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113 Cards in this Set
- Front
- Back
Three components of depression
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sadness, hopelessness, worthlessness. women, african americans and hispanics more likley to report these signs then men
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grief
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occurs after the death of someone we care about, physical distress that is not classified as depressive dissorder.
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adjustment disorder with depressed mood
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life events that bring upon depressed moods, not due to bereavement
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3 general types of mood disorders
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depressive, bipolar, other(caused by a medical condition or are substance induced)
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prevalance of mood disorders in general population
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10% (major depressive disorder is the second greatest cause of disability worldwide)
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mood disorders are often not treated bc...
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1)social stigmatizm
2) failure to recognize disease 3)lack of awareness of potential benefits of treatment |
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comorbid
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mood disorders are often comborbid, especially with substance abuse and mood disoders, women more effected by mood disoders then men
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Depression
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negative moods and behavior changes, mood change may be temporary or long lastings, differs in degrees of intensity
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unipolar disorders
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one or more episodes of depression but no manic or hypomanic episodes, or those with history with at least one episode of mania or hypomanis
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Risk factors for depression/mood disorders
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herditary, age, gender, negative life effects, low social support
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Heredity-relationship with twins
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much greater risk of developing disorder if MZ twin or DZ twin had the disoder
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younger in age a person is when they have their first episode of depression....
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the more likley their relatives will have the disorder
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Age
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risk factor for depression is highest in women bw ages of 20-29, for men ages 40-49
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rate of depression in 20th century
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1966-1975 had much greater risk of depression then ppl born in earlier decades, in each succeeding decade the risk was higher and age of onset of depression was earlier-->due to increases in life stresses in society today
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Larry Gellerstedt
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businessman who was able to recover well from depression
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Gender
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women twice as likley to experience depression then men (women more liiley to consult help and express emotional problems, more likley to give support, child caring)
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other factors for depression affecting women
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low income, poverty, poor support systems, older african american women more likley to be stressed,
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Ruminative response
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women discuss problems and ruminate while men are more action oriented, ruminative response is associated more with severe and lengthly depression
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Life Events
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stressful life events associated with person's vulnerability and life circusmatnces, ***assocition bw life events and onset of major depression decreases as th enumber of depressive episodes increases
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Social Support
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the belief that one is cared about by others who are also availabel to provide help or emotional support, important protection from depression
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Depression and Divorce
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those who are divorced or spearated are more likley to be depressed then those who are married, separated dicorced women=highest rates of depression
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Dysthymic Disorder
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feelings of depression for many years, feeling depressed is normal and way of life, helpless to change conditions
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Dysthymia
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mild and chronic depressive symptoms, common to general population and affects 5-6% of persons, biologically related to depression, more common in women the men and in single then married, some consider it a personality disorder bc it is LONG LASTING
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Characteristics of Dysthmia individuals
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gloomy, humorless, pessimistic, guilty, low self esteem
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double depression
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person with dysthemic disorder develops symptoms of depression...dysthymia and major depressive disorder have a high degree of comorbidity
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ages of ppl with dysthmia
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age rate is stable from about age 18-64(chronic), with depression the rate of it increases with different age groups
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% with symptoms
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more ppl with major depression disorder show symptoms then ppl with dysthymia
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Major Depressive Disorder
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one or more major depressive episodes without ever experiencing a manic or hypomanic episodem, unable to function and severe depression is highly visible to others
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Major depressive episode
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depressed mood or loss of interest in almost all activities and four of the following symptoms...weight loss/gain, sleep problems, fatigue, feelings of worthliness, suidide/death thoughts, symptoms must last at least 2 weeks-but can last for up to a year later
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Recurrent Major Depressive Disorder
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half of ppl with mde will experience recurrence of major depression, 3 or more episodes = 80% of having more episodes, for many ppl an initial episode will develop over tim e into a recurrent illness
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% of ppl with major depression that have psychotic symptoms
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15%, delusions do not always have guilty themes
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Depression can follow
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stressful life events and personal successes
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Depression is related to
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biochemical factors see pg342 for bio info!!!! bc im too lazy to try to write all of that stuff out here!
