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84 Cards in this Set

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bipolar disorder
manic depression
mania
great energy and enthusiasm concerning everything


talking, thinking, moving really fast
depression
lowered energy and enthusiasm

slower in everything the person does
unipolar depression
people experience only depression, no mania
emotional symptoms of depression
sadness constantly

loss in interest in almost everything (anhedonia)
psych. and behavorial symptoms of depression
bodily functions are disrupted: there are changes in sleep, apetite, and activity

many people are slowed down completey -- psychomotor retardation (rarely it will be the exact opposite)

feeling of fatigue, loss of energry
cognitive symptoms of depression
people may be filled with feelings of worthlessnes, guilt, hopelessness, and mau even consider suicide

sometimes they lose complete touch with reality

experience delusions and hallucinations
categories of unipolar depression
major depression

dysrythmic disorder
major depression
the person experiences either depressed mood or loss of interest in things in their life; they also must experience at least four symptoms of depression chronically for at least 2 wks.; these syptoms must be severe enough to interfere with the persons everyday life
dysrythmic disorder
less severe form of depressive disorder, but more chronic; a person much be experiencing depressed moods plus 2 other symptoms for at least 2 yrs.; during this time the person must never be w/out these symptoms for more than 2 months;
double depression
experiencing both depression and dysrythmic disorder at the same time; people are chronically dysrythmic and occasionally slip into very severe periods of major depression; however once the major depression periods pass, they are still dysrythmic; very debilitating; less likely to respond to treatment
most people diagnosed w/ major depression or dysrythmia experience another psych. prob.
common examples: substance abuse, anxiety disorder; panic disorder; an eating disorder; depression can also be a cause of one these disorders or be caused by one these
subtypes of depression
depression w/...

melancholic features: symptoms of depression are very prominent

catatonic features: ranges from complete lack of movement to severe agitation

psychotic features: people experience delusions and hallucinations during depressive episodes

atypical features: odd assortment symptoms

postpartum onset: major onset of depression can occur in woman w/in 4 wks. of delivering a child
-biploar with postpartum onset can also occur
-postpartum blues are common: fades more quickly

seasonal affective disorder (SAD):
seasonal affective disorder (SAD)

a subtype of depression
people with this have a history of at least 2 yrs. of having depressive episodes and then fully recovering; symptoms are tied to the amount on light hours in a day; people become more depressed during days with less light hours; mood changes are not due to psychosocial;
more common in sweden
- bipolar disorder with seasonal pattern: some people may actually develop mania and experience manic episodes;
prevalence and course of depression
one of the most common disorders

16 percent experience major depression

15 to 24 yr olds are most likely have exprienced an episode w/in the past month

lower rate among 45-54 yr olds and 55-70 year olds

higher rates in those 85 and older; more severe and debilitating

woman are about 2x as likely as men to experience depression
treatment of depression
some people do not get treatment due to the expense

others think that i will go away on its own

sometimes it actually does go away on its own
depression in children and adolescents
depression is less common in children than in adults

b/t 15 and 20% of youth will experience an extreme depression episode before age 20
scars of depression in kids
when kids experience depression it is more like to leave scars than when adults experience it b/c during this time their self concept is undergoing a sustantal change
increases negative thinking
the effective of puberty and depression
girls' rates of depression escalate during puberty, while boys' rates do not; this is not just because of the changes in hormones; girls are dealing with their looks and body changes and value this more than boys do
symptoms of mania
people can be elated, it is often mixed with irritation or agitation;

also involves grandiose self esteem

thoughts and impulses race through the mind

the person may speak rapidly or forefully

the person may engage in impulsive behaviors

grand plans or goals which are pursued frenetically
diagnosis of mania
to be diagnosed with mania, the person must experience elevated, expansive, and irritable mood for at least one week, plus at least 3 other manic symptoms; the symptoms must impair the person's ability to function
bipolar I disorder
people experience mania, but also fall into depressive periods; some have major depressive episodes while others may only experience mild and infrequent depression
bipolar II disorder
these people experience severe depressive episodes that would qualify as major depression, while they experience mania more rarely and mildly --> hypomania
hypomania
same symptoms as mania, except that these symptoms do not interfere with functioning and do not involve hallucinations or delusions
cyclothymic disorder
more chronic but less severe form of depression; the person alternates between hypomania and moderate depression chronically for at least a 2 yr. period; does not effect functioning all that much; but the depression can
rapid cycling bipolar disorder
when a person has 4 or more cycles of mania and depression w/in a year
prevalence of bipolar disorder
less common then unipolar depression

men and women are equally likely to develop it

higher social classes are more likely to recover, b/c of the greater ability to get help ad support and medicine

