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Lecture

PSY240H1 Lecture Notes - Light Therapy, Reuptake, Cyclothymia


Department
Psychology
Course Code
PSY240H1
Professor
S.Cassin

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Chapter 9 and 10: Mood Disorders and Suicide
MOOD DISORDERS
Types of Mood Disorders
-Unipolar
- Mood remains at one pole of the depression-mania continuum (usually
depression)
-Bipolar
- Mood swings across the depression mania continuum (one minute depressed, the
next, manic)
(Many people may experience symptoms of depression, but not necessarily to a large
enough degree to be considered a full depressive episode…)
Can also be divided by:
-Exogenous depression linked to an event in life that may have triggered it
-Endogenous not linked to a life situation that triggered it (internal factors, like
neurotransmitters)
Types of Unipolar mood disorders
Major Depressive Disorder
- 2 or more major depressive episodes (single episode = Major Depressive episode)
Dysthymic Disorder
- “low grade depression lasting more than two years
Double Depression
- Experience major depressive episodes superimposed on dysthymic disorder
Depression – Diagnostic Criteria
-Sad, depressed mood and/or loss of interest and pleasure (anhedonia) in usual
activities, plus 3 or 4 additional symptoms:
- Sleep difficulties (major disruption)
- Psychomotor agitation (must be apparent to other people)/retardation
(retardation=everything is a huge effort and move slower)
- Change in appetite (eat too little/much)/weight (at least a 5% change in weight)
- Low energy, fatigue (day to day chores feel like huge energy expenders)
- Feelings of worthless and/or excessive guilt (like decisions that they regret from
years ago)
- Difficulties concentrating (like getting lost tracking conversations, work,
reading) and/or indecisive (must be a clear increase in indecisiveness)
- Recurrent thoughts of death (the idea that death would be better than
going on with life) or suicide (has many levels; like thinking about suicide to
actual suicide attempts)
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Most should show clear change in functioning; clearly different than before
-Symptoms must occur most of the day, nearly every day, for at least 2 weeks
-If a person had all the symptoms of the above list, but no depressed mood or w/e,
then it isn’t considered depression
If these symptoms follow bereavement, it would only be considered depression if
it continued for about two months after death
Diagnosis is up to ones discretion though; varies
Depression – Epidemiology
-Lifetime prevalence estimated at 5-10% for men and 10-20% for women (over
entire lifespan)
Maybe women’s rates are higher because of hormonal changes from puberty or
pregnancy, different expectations for women (marriage/career/kids/relationships),
and maybe men don’t come forward to treat depression until much later
-Average onset age of 20-29 in women and 40-49 in men
-Tends to be episodic and recurrent (maybe due to trigger or hormonal fluctuation;
50% change of getting a second episode if they already had one)
-Comorbidity (occurrence with other disorders) is common
- anxiety, schizophrenia, chronic pain disorders, substance use disorders, and
personality disorders
Dysthymia – Diagnostic Criteria
-Depressed mood plus two additional symptoms:
- change in appetite
- sleep difficulties
- low energy
- low self-esteem (important but this is hard to diagnose; relies on self report)
- poor concentration
- hopelessness
-Symptoms must occur most of the day, more days than not, for at least two years
Is like depression, but not as severe
Some people think that it’s more of a personality disorder since it doesn’t have as
many acute symptoms as depression
Psychosocial Models of Depression
- Psychodynamic
-Interpersonal
-Life events
-Behavioural
- Lewinsohn’s Theory, Learned helplessness Theory
-Cognitive
- Beck’s Theory, Reformulated Learned Helplessness Theory
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Psychodynamic model
-Freud noted the similarity betweenmourning” andmelancholia”
-Suggested that loss can lead to depression
-Person becomes angry at the lost person and turns the anger inward (such as
losing father, getting angry at father’s death, inwardly becoming angry at father)
-Depression = anger-turned-inward
Interpersonal Model
-Depressed individuals have fewer and poorer quality relationships
-Others may be unwilling to interact with individuals with depression, which
exacerbates this problem (makes problem worse, since others may interact with
depressed individual badly; depression pushes others away which only makes it
worse)
-Individual with depression may lack skills to overcome this problem
Life Events Model
-Person is vulnerable to depression and succumbs to depression in response to a
significant life event, like loss or failure
-Some research demonstrating association between stressful life events (like early
parental loss) and depression (empirical research has proven this)
A study looked at women with depression; 61% of them had a major life stressor
within the year leading up to depression
Women who had preschool age children were at the highest risk (at this time,
least social support and a lot of responsibility)
Lewinsohn’s Behavioural Theory
-Individuals with depression have had an increase in aversive events and a loss of
reinforcement (like the loss of: pleasurable activities, jobs, social contact [leading
to isolation])
-People with depression – will less likely participate in activities that would
alleviate their depressed mood
Learned Helplessness theory
-Individuals with depression may have a learning history of being unable to control
reinforcement and the environment in general
-They come to believe that their responses are independent of reinforcement, so it
does not matter what he/she does (feel loss of control and helplessness)
This theory was reformulated into a more cognitive based theory, because it didn’t
account for why people with depression often blamed themselves for the situations
they were in
Beck’s Cognitive Model
-Cognitive Triad
- Negative perceptions of the self, world, and future
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