-
normal?
o every area of life
o persists
o no reason
-
2 extremes
o dysphoria
o euphoria
-
episodes
o time period
o specifiers
§
severity
§
first or
reoccurrence
§
nature of
symptoms
-
major depressive
episode
o symptoms
§
emotional
symptoms
§
cognitive
symptoms
§
somatic/behavioral
symptoms
o course
§
gradual onset
§
mid 20’s
§
2 weeks
§
remits after 6
months (no treatment)
·
¼
symptomatic
o prevalence
§
90% of diagnosed
mood disorders
§
males vs. females
·
13/100 vs. 21/100
§
older adults
§
reoccurrence
·
60%
-
dysthymia
o fewer symptoms, less severe
o 2 years
o major depression
§
10%
o children, adolescents
§
1 year
§
cranky, irritable
o onset
§
early, chronic
§
males vs. females
·
5% vs. 8%
§
older
·
2%
·
somatic symptoms
o 1 week
o episodes sudden
o symptoms
§
emotional
§
cognitive
§
somatic/behavioral
-
2 levels
o 1. hypomanic
o 2. manic
-
bipolar I
o 1 manic episode
o possibly MD
-
bipolar II
o major depression, hypomania
-
prevalence
o 1.6%
o males vs. females
§
mania
o course
§
20’s
§
over 65, 0.1%
§
90% probability
of reoccurrence (mania)
·
kindling
o occurrence when medicated
§
intervals
decrease with age
§
rapid cycling
·
4-8 episodes a
year
·
5-15%
-
cyclothymia
o 1%
o fluctuating mood
o doesn’t meet bi-polar criteria
o 2 years (1 for kids)
o 10-15%
§
develop BP I or
BP II
-
biological
theories
o genetics
§
runs in families
§
twin studies
·
15-20% vs. 67%
§
adoption studies
·
31% vs. 2%
§
multiple genes
o neurotransmitters
§
monoamine
depletion model
§
low GABA levels
§
high cortisol levels
o area 25
§
overactive
-
psychological theories
o childhood loss
o stressful life events
§
change
“scripts”
o cognitive triad
§
negative view of
self, world, future
o cognitive distortions
-
sociocultural theories
o interpersonal theory
§
poor social
skills
§
depression
§
maintained by
impaired skills, depression
Treatment of Depression
-
medical options
o antidepressants
§
SSRI’s
·
50-70% respond
·
6 – 12
months
§
children,
adolescents
·
Prozac
o ECT
o stimulating area 25
-
psychotherapy
o cognitive behavioral therapy
§
new behaviors,
change thoughts
§
75% show
improvement
§
lower relapse rates
§
fewer side
effects
-
sociocultural techniques
o interpersonal therapy
§
measure degree of
depression
§
social skills,
problems
§
support,
education, self-exploration
Theories of Mania
-
genetics
o twin studies
§
43% vs. 6%
-
brain differences
o amygdala, prefrontal cortex
o neurotransmitters
-
medication
-
illnesses
-
sleep deprivation
-
stressful life
events
Treatment of Bipolar Disroder
-
medication
o mood stabilizers
§
Lithium
o antidepressants
o antipsychotics
-
psychotherapy
o not substitute for medication
-
education
-
healthy lifestyle