pediatric bipolar disorder is chronic
creativity and bipolar disorder
the increased manic periods help to give people new ideas and creative ideas; while the melancholy period provide inspiration; lincoln, napolean, martin luther, mussonlini, winston churchill, alexander hamiliton, duke of malborough, all experience bipolar symptoms

writers, artists, and musicians, all have higher rates of depression
biological theories of mood disorders:

genetics
family history studies: first degree relatives of people with bipolar disorder are more likely to have bipolar disorder or unipolar depression; first degree relatives of those with unipolar disorder are 2-3x more likely to suffer from depression, but not greater risk for being bipolar; bipolar disorder has a genetic basis different from that of unipolar depression

twin studies: bipolar disorder has 60% concordance with identical twins, while 13% concordance w/ fraternal -- genetics plays a big role; twin studies of major depression also had fairly high concordance rates; possibly heavier role in women than in men

specific genetic abnormalities: some studies suggest that serotonin transporter gene may cause vulnerability to depression; many people believe that predispostition is multifactorial
treatment of depression
some people do not get treatment due to the expense

others think that i will go away on its own

sometimes it actually does go away on its own
depression in children and adolescents
depression is less common in children than in adults

b/t 15 and 20% of youth will experience an extreme depression episode before age 20
scars of depression in kids
when kids experience depression it is more like to leave scars than when adults experience it b/c during this time their self concept is undergoing a sustantal change
increases negative thinking
the effective of puberty and depression
girls' rates of depression escalate during puberty, while boys' rates do not; this is not just because of the changes in hormones; girls are dealing with their looks and body changes and value this more than boys do
symptoms of mania
people can be elated, it is often mixed with irritation or agitation;

also involves grandiose self esteem

thoughts and impulses race through the mind

the person may speak rapidly or forefully

the person may engage in impulsive behaviors

grand plans or goals which are pursued frenetically
diagnosis of mania
to be diagnosed with mania, the person must experience elevated, expansive, and irritable mood for at least one week, plus at least 3 other manic symptoms; the symptoms must impair the person's ability to function
bipolar I disorder
people experience mania, but also fall into depressive periods; some have major depressive episodes while others may only experience mild and infrequent depression
bipolar II disorder
these people experience severe depressive episodes that would qualify as major depression, while they experience mania more rarely and mildly --> hypomania
hypomania
same symptoms as mania, except that these symptoms do not interfere with functioning and do not involve hallucinations or delusions
cyclothymic disorder
more chronic but less severe form of depression; the person alternates between hypomania and moderate depression chronically for at least a 2 yr. period; does not effect functioning all that much; but the depression can
rapid cycling bipolar disorder
when a person has 4 or more cycles of mania and depression w/in a year
prevalence of bipolar disorder
less common then unipolar depression

men and women are equally likely to develop it

higher social classes are more likely to recover, b/c of the greater ability to get help ad support and medicine

pediatric bipolar disorder is chronic
creativity and bipolar disorder
the increased manic periods help to give people new ideas and creative ideas; while the melancholy period provide inspiration; lincoln, napolean, martin luther, mussonlini, winston churchill, alexander hamiliton, duke of malborough, all experience bipolar symptoms

writers, artists, and musicians, all have higher rates of depression
biological theories of mood disorders:

genetics
family history studies: first degree relatives of people with bipolar disorder are more likely to have bipolar disorder or unipolar depression; first degree relatives of those with unipolar disorder are 2-3x more likely to suffer from depression, but not greater risk for being bipolar; bipolar disorder has a genetic basis different from that of unipolar depression

twin studies: bipolar disorder has 60% concordance with identical twins, while 13% concordance w/ fraternal -- genetics plays a big role; twin studies of major depression also had fairly high concordance rates; possibly heavier role in women than in men

specific genetic abnormalities: some studies suggest that serotonin transporter gene may cause vulnerability to depression; many people believe that predispostition is multifactorial
biological theories of mood disorders:

nuerotransmitter dysregulation
monoamines are the main nuerotransmitters that are linked to mood disorders (norepinepherine, serotonin, and dopamine); found in the limbic system assosciated with bioloical processes; imbalnaces can produce mania or depression;
monoamine theories
depression was caused be a reduction of norepinepherine or serotonin at the synapses; mania was thought the be caused by a dysregulation ofamines, or dopamines
biological theories of mood disorders:

brain abnormalities
the prefrontal cortex, the hippocampus, the anterior cingulate cortex, and amygdala;

prefrontal cortex: reduction of metabolic activity and less volume of gray matter; this area deals with goal related activity which can explain why depressed people often feel hopeless

anterior cingulate plays an important role in responding to stress, as well as emotional and social behavior and processing difficult info. ; there is less activity in this area for depressed people, which can account for coping probles, attention problems, etc

