Mood Disorders

Also known as affective disorders Depression, mania, or both Definition of depression Definition of mania

Hypomania

Types of Mood Disorders

Unipolar Mood Disorder Technically could mean either depression or

mania only, but almost exclusively used for depression

Bipolar Mood Disorder Alternates Between Depression and Mania Often referred to as manic-depression

Major Depression

Extremely Depressed Mood Lasting at least 2 weeks

Anhedonia Cognitive Symptoms Vegetative Symptoms Single or Recurrent Episode

Milder Symptoms than Major Depression But Longer Lasting

At least 2 years With no more than two weeks without symptoms

Can last a lifetime

Dysthymic Disorder

Double Depression

Suffer from both Major Depression Dysthymia

Dysthymia Typically First

Patterns of Depression

Normal Mood Fluctuations Major Depression

Dysthymia "Double" Depression

Manic-Depression “Roller Coaster” of Mood Manic Episode

Elevated Mood Grandiosity Increased Activity

Often Reckless Varied Impairment

Bipolar Disorder

Bipolar Disorder

Bipolar I Major Depressive Episode(s) and Manic Episode(s)

Bipolar II Major Depressive Episode(s) and Hypomanic

Episode(s) Cyclothymia

Dysthymic Episode(s) and Hypomanic Episode(s)

Patterns of Manic Depression

Normal Mood Fluctuations Bipolar I

Bipolar II Cyclothymia

Familial and Genetic Influences

Table 6-2, p. 217

Lifetime Prevalence See previous chart

Sex Differences Females are twice as likely to have a mood disorder

compared to men The gender imbalance in depression disappears after

age 65 Bipolar disorders are distributed equally between

males and females Comorbidity, especially with Anxiety Seasonal Pattern (aka Seasonal Affective Disorder)

Additional Aspects

Social and Cultural Dimensions

Marriage and Interpersonal Relationships Marital dissatisfaction is strongly related to

depression Gender Imbalances

Occur across all mood disorders, except bipolar disorders

Gender imbalance likely due to socialization

Social and Cultural Dimensions

Social Support Grief/Bereavement Age Oppression and poverty Creativity Life Stress

Fig. 6-5, p. 231

Tricyclic Antidepressants

Widely Used (e.g., Tofranil, Elavil) Block Reuptake of Norepinephrine and Other

Neurotransmitters Takes 2 to 8 Weeks to Take Effect Negative Side Effects Are Common May be Lethal in Excessive Doses

Monoamine Oxidase (MAO) Enzyme that breaks down

serotonin/norepinephrine MAO Inhibitors Block Monoamine Oxidase MAO Inhibitors Are Slightly More Effective

than Tricyclics Must Avoid Foods Containing Tyramine (e.g.,

beer, red wine, cheese)

Monoamine Oxidase (MAO) Inhibitors

Selective SerotonergicReuptake Inhibitors (SSRIs) Specifically Block Reuptake of Serotonin

Fluoxetine (Prozac) is the most popular SSRI Paxil and others becoming more popular

SSRIs Pose No Unique Risk of Suicide or Violence Disclaimer about Adoloescents

Negative Side Effects Are Common, but Fewer than Other Antidepressants

Herbal/OTC Treatments

St. John’s Wort SAMe Some evidence of effectiveness, but beware

Lack of supervision Interactions

Lithium

Lithium Is a Common Salt Traditional mood stabilizer for bipolar

disorders However, does not help everyone

Side Effects May Be Severe Dosage must be carefully monitored

Why Lithium Works Remains Unclear

Lithium (cont.)

Table 6-5, p. 235

Electroconvulsive Therapy (ECT)

ECT Brief electrical current applied to the brain Results in temporary seizures Several treatments are often required

ECT Is Effective for Cases of Severe Depression (When All Else Fails)

Side Effects Include Short-Term Memory Loss Uncertain Why ECT Works and Relapse Is

Common

Psychological Treatment of Mood Disorders Cognitive Therapy

Addresses cognitive errors in thinking Also includes behavioral components

Behavioral Activation Increased contact with reinforcing events

Interpersonal Psychotherapy Focuses on problematic interpersonal

relationships Outcomes with Psychological Treatments Are

Comparable to Medications

pp. 256-257

Suicide

Facts and Statistics 30,000+ Kill Themselves Annually 8th Leading Cause of Death

Higher among Young Adults More Men Kill Themselves More Women Attempt Pattern in Adolescents (see graph)

Fig. 6-10, p. 245

Fig. 6-9, p. 245

Suicide Risk Factors

Past Suicidal Behavior Suicide in the Family Age Gender A Psychological Disorder Alcohol Use and Abuse Low Serotonin Levels Publicity about Suicide and Media Coverage