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8. Mood Disorders.pdf

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PSYC 3230
James Alcock

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8. Mood Disorders Monday, March 4, 2013 9:00 AM Unipolardisorders • Major Depressive Disorder • Dysthymia MajorDepressiveDisorder • Depressed mood or a loss of interest or pleasure in daily activities consistently for at least a two week period • Occupational, educational, or other important function must also be negatively impaired by the change in mood • Not due to alcohol, drugs, medical condition, or grief at loss of a loved one • Mean age of onset 25 years • Emotional symptoms ○ Extreme sadness, feelings of worthlessness ○ Anhedonia-- inability to find pleasure in previously pleasurable activities ○ Crying spells, or being "unable to cry" ○ Loss of feelings of affection for family/friends • Motivational symptoms ○ Lack of drive; markedly diminished loss of interest in almost all activities ○ Loss of libido ○ Thoughts of suicide • Behavioral symptoms ○ Lower activity level ○ Psychomotor retardation or agitation • Cognitive symptoms ○ Negative self-image ○ Negative self-talk ○ Guilt and self-blame ○ Confusion, poor memory, indecisiveness • Somatic symptoms ○ Disturbances in sleep-- early morning awakening, insomnia, sleeping all the time ○ Fatigue, exhaustion ○ Decrease or increase in appetite; weight change ○ Aches and pains, dizziness • Psychotic symptoms (severe depression) ○ Delusions ○ Hallucinations • An estimated 1 in 4 Canadians has a degree of depression serious enough to need treatment at some time in his or her life • Until age 65, twice as many women as men receive treatment for depression. Possible reasons: ○ The most vulnerable are single mothers with small children ○ Women are taught to handle stresses differently than men ○ Female hormones may possibly contribute to higher rates of depression ○ Women may be more likely to seek help • Men tend to suffer more prolonged depression than women later in life ○ Perhaps due to the fact that widowers tend to grieve more than widows because the wife may tend to keep many aspects of his life together (e.g., cooking, cleaning) Dysthymia • Chronic mild depression • Chronic mild depression • Less disabling than Major Depressive Disorder, but more prolonged • May be associated with impaired social and/or vocational functional • Mean age of onset: early 20s • Symptoms can go unchanged for 20 years or more • Onset prior to age 20: greater chronicity Theoriesof unipolardepression • Psychodynamic ○ Depression often triggered by major loss ○ Due to a series of unconscious processes set in motion when people feel real or imagined (symbolic) loss ○ E.g., losing a job may be symbolic of losing a partner: "My husband won't want me if I can't keep a job" • Behavior theory ○ Depressive style of functioning is the result of a significant reduction in the total rate of reinforcements-- especially social reinforcements  Social reinforcements-- e.g., strangers smiling at you, saying "hello" • Cognitive theory (Beck) ○ Due to negative and distorted automatic thoughts ○ "Cognitive triad of depression":  Negative view of self  Negative view of environment  Negative view of future ○ Have patient record situations in the following categories:  Situation | Interpretation | Emotion | Physical response | Action | Outcome ○ Negative thoughts produce negative feelings and negative actions, leading to negative outcomes • Learned helplessness model (Seligman, Peterson, et al.) ○ Individuals learn that their actions do not bring about any positive results • Attributions may play a role in learned helplessness ○ When people perceive circumstances to be beyond their control, they may attribute this to stable, internal causes, leading to depression  An attribution to unstable, external causes may help avoid depression Bipolardisorders • Formerly called "manic-depressive psychosis" Mania • May involve frenzy, anger, laughing binges, racing and disjointed thoughts, agitation, over-talkativeness, impulsivity • May involve delusions (grandeur, erotomania [e.g., believing that famous people are in love with you]) or even hallucinations • May cycle from mania to depression, with or without intervening normal periods • Questions a psychologist may ask re: mania ○ Was there ever a time when you:  Stayed very excited (e.g., for days)?  Were too hap
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