hippocampus: controls fear related learning and memory; depressed people and bipolar people have a smaller volume of this and less metabolic activity here; there are also a lot of cortisol here which is realted to stress

amygdala: deals with emotional stimuli; there are abnormalities in the structure and functioning in ppl with mood disorders;

abnormalities can be caused by enrvironmental factors and issues such as stress and loss of control; it can be environmnental or genetic causes
biological theories of mood disorders:

nueoendocrine factors:
neuroendocrine system regulates many imporant hormones which affect basic functions; HPA is important part of stress response; people with mood disporders have hyperactivity in this area, which inhibits monoamines;

hormonal cycles of women: female hormones may account for the higher rate of depression in women; also women are more at risk for depression during premenstrua and postpartum time, and menopause

stress very early in life can also make people more prone to depression b/c it can lead to neuroboloical abmnormalities
behavioral theory of mood disorders:

lack of positive reinforcers:
peter lewinsohn's behavioral theory of depression suggests that life stress leads to depression bc of a lack of positie reinforcement; peron begins to w/draw, which causes a greater lack, and a chiain is created
behavioral theories of mood disorders:

learned helplessness
uncontrollable negative events are what are most likely to to lead to depression; this leads to people believing that they are helpless to control anything that happens to them;

learned helplessness deficits: low motivation, lack of passivity; and indecisiveness
cognitive theories of mood disorders:

aaron beck's theory
ppl. with depression look at the world through a neative cognitive triad:
1. negative views of themselves
2. negatives views of the world
3. negatives views of the future

this leads to ppl. jumping to negative conclusions,ignoring the good, focusing on and exaggerating negative events; these types of thouhts are often automatic

led to cognitive behavioral therapy
cognitive theories of mood disorders:

reformulated learned helplessness theory
created to explain how cog. factors may influence whether whether a person becomes helpless and depressed following a negative event; focuses on people's causal attributions for an event; they somehow blame themselves for bad things that happen to them; this leads to more long term learned helplessness and self esteem loss;
depressive realism
depressed people are far more aware of the amount of control they have over things (which is not very much at all) then overly depressed people are; they do not have illusions about control and superiority in their lives
cognitive theories of mood disorders:

ruminative response styles theory
focuses more on the process of thinking, rather than the concept, as a contributor to depression; when people are sad they tend to think more about how they feel and the causes of it, rather than how to change the causes; women are more likely to do this than men are;
psychodynamic theories of mood disorders
patterns of unhealthy relationships stem form people's childhood experiences that have prevented them from developing strong and positive sense of self reasonability independent of other's evaluations; these people crave approval and will not get out of abusive or unhealthy situations due to their fear of abandonment or being alone; when a close relationship fails or failure to achieve perfection occurs, they become depressed; their sadness is more directed at blaiming or punishing the people who have left them --> introjected hostility theory

fairly supported
interpersonal theories of mood disorders
concerned with people's roles in their close relationships; disturbances in these roles are thought to be the main source of depression; children who do not have reliable caregivers develop an insecure attatchment to them, which sets the stage for all future relationships

contingencies of self worth: children with insecure attachments develop this and they believe that they must say or do certain things in order to win the approval of others; failures to meet these result in depression
the cohort effect in depression
people born in one historical period or more at risk for depression than people born in another

ex: more people born after 1970 experience deperession;

reasons could be the decrease in social support and identification of social values; also people now may have higher expectations of themselves;

social status: people of a lower social status tend to show a greater predisposition to depression; examples could be the rate of poverty, discrimination, etc.; african americans have an extemely low rate of depression however; women also have higher rates of depression considering they are at higher risk for physical and sexual abuse

cross-cultural differences: depression levels are lower among less idustrialized groups and less modern countries; however this could be b/c it manifests itself in different ways, such as pain, etc.; the idea of depression may acutally be unique to western cultures
drug treatments for depression:

tricyclic antidepressants
help reduce symptoms of depression by preventing the reuptake of norapinephrine and serotonin in the synapses or changing the responsiveness of receptors to these nuerotansmitters; reasonably effective; many sideffects, such as sweating, blurred vision, urninary retention, sexual dysfunction; take 2 months to show effects; can be fatal if overdose occurs; physicians are wary to prescribe them for this reason
drug treatments for depression:

monoamine oxidase inhibitors
(MAOIs)
causes the breakdown of monoamine nuerotransmitters at the synapse; decease the action of MAO which increases levels of neurotransmitters; moderately effective, but side effects are very dangerous; when people ear foods containing tyramine, they can get a high rate of blood pressure which is fatal; also interact with several drugs; cause liver damage, weight gain, and severe lowering of blood pressure;
drug therapies for depression:

selective serotonin reuptake inhibitors and related drugs
(SSRIs)
like tricyclics, but work more directly to effect serotonin; very popular; moderately effective; people get relief after only a few weeks; less severe side effects; not fatal if OD occurs; helpful in treating various areas of depression; main side effects include agitation and nervousness; nasua and less apetite are also common;

