DOWN IN THE DUMPS..UP IN THE CLOUDS…

Mood Disorders

SWINGS IN EMOTIONAL STATES THAT ARE MORE EXTREME (THAN NORMAL) AND MORE PROLONGED

(LONGER LASTING)

COMMON DISORDERSSEASONAL AFFECTIVE DISORDER

DEPRESSIONBIPOLAR DISORDER

What is a mood disorder?

LIFE BRINGS EVENTS THAT MAKE US SAD,

DISAPPOINTED, FRUSTRATED…

Depression

What is Depression?

Range (5 or more symptoms)

Typically lasting 2 or more weeks (no apparent reason)

SymptomsProfound unhappiness (most of the time)Lack of interest in usual life pleasures (eating, sex, hobbies, sports, work, etc.)Weight loss/gainFatigueInsomniaFeelings of death/suicideDifficulty concentratingFeelings of worthlessness, helplessness/anxiety

How Common is Depression?Depression is the “common cold” of mental

illness

21.3% of women seek treatment for depression at some time in lifetime.

12.7% of men seek treatment at some time in lifetime.

Why are 2/3 of all patients women?

Women Men

Suicide

7th Leading cause of death in USSuicide is the 2nd leading cause of death

in young people.Roughly- 1 person in 100 attempts

suicideOn average- Between 15-19 adolescents

commit suicide every day in the US (30% increase in past 18 years)

Highest range is 15-24.Women make more attempts- Men 3X

more successful

Major Risk FactorsMajor Risk Factors Warning SignsWarning Signs

Drug or alcohol abuseA prior suicide attemptDepressionHopelessnessAntisocial or aggressiveFamily history of

suicide/bipolar disorderShame, humiliationAvailability of firearm

Withdrawal from othersSudden swings in moodRecent crisis or shockGiving away prized

possessionsDepression/hopelessnessRisk takingPreoccupation with

deathDirect threats of suicide

Suicide

SSRI –Treatment (do antidepressants cause suicide?)

The only Antidepressant approved by the FDA is Prozac (all others contain “black box” warning)

Slight significant increased risk for suicide (approximately 2%)

Do antidepressants work?

What is your definition of “work”?

For people with mild to moderate depression, placebos work nearly as well as antidepressants.

Dysthymia is exception (chronic conditions generally have poor response to placebo)

Why is this controversial?

Alternative treatments: cognitive behavior rational emotive Learned optimism

Causes of Depression

Life situation/behaviorGenetic factors Substance abuseAbnormal brain chemistry (reduced

norepinephrine and reduced serotonin)= importance of serotonin

Learned helplessness (Martin Seligman)Negative self beliefs

SymptomsSymptoms CausesCauses

Rapid Speech (push)Extreme

hyperactivityElation/GrandiosityDecreased need for

sleepFlight of ideasHarmful activities

Genes: 1987 Amish Study (why study the Amish?)

Biology (neurotransmitters in the brain)

Environmental

Bipolar Disorder= wide swings in mood from deep depression to wild elation (mania) was previously called

Manic-depression

Establishing the line between “normal” and “clinically” abnormal depression can be

challenging

Clinicians focus on “self-report”Cyclothymia= similar to bipolar but involves less severe bouts of mania and depression. (over 2-year)

MedicationMedication Cognitive PsychologyCognitive Psychology

Lithium (mostly for mania/suicide)

Depakote (anticonvulsants)

Anti psychotic medication

SSRI (Antidepressant)

Hospitalization (when necessary)

(1) View that says Individuals with depression see bad events as:Internal= blame themselvesStable= likely to lastGlobal= major impact(2) Aaron Beck= negative view of self(3) Martin Seligman=learned helplessness

Bipolar Treatment