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Chapter 10

PSYB32H3 Chapter Notes - Chapter 10: Canadian Studies, Monoamine Oxidase Inhibitor, Borderline Personality Disorder

Course Code
Konstantine Zakzanis

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Chapter 10: Mood Disorders
General Characteristic of Mood Disorders
Mood disorder: involve disabling disturbances in emotion from sadness of
depression to the elation and irritability of mania
Depression – Signs and Symptoms
Depression: emotional state marked by great sadness and feelings of
worthlessness and guilt
Symptoms: withdrawal from others and loss of sleep, appetite, sexual desire,
and interest and pleasure in usual activities
Associated with other problems – panic attacks, substance abuse, sexual
dysfunction, and personality disorder
They may speak slowly, after long pauses, using few words, monotonous
They prefer to sit alone and remain silent
May neglect personal hygiene and appearance and make numerous
complains of somatic symptoms with no apparent physical base
Vary across the lifespan (symptoms)
Children – results in somatic complaints (headaches or stomach aches)
Older adults – (distractibility and complaints of memory loss)
Some cross cultural variation – because of difference in cultural standards of
acceptable behaviour
Psychologizers: people who emphasize the psychological aspects of
o15% of patients in Canada
oMore non western cultures express physical symptoms rather than
Average untreated depression may stretch for 3-5 months or longer
1/3 suffer from chronic depression
Mania – Signs and Symptoms
Mania: an emotional state or mood of intense but unfounded elation
accompanied by irritability, hyperactivity, talkativeness, flight of ideas,
distractibility, and impractical, grandiose plans
Usually it’s a cycle between depression and mania. Mania alone is rare
Last from several days to several months
Symptoms – loud stream of remarks, full of puns, jokes , rhyming, and
interjections about objects and happening that have attracted the speaker’s
Their speech is difficult to interrupt
Usually comes on suddenly
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Formal Diagnostic Listing of Mood Disorders
2 major mood disorders major depression (unipolar depression) &
bipolar depression
Diagnosis of Depression
Major depression/unipolar depression
Requires the presence of 5 of the following symptoms for at least 2 weeks
(but depressed mood or loss of interest and pleasure must be one of the 5
oSad, depressed mood, most of the day nearly every day
oLoss of interests in usual activities
oInsomnia or too much sleep
oShift in activity level becoming either lethargic (psychomotor
retardation) or agitated
oPoor appetite and weight loss of increased appetite and weight gain
oLoss of energy/fatigue
oNegative self-concept, self reproach and self blame (worthlessness and
oDifficulty concentrating
oRecurrent thoughts of death or suicide
Prevalence of 5.2 – 17.1% - American studies & 4-6% in Canadian studies but
higher ones were also found
2x more common in women
More often in younger ages than older and in low socio economic class
Females are more likely to engage in ruminative coping (want to understand
the meaning of why they feel that way) and males tend to do something that
diverts their attention
Male and females differ in the stressors they experience (ex. Single mothers
vs. Married)
Females are more likely than males to be exposed to various forms of
Depression is a recurrent disorder, 80% experience another episode lasting
3-5 months
12% of the cases become chronic
Diagnosis of Bipolar Disorder
Bipolar disorder: involves episodes of mania or mixed episodes that include
symptoms of both mania and depression
Requires the presence of elevated or irritable mood plus 3 additional
symptoms (4 if the mood is irritable)
The symptoms must be sever enough to impair social and occupational
oIncreased activity level at work, socially or sexually
oUnusual talkativeness, rapid speech
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oFlight of ideas or subjective impression that thoughts are racing
oLess than usual amount of sleep needed
oInflated self esteem (belief that they have some special powers)
oDistractibility: attention easily diverted
oExcessive involvement in pleasurable activities that are likely to have
undesirable consequences (reckless spending)
Less often than major depression
Prevalence – 1%
Average onset is 20s
Occurs equally in men and women (women – episodes of depression are more
common and episodes of mania less common than among men)
It also tends to reoccur
50% of cases have 4 or more episodes
Heterogeneity within the Categories
Heterogeneity: people with the same diagnosis can vary greatly from one
Mixed episode: some bipolar patients experience the full range of
symptoms of both mania and depression almost every day
Bipolar II disorder: patients have episodes of major depression
accompanied by hypomania (a change in behaviour and mood that is less
extreme than full blown mania)
The presence of delusions is a distinction among people with unipolar
depression (they do not respond well to drug therapy also but respond to
drugs treated for other psychotic disorders) this type of depression is more
severe and less time between episodes
Some patients have melancholic features (no pleasure in any activity and
unable to feel better even temporarily when something good happens)
odepressed mood is worse in the morning (wake up 2 hours too early,
lose appetite and weight and are either lethargic or extremely
Both manic and depressive episodes have catatonic features (motor
immobility or excessive, purposeless activity)
Postpartum depression: depressive episodes that occur within 4 weeks of
Seasonal affect disorder (SAD): depression linked to a decrease in the
number daylight hours
oTherapies include exposing the patient to bright, white light
oPhototherapy: exposure to bright, white light is highly effective
Chronic Mood Disorders
Must be evident for 2 years but are not severe enough to warrant a diagnosis
of a major depressive or manic disorder
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