it and the newspaper is writing about it, it might be a source of inspiration (the way they did it especially) - Serious illness, loss of a spouse. Especially elderly men tend to attempt/commit suicide when their spouse dies. |
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Suicide: Assessment and treatment |
- When making a risk assessment it's important to see if there's any previous attempts, recent stressful life events that could trigger a suicide. - If the patient has made a plan, chosen a method, means and access for what s/he needs for a suicide, it's a huge warning sign. - A therapist and a patient can make a "no-suicide contract", where the patient has to sign that they promise not to commit suicide. - CBT, and problem solving therapy. - Stress reduction (of the triggering problem/s) - Hospitalization, complete or partial, when the patient is in a really bad condition and has a very high likelihood of committing suicide. |
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Potential Warnings and Signs of Suicide |
- Verbal suicide, making threats to do it or statements that it might happen. - Previous suicide attempts. - Risk-taking behavior, recklessness and not caring for safety. - Making the final arrangements, like giving away belongings, making peace, tying up loose ends. - Separation from loved ones/S.O. - Saying that s/he wants to die. - Making art about dying. - Chronic depression, prolonged grief after a loss. - Unusual purchases; rope, gun, medication, gathering of pills or poison. - Unusual sadness, discouragement and loneliness. |
