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Chapter 7

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PSYC 3390
Margaret Lumley

Chapter 7 Summary Two key moods involved with mood disorders: Mania(intense and unrealistic feelings of excitement and euphoria) Depression(feelings of extraordinary sadness and dejection) - Can have symptoms of mania and depression at the same time (mixed episode cases) - Unipolar – person experiences only depressive episodes - Bipolar- experience both manic and depressive episodes - Differentiate mood disorders based on 1. Severity- the number of dysfunctions experienced and the relative degree of impairment 2. Duration- whether the disorder is acute, chronic, intermittent - Most common form of MD is major depression (unipolar) - Other kind of MD is manic episode in which a person shows markedly elevated, euphoric mood often interrupted by outbursts of intense irritability/violence * see textbook page 231 for DSM criteria for major depressive episode and manic episode - Rates of unipolar depression higher for women than man The grieving process is NOT a mood disorder. It is a psychological process one goes thru following death of a loved one (more difficult for men). There are four phases: 1. Numbing and disbelief- a few hours to week 2. Yearning and searching for the dead person- weeks to months 3. Disorganization and despair- finally accepts that person is dead (this is also where major depression can set in) 4. Some level of reorganization when ppl gradually rebuild their new lives Postpartum ‘blues’- very common in 50 to 70 percent of women Dysthymic Disorder- have persistently depressed mood most of the day, for more days than not, and for more than 2 years plus six additional symptoms of depression. 3 to 6% of Canadian adults have this Major Depressive Disorder- person exhibits more symptoms than are required for dysthymia and the symptoms are more persistent. To be diagnosed, must be in a major depressive episode with either depressed moods or marked loss of interest in pleasurable activities, most of everyday, nearly every day, for at least two consecutive weeks. Plus 3-4 additional symptoms - Unipolar mood disorder often occurs during late adolescence up to middle childhood. Incidence of depression raises sharply in adolescence and can continue unto later life - Specfiers- different patterns of symptoms in major depression ex. Major depressive episode with melancholic features (has criteria for depression plus no pleasure in things they use to do plus 3 of the following: early morning wakening’s, depression being worse in morning, marked psychomotor retardation or agitation, significant loss of appetite, depressed mood - Severe major depressive episode with psychotic features – loss of contact with reality and delusions ( false reality) as well as criteria above - Major depressive episode with atypical features- a pattern of symptoms characterized by mood reactivity that is the person’s mood brightens in response to potential positive events. Must show two of the following symptoms as well : significant weight gain, hyper insomnia, leaden paralysis (heavy feelings in arms /legs), long standing pattern of being acutely sensitive to interpersonal rejection - Double depression- not an official specifier, when major depression coexists with dysthymia Chronic major depressive disorder- a disorder in which a major depressive episode does not remit over a 2 year period Recurrence- a new occurrence of a disorder after a remission of symptoms. This is high, about 80 percent Relapse- return of the symptoms of a disorder after a fairly short period of time SeasonalAffective Disorder- person must have at least two episodes of depression in the past two years occurring at the same time of the year and full remission must occur at the same time of the year Casual Factors in unipolar mood disorders : genetic influences (evidence of moderate genetic contribution to the vulnerability for major depression but probably not for dysthymia. Major depression is clearly associated with multiple interacting disturbances in neurochemical, neuroendocrine, and neurophysiological systems. Disruptions in circadian and seasonal rhythms are also features of depression Among psychosocial theories, Becks cognitive theory and the reformulated helplessness and hopelessness theories which are formulated as diathesis-stress models explain depression. The diathesis is cognitive in nature (eg. Dysfunctional beliefs in becks theory and pessimistic attributional style in the helplessness/hopelessness theories) and stressful life events are often important in determining when those diatheses actually lead to depression Abnormalities of hormonal regulatory systems = depression - Failure of feedback mechanisms ( suppressor of plasma cortisol fails) - Elevated cortisol also shows memory impairment - Two systems that deal with depression and hormones= hypothalamic – pituitary- adrenal axis AND hypothalamic- pituitary thyroid axis Stressful life events are known to be involved in the onset of a variety of disorders - Studies show stressful events lead to unipolar depression ex. Childhood abuse/neglect, loss of loved one - Minor stressful events NOT related to depression - Women are more sensitive to stressful life events - You are more likely to experience depression if 1.Are having an intimate relationship 2. Have more than three children at home 3. Having a job outside the home 4. Have a serious religious commitment Diathesis-stress model: view of abnormal behaviour as the result of stress operating on an individual who has a biological, psychosocial, or sociocultural predisposition to developing a specific disorder - Personality and cognitive diathesis- neuroticism is the primary personality variable that serves as a vulnerability factor for depression - High levels of introversion may also play a factor - Early parental loss also plays a role Becks Cognitive theory of depression - FIGURE 7.4 pg. 248 for chart - Certain kinds of early experiences can lead to the formation of dysfunctional assumptions that can leave a person vulnerable to depression later on in life if certain critical incidents (stressors) activate those assumptions. Once activated, these dysfunctional assumptions trigger automatic thoughts that in turn produce depressive symptoms, which further fuel the depressive automatic thoughts
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