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Introduction to Brain and Behavior [NOTES] Part 15 -- I got a 92% in the course

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PSB 2000
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Mood Disorders  What are mood disorders? • Affective disorders → Illnesses that affect the emotional coloring with which we see the world • Prevalence → 14% lifetime prevalence in 13-18 year olds → 20.8% lifetime prevalence in adults  Major depressive disorder • Emotional → Sadness and helplessness for days and weeks at a time → Little pleasure from sex or food (or anything) → Emotional: absence of happiness more reliable symptom than increased sadness ⇒ Study 1: people carries beepers; randomly signaled to report emotional reactions  depressed people far below average number of pleasant experiences • Somatic → Low energy → Insomnia or hypersomnia → Weight loss or gain → Psychomotor agitation or retardation • Cognitive → Feel worthless, or excessive or inappropriate guilt → Can’t imagine being happy again → Thoughts of death, contemplate suicide → Lack of concentration, increased indecisiveness • Both emotional, plus at least 3 others, for most of every day for 2 weeks, and this is obvious change from person’s usual state • More on suicide → Thoughts of suicide are considered a medical emergency  Other types of depression • Atypical depression → Responds to positive and negative experiences, but especially sensitive to negative experiences → Often have many partners, frequent break ups → Weight gain, hypersomnia, increased appetite → Respond best to ssri’s with psychotherapy • Dysthymia → Mild and persistent (chronically miserable) → Tend toward the emotional and cognitive symptoms → Sometimes worsen into major depressive  Genetics and depression • Adopted children resemble biological parents more than adoptive parents • Increased risk if a relative developed severe early-onset depression (especially if female) • Many genes increase the risk… → 80% decrease in brain’s activity to make serotonin → Serotonin transporter gene (short-type vs. long type) • …but you need environmental factors as well  Hormones and depression • Stress can elevate cortisol  weak immune system and impairment of sleep  stage “set for depression” • Females vs. males → Equal in boys and girls → More common in women than men ( in all cultures, not due to who seeks treatment) • Sex hormones → Emotional distress after giving birth ⇒ Baby blues ⇒ Postpartum depression → Drug-induced drop in estrogen and progesterone cause depression in women who already suffered from PPD ⇒ Used gonadotropin releasing hormone agonist followed by a withdrawal of that drug, inducing drop in estrogen and progesterone → Estrogen relieves depression during menopause  Bipolar disorder • Used to be called manic-depressive disorder • Bipolar 1 → Full manic episodes ⇒ Lifetime prevalence – 2% • Bipolar 2 → Anxiety • Symptoms of mania → Restless activity (goal-directed or psychomotor agitation) → Decreased need for sleep…enormous surge of energy → Excitement (elevated, expansive, or irritable mood) → Laughter → Self-confidence (inflated self-esteem or grandiosity) → Rambling speech → Flight of ideas or subjective experience that thoughts are racing → Loss of inhibitions (excessive involvement in pleasurable activities that have high potential for painful consequences) → Distractibility → Impairments in verbal memory • Genetics of bipolar disorder → Identical twins: 50% concordance → Fraternal twins, siblings, children: 5-10% chance of developing it → Adoptive children with bipolar disorder likely to have biological relative with mood disorder → Several genes more common in people with bipolar, but these only increase risk • Physiological treatment for bipolar disorder: Lithium → Most effective w/ mania, and then prevents following depression → No suppression of normal feelings of emotion, no intellectual impairment → Usually begin to improve within 1-2 weeks → Low therapeutic index which requires regular blood tests → Nasty side effects ⇒ Tremor, weight gain, excessive thirst and urination, toxic doses, nausea, diarrhea, incoordination, confusion, coma → How does it work? ⇒ Not sure… ⇒ By stabilizing serotonin receptors? • Preventing shifts in sensitivity ⇒ By producing proteins that help prevent cell death? • 4 weeks of lithium  increased gray matter  Genetics and mood disorders in general • Having a relative with a mood disorder increases your likelihood of developing a mood disorder (but not necessarily the same one) • Most genes that may be involved are related to dopamine or serotonin transmission (particularly, their receptors)  Antidepressants • Tricyclics prevent reuptake of serotonin, norepinephrine → Side effects: dry mouth, drowsiness, difficulty urinating, heart irregularities → Affect other neurotransmitters as well, hence the side effects • MAOIs (MAO inhibitors) block breakdown of
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