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Scanning techniques
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have revealed that depression is associated with some type of regional brain dysfunction
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Circadian rhythms
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regular daily rhythms in the functioning of human beings, when rhythms get out of synchrony changes occur. biological rhthms have been known to affect sleep patterns
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Seasonal affective disorder (SAD)
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type of depression related to seasonal rhythms- when biological rhythms are influenced by light
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2 major biologically based treatment approaches
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antidepressant medication and electroconvulsive therapy
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categories of antidepressants
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Monoamine oxidase inhibitors (MAOI)
Tricyclic Antidepressants (TCAs) Selective serotonin reuptake inhibitors (SSRIs) |
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MAOI
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first widly used antidepressamts. tb patients showed prolonged elevation of mood when treated with IPRONIOZID, troubeling side effects
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TCA
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imipramine elevates ppl moods but also side effects
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SSRI
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fluoxetine hydrochloride f (Prozac) ound to be effective and have fewer side effects then MAOI or TCA
most widly used medications for depression today |
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SAD
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occurs most often in northern states, usually begin in november and last 5 months
symptoms=mood change, loss of energy, anxiety, wieght gain begins in early adulthood, most often in women Phototherapy-light therapy to help patients with this disorder |
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Typical pattern of disorder
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initial symptoms and progression into the disorder, followed by a lessoning of symptims without a return to completely normal functioning
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relapse
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symptoms reappear
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remission
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symptoms lessen so that the person returns to normal state
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recovered
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relapses can occur during a remission, but if the remission continues for 6 months the patient is said to be recovered
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Recurrence
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an episode of depression that occurs after recovery
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Maintenance Therapy
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continuing medication for some time after the patient shows an improvement in or a remission of symptoms
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Sleep Disturbances common to depression 1)shallow sleep
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decreased stage 3/4 sleep, sensitivity to noise
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fragmented sleep
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increased awakenings. stage shifts. decreased sleep efficency
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short sleep
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decreased total sleep
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INTENSE REM SLEEP
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increased REM and there can also be rem sleep advanced toward sleep onset
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antidepressants may be more effective if they are made to be more
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complex
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problem with antidepressants
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time lag between initial use and first signs of improvement in persons mood
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electroconvulsive therapy
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rapid results, produces a series of brief generalized siezures by passing an electric current through the brain, 6-12 sessions, brings about changes in the brain especially in the area of hypothalmus, eletctrodes now only placed on one side of the head-safer
thomas eagleton-stigmatized for using ECT |
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transcranial magnetic stimulation
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alternate form of brain stimulation, electromagentic coil that produces positive mood changes and few cognitive damages
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psychologically based treatment
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psychotherapy yields lower results then medication
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John Bowlby
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importance of childhood loss or separation to later development, leads to depression
` |
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Interpersonal therapy
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originally designed to prevent relapse
-helps a depressed person solve problems they may have wit hother people 1)detailsof person's interpersonal relationshpis 2)options in dealing with interpersonal problems tecah ppl to be more socially effective |
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Existentialist perspective
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loss of self esteem, change occurs in individuals self assessment as result of a loss
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humanistics
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discrepenices bw a persons views of the ideala nd his or her actual self, source of depression and anxiety comes from this difference when it becomes too great to tolerate (dilema for women bc hey attenot to fullfll many roles today)
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behavioral perspective on depression
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depression in terms of ppls skills in geting social reinforcement and their typical ways of dealing with stressful situations-negative spiral that exists bc of poor social skills with others
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Social skills training
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behavioral approach to treating depression
1)taught basic verbal and nonverbal skills 2)taught to be perspective about cues in environment, learn how to reinforce behavior, role playing as well |
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Cognitive view on depression
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ppl who are depressed consistently perceive causes of events in ways that are unfavorable to themselves
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schemata
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ways of coding and interpeting behavior, possible cause of negativ einterpetations
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cognitive triad
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beliefs ppl hold regarding the world, self, futiure
aaron Beck |
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responsibility depressed person puts on person/situation
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person-puts respsnibility for negative things that happen
situation-puts responsibility for positive things that happen |
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attributions
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depressed individuals attributions will be personal-depressed ppl will blame themselves for anything that happens
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learned helplessness
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ppl who are depressed feel helpless to control their environment, some ppl feel generally helpless whlie other feels helpless only in certain situations, diff in these two is the type of attributions ppl make about stressful situations
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cognitive behavioral therapy
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help ppl ot think more adaptively and to experience positive vhanges in mood...the more depressed a client is the mor el iley behavioral therapy will be used in the beginnig, ppl are taught to moniter and record negative thoughts
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automatic thoughts
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recurring thoughts that come into a persons mind by habit, link outside events and a clients reaction to events
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study done on treatments for depression
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combination of medication and cognitive-behavioral therapy most effective then iether medication or therapy alone 85% improvement rate over 50% for each one alone, but psychotherapy has been found to have more long lasting therapitic effects