Remeron,serzon, effexon,cymbalta,
elecrtoconvulsive therapy for depression (ECT)
orginally created for schizophrenia;

consists of a series of treatments during which a brain seizure is induced by passing electrical current through the brain; patients are first given anesteshia and muscle relaxers; a convulsion lasts for a minute, consists of 6-12 seperate sessions; often given to people who do not repsond to drugs, works in 50-60% of people; usually delivered to only one side of the brain to try to stop memory loss and difficulty learning; relapse rate is 85%;
repetitive transcranial magnetic stimulation (tTMS)
uses magnets to stimulate areas of the brain; exposes brain to high intensity magnetic pulses; results in long term changes in nueortransmission across synapses; few side effects;
vagus nerve stimulation (VNS)
small pacemaker like machine is impanted into the left chest wall; the vagus nerve carries info. around the body and to the brain, including hypothamamus and amygdala; helps to improve mood; few side effects; somewhat effective;
light therapy
helps reduce SAD by resetting circadian rhythms - natural cycles of bio. activities that occur ever 24 hrs.; may help to normalize production of hormones and neurotransmitters; may also decrease melotonin;
drug treatments for bipolar disorder:

lithium lithium
stabilizes a number of neurotansmitter systems; more effective in reducing mania; ppl are often given this to help curb mania and an antidepressant to deal with the depression; helps to prevent relapse; it is hard to gauge a proper dose and there is not a big difference between a good dose and a fatal one; patients must be carefully watched;
drug treatments for bipolar disorder:

antconvulsants, calcium channel blockers, antipsychotic drugs
alternate ways to treat mania; not as effective for long term treatment;
behavior therapies for depression
focus on increasing the number of positive reinforcers in people's lives and decreasing negatives ones by changing the way that depressed people interact with their environments; people judge when they feel the best or the worst;

1. change the aspects the environment that cause depression
2. teach the depressed person skills to change negative circumstances; esp. negative social interaction;
3. teach the client mood management skills that can be used in negative situations
bulimia nervosa
cycle of binging and taking extreme measure to avoid weight gain such as purging; normally normal weight or even slightly overweight; chronic; more common in women
bing eating disorder
the person regularly binges but does not purge
anorexia nervosa
characterized by a pursuit of thinness that leads people to starve themselves; more common in women
diagnosis of anorexia nervosa
requires that person refuses to maintain a body weight that is healthy and normal; person weight must be at at least 15% below a min. healthy weight for them
amenorrhea
weight loss causes women to stop menstruating
prognosis of anorexia
they have intense fears of becoming fat; self-evaluations hinge on their weight and eating; they are always fatigued yet keep exercising excessively; food rituals;
restricting type of anorexia nervosa
people simply refuse to eat or will only eat in tiny amts. when they have to;

more likely to have trust issues
binge/purge type of anorexia nervosa
people periodically engage in binging or purging

different from bulimia b/c:
1. the person must be at least 15% below their min. healthy weight
2. women develop amenorhea

more likely to have probs. with unstable mood and alchohol
bingeing
uncontrolled eating

ave. binge = 1500 calories
purging type of bulimia nervosa
people who use self-induced vomiting or purging medications to control weight; also binge
nonpurging type of bulimia nervosa
people who use excessive exercise to control their weight
binge-eating disorder
resembles bulimia except that the person does not regularly engage in purging; people are generally overweight and disgusted with themselves; they may eat constantly with no planned meal times; sometimes in response to depression or stress; often have a history of frequent dieting; more common in women; more common in african american women; high rates of depression and and anxiety
biological theories behind eating disorders
tend to run in families

hypothalamus plays a central role in regulating eating

many bulimics have too little serotonin, which can lead to cravings of carbs.
social pressure and cultural norms that breed eating disorders
standards of beauty

athletes and eating disorders

socioeconomics and ethnicity: middle or upper class white females are most likely to suffer
dieting subtype
greatly concerned about their weight and shape, try to maintain strict habits but frequently will give up and binge; then they vomit or exercise to correct it
depressive subtype
concerned about weight and body type but plagued by issues of low self esteem; eat to quell these feelings
cognitive models of eating disorders
overvaluation of appearance is the primary cause of the disorder; people who see thinness as improving their lives will start to exhibit unhealthy behaviors; disordered eating can result from perfectionism and low self esteem; people with eating disorders are concerned with the way people see them;
family dynamics
often occurs in high achieving girls;

people who suffer often come from enmeshed families(interdependent families, ie princess diana)