Major Depression
Extremely depressed mood lasting at least two weeks
Cognitive symptoms
Disturbed physical functioning
Anhedonia
Single episode - highly unusual
Recurrent episodes - more common
Manic episode
Extreme elation, euphoria, and hyperactivity
Lasts at least 1 week, causes impairment in normal functioning
Mania Hallmarks
Sexual Promiscuity
Spending Sprees
Delusions of Grandeur
Mania "Light"- Hypomanic Episode
A period of elevated mood lasting at least 4 days, NOT severe enough to cause impairment in normal functioning
Dysthymia or Persistent Depressive Disorder
Milder" than major depression
Persists for at least two years
No more than two months symptom free
Related to depression?
Bipolar I Disorder
Alternations between full manic episodes and depressive episodes
Bipolar II Disorder
Alternations between major depressive and hypomanic episodes
10% to 25% of cases progress to bipolar I
Mixed Episode
Manic and depressive episodes nearly every day for at least 1 week
-Causes impairment in normal functioning
Cyclothymic Disorder
Involves Hypomanic Episodes along with depressive symptoms that do not meet criteria for a Major Depressive Episode
Prevalence of Mood Disorders
No gender gap in bipolar disorder because it's genetics
Life Span Developmental Influences on Mood Disorders
Mood disorders are often misdiagnosed as ADHD (maybe?)
Children were being diagnosed with bipolar at high rates, now "disruptive mood dysregulation disorder
Premenstrual Dysphoric Disorder
In the majority of menstrual cycles, at least five mood disorder symptoms (feeling suddenly sad or angry)
Mood Disorders: Familial and Genetic Influences
Family studies
-Severe mood disorders - genetic contribution
Neurotransmitter systems
-Low levels of serotonin?
-Permissive hypothesis
(fall in serotonin causes fall in norepinephrine)
Mood Disorders: Neurobiological Influences
Sleep disturbance
Hallmark of most mood disorders
Relation between depression and sleep
Mood Disorders: Psychological Dimensions (Stress)
Stressful life events
Stress is strongly related to mood disorders
Reciprocal-gene environment model
Mood Disorders: Psychological Dimensions (Cognitive Theory)
Cognitive errors and the depressive cognitive triad
-Think negatively about oneself
-Think negatively about the world
-Think negatively about the future
Types of cognitive errors:
-Arbitrary inference - overemphasize the negative
-Overgeneralization - neg
Mood Disorders: Psychological Dimensions (Learned Helplessness)
The learned helplessness theory of depression
-Lack of perceived control over life events
A depressive attributional style:
-Internal attributions
It's all my fault!
-Stable attributions
Don't bother, I'm going to ruin everything in the future anyway!
-Gl
Mood Disorders: Social and Cultural Dimensions
Marital relations
-Marital dissatisfaction is strongly related to depression
-This relation is particularly strong in males
-Why?
Mood disorders in women
-70% of major depression and dysthymia are women
-Women ruminate more than men (really?)
Social suppo
Which country is most depressed?
Lebanon
An Integrative Theory
Shared biological vulnerability
Inadequate coping and depressive cognitive style
-Diathesis-stress model
Biological, psychological and social factors
Treatment of Mood Disorders: Selective Serotonin Reuptake Inhibitors (SSRIs)
-Block reuptake of serotonin
Fluoxetine (Prozac)
-Negative side effects are common
Treatment of Mood Disorders: Tricyclic Antidepressants
Widely used (e.g., Elavil)
Block reuptake
-Norepinephrine and other neurotransmitters
Treatment of Mood Disorders: Mixed Reuptake Inhibitors
Venlafaxine (Effexor)- blocks reuptake of norepinephrine as well as serotonin
Treatment of Mood Disorders: Monoamine Oxidase (MAO) Inhibitors
Monoamine oxidase (MAO)
Blocks monoamine oxidase
This enzyme breaks down serotonin/norepinephrine
Treatment of Mood Disorders: Lithium
Side effects may be severe
Why lithium works remains unclear
Treatment of Mood Disorders: Electroconvulsive Therapy (ECT)
ECT is effective for cases of severe depression
The nature of ECT
brief electrical current to the brain
Usually 6 to 10 outpatient treatments
Short-term memory loss
Why does ECT work?
Treatment of Mood Disorders: Transcranial Magnetic Stimulation (TMS)
?????
Psychosocial Treatments
Cognitive-behavioral therapy
Interpersonal psychotherapy
-Focuses on problematic interpersonal relationships
The Nature of Suicide: Facts and Statistics
11th leading cause of death in the United States
Gender differences
-Males are more successful at committing suicide --Females attempt suicide more often
The Nature of Suicide: Risk Factors
Risk factors:
-Suicide in the family
-Low serotonin levels
-Preexisting psychological disorder
-Alcohol use and abuse
-Stressful life event
-Past suicidal behavior
Suicide
Suicide is an increasing problem
Not unique to mood disorders
Eating Disorders
90% of cases involve females
Adolescence onset
Of those admitted to hospitals, mortality rate is 10%
Anorexia Nervosa
- Refusal to maintain body weight at normal range)
AND....
-Comorbidity!
-Life threatening consequences
Bulimia Nervosa
- Recurrent episodes of binge eating
- Recurrent compensatory behavior (vomiting, fasting, etc.)
-Occurs at least twice (now once!) a week for 3 months
-Purging methods can result in severe medical problems
-Erosion of dental enamel
Binge Eating Disorder
Recurrent episodes of binge eating
No compensatory behavior
Most are overly concerned with body shape
Comorbidity!
Bulimia and Anorexia: Facts and Statistics
Majority are female - 90%+
6-7% of college women suffer from bulimia
From middle- to upper-middle-class families
Media and cultural considerations
Being thin = success, happiness....really?
Media ideal
Medical and Psychological Treatment of Eating Disorders
Psychosocial treatments
-Cognitive-behavioral therapy (CBT)
-Is the treatment of choice (why?)
Medical and drug treatments
-Antidepressants
-Can help reduce binging and purging
-Not efficacious in the long-term
Long-term prognosis for anorexia is poorer t
Sleep Disorders
Two major types of sleep disorders:
1. Dyssomnias
2. Parasomnias
The Dyssomnias: Insomnia
Insomnia/Hypersomnia
One of the most common sleep disorders
Facts and statistics:
-Often associated with medical and/or psychological conditions
-Affects females twice as often
The Dyssomnias: Narcolepsy
Narcolepsy - daytime sleepiness and cataplexy
-Cataplexic attacks
Rare condition
-.16% of the population
-Equally males and females
The Dyssomnias: Breathing-Related Sleep Disorders
Breathing-related sleep disorders
-Sleep apnea
-1-2% of population
-More common in males
-Associated with obesity and increasing age
Medical Treatments
Insomnia
-Benzodiazepines and over-the-counters
Hypersomnia
-Stimulants (i.e., Ritalin)
-Cataplexy
-antidepressants
The Parasomnias: Sleep Terror Disorder
Sleep terror disorder
-5% of children and <1% of adults
Sleep walking disorder - somnambulism
-Occurs during non-REM sleep
Summary of Eating and Sleep Disorders
Incidence of eating and sleep disorders is increasing
More effective treatments needed!