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% who refuse to take medication
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5-10%
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% who cannot tolerate side effects
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10-15%
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Bipolar disorder aka manic-depressive illness
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ppl experience swings in modd from overly high to sad and hopeless wit hperiods of normal or near normal in between
.3-1.5% population, number of cases rising, symptoms appear when person us young, peak age is suring adolesence, sudden onset |
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Mania
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episode haracterized by elevated, expanisve, irritable moods....that include inflated self esteem, extreme talkitiveness, pleasurable activites, increased goal-directed activity
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Hypomania
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milder elevated statethat may not be recognized as dysfunctional
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Depression
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diminshed energy, inability to experience pleasure, slowing of mental activity, fatigue, insomnia
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MIxed mania
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40% of bipolar patients, mania or hypomania occurs simultaneously with depressive symptoms
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cyclothymia
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mood swings bw hypomania and less severe depression,
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rapid cycling
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20% of patients... four or more episodes in past 12 months of depression, mania, hypomania that are separeted from one other
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Bipolar 1 disorder
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episodes of mania and major depressive episodes, Robert Lowell, occurs in high frequency in highy creative ppl, associated with high risk for suicide
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bipolar II disorder
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hypomanic episodes. distinct period of elevate dmood, but they are still able to function. the abillity to functoin is what distinguished mania from hypomania
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alice faye redd
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case illustrates strong genetic factor in bipolar disorder
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cyclothymic disorder
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chronic state of mood distrurbance, hypomanic and depressive behvior occur but it is not as extreme as mania or the depressive episodes found in bipolar disorder, episodes have a seasonal pattern and are more commonion spring or fall
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mz twins and bipolar
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40-705 chance that the other twin will have the disorder, 2/3 of ppl wh odevelop disorder have family history, genetic vulnerability may also be important, no single chromosone has been identified in causing bipolar disorder
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can bipolar be cured
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no it is chronic
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most common treatment for bipolar
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lithium
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relapse rates
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high-40% in first year to 73% over years
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manic or hypomanic episodes are likely to follow
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stressors that distrupt a persons sleep cycle
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depressive symptoms are likley to follow
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loss events
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psychoeducational programs
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helpful for famly, psychoeducation-help family learn about the disorder
-proven to cause an increase in positive nonverbal behavior patterns of patients |
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Suicide
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"self murder"
30,000 ppl die each year 650,000 attempted suicides 12.5 per 100000 population |
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lifetime risk for suicide amongst mood disorders
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highest for bipolar II, intermediate for bipolar i and lowest for unpolar
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Parasuicide
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suicidal behavior not resulting in death
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risk factors for suicide- age
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1)adolescents and young adults
2)those over age 70 rate has been risingvery rapidly for young ppl, 3rd most frequent cause of death fpor teenager age groups |
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groups of teenagers at high risk for suicide
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gay/lesbian.bisexual
homeless, runaways, delinquents incarceration those exposed to the suicidal behavior of others social withdrawl and isolation or characteristic of teenagers who commit suicide, college students not at high risk |
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sex
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women make more attempts but men are more likley to kill themselves
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most common method of suicide
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firearms, men more likely to use firearms then females
women usually use drug overdose |
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race/ethnicity
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high rate for native american/alaskian native men
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cultural attitudes
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higher in japan then us-more culturally appropaite way t odeal with shame
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hopelessness
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negative expectations and hopelessness
Beck Hopelessness Scale-higher scores=possibility of incrreased risk |
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perfectionism
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ppl who set high standards for themselves more critical of self evaluations, increases chance of suicide
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Escape theoy of suicide
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roy baumeister-suicide is an attempt to escape aversive self-awareness-casual events can lead to suicide, immediate or short term goals make suicide acceptable
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job loss, divorced ppl, physcians, lawyers, dentists, unskilled laborers
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all have high rates of suicide
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suicide by contagion
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when the suicide of a well known person makes news and increase in suicide occurs thereafter-copycat effect
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preventions of suicide
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increasing awareness of possibe suicidal thinking, crisis centers, changing cultural expectations about how ppl should deal with their problems
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posvention programs
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instituted after a suicide has taken place- can be helpful in preventing future suicides
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signs of suicide
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changes in eating/sleeping habits, withdrawel from friends, violent actions, drug/alcohol use, neglect of personal appearance, personality change, bredom, inability to tolerate praise or rewards
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Emil Kraepelin
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first writer t classify schitz, dementia praec0x (premature madness-0nset is early)
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Eugene Bleuler
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emphasizes physi0l0gical aspects, 0t a single cause, c0ncept f vulnerability
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highest gr0ups with schitz
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chlid with tw0 parents, m0n0zyg0tic twins, the m0re genes the pers0n has in c0mm0n the greater the risk
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l0w frequency 0f alpha waves
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suggest hallucinati0ns, and less metab0lic activity is an indicat0r 0f schitz
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