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PSY240H1 Chapter Notes -Major Depressive Episode, Seasonal Affective Disorder, Bipolar Disorder


Department
Psychology
Course Code
PSY240H1
Professor
Martha Mc Kay

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Chapter IX: Mood Disorders
Unipolar Depression:
Symptoms: emotional (anhedonia, sadness, irritability), physiological and
behavioural (appetite and sleep disturbances, psychomotor retardation/agitation,
catatonia, fatigue), cognitive (sense of worthlessness/guilt, suicidal thoughts,
delusions (unrealistic beliefs), hallucinations (幻觉/幻听))
Major depression: depressed mood/anhedonia + 4± other symptoms + 2± weeks
Dysthymic disorder: less sever but more chronic form of depressive disorder;
depressed mood + 2± other symptoms + 2± years
Double depression: major + dysthymic
Subtypes:
With melancholic features: physiological symptoms of depression prominent
With psychotic features: delusions and hallucinations
With catatonic features: strange behaviours that range from complete lack of
movement to excited agitation (catatonia)
With atypical features: positive mood reactions to some event, weight
gain/increase appetite, hypersomnia
With postpartum onset: emotional lability (unstable) first few weeks after
giving birth
With seasonal pattern (Seasonal Affective Disorder, SAD): at least 2 years of
experiencing major depressive episodes and fully recovering from them; tied
to the number of daylight hours in a day (usually occur during
winter)bipolar disorder with seasonal pattern
One of the most common psychological problems; number one source of disability
in the Canadian workforce
Study: major depression rate in a one-month period, 15-24 highest, 45-54 lower,
55-70 lowest
Women are twice as likely as men to experience depressive symptomsgender
differences in prevalence rates of major depression smaller when older
1/4 of people with major depressive disorder experience chronic symptoms
Depression in Childhood and Adolescence:
Less common among children, 15%-20% will experience depression before 20
Subclinical depressive symptoms even more common in adolescents
American Indians>Hispanics>Whites>Asian Americans>African Americans
Most likely to leave psychological and social scars if occurs during childhood
Negative self-viewvulnerability for depression across lifespan
Stress-generation models: symptoms of depression interfere with youngsters;
functioning in all domains of their livesincreases in many kinds of stressors
Girls dislike the weight gain of puberty v. boys like the increase in muscle mass
lower self-esteemhigher rates of depression
May occur only among European-American girls and not African-American
and Latino girls

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Bipolar Mood Disorders:
Up v. down; depression v. mania
Mania: elated mood often mixed with irritation and agitation; diagnosed if shows
an elevated/expansive/irritable mood for 1± week + 3± symptoms:
Filled with grandiose self-esteem
Decreased need for sleep
Racing thoughts and impulses
Speak rapidly and forcefully
Impulsive behaviours
Grand plans and goals
Hypomania: same symptoms as mania, but not sever enough to interfere with
daily functioning, no hallucinations/delusions
Bipolar I
Bipolar II
Experienced mania
Major depressive/hypomanic episodes
may occur, but not necessary
Never experienced mania
Major depressive episodes +
Hypomanic episodes
Cyclothymic disorder: less severe but more chronic form; alternates between
episodes of hypomania and moderate depression over 2± years
90% of bipolar patients have multiple cycles during lifetime
Rapid cycling bipolar disorder: 4± cycles (mania + depression) within a year
Less common than depression
Men and women equally likely to develop the disorder; no consistent differences
among ethnic groups
Most develop in late adolescence or early adulthood
Judd: significant symptoms 47% of the weeks, depression 32%, mania 9%
Mania can actually benefit people and depression is inspirational for artists?
Abraham Lincoln, Winston Churchill, Napoleon Bonaparte
Study: relatives of people with bipolar or cyclothymia were more creative
Biological Theories of Mood Disorders:
Genetic
Disordered genespredisposition
Physiologically based symptoms had the highest
genetic component, mood and tearfulness
components are least
MZ twins: 60% concordance rate v. DZ twins 13%
Neurotransmitter
Monoamines (norepinephrine, serotonin, to a
lesser extent dopamine) concentrated in the
limbic system that regulates sleep, appetite, and
emotional processes.
(1) Monoamine theories: excess/deregulation of
monoamines, especially dopamine)mania
(2) Abnormal number and sensitivity of
monoamine receptors:
few/insensitivedepression
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(3) Meyor: same serotonin-binding potential, but
different serotonin receptor density of
depression patients (they have many
dysfunctional beliefs)
Neurophysiological Abnormalities
(1) Reduction in metabolic activity and volume of
grey matter in prefrontal cortex (particularly
left side, associated with approach-related
goals)
(2) Decreased activity in anterior cingulate
relative to controlsanhedonia, attention
deficit
(3) Chronic arousal of stress responsehigh
cortisol levelinhibit development of new
neurons in hippocampussmaller volume in
hippocampus (critical in memory and
fear-related learning)
(4) Enlargement and increased activity of
Amygdala (helps direct attention to stimuli
that are emotionally salient/important)
Cause or consequences? Initially environmental?
Neuroendocrine Abnormalities
Active HPA axisincreases cortisol (help body
respond to stressor, fight-or-flight)HPA axis
activity returns to baseline when stressor is gone
(1) Depression: chronic hyperactivity in HPA axis
and an inability for the HPA axis to return to
normal functioning following a
stressorexcess hormones inhibit effect on
receptors for monoamines
(2) Women more vulnerable due to estrogen and
progesterone BUT studies found no relation
premenstrual dysphoric disorder should be
considered only exacerbation of major
depression/dysthymiaWhiffen: Postpartum
depression is an adjustment disorder
(3) Abused or neglected in childhoodresponses
to stress, HPA axis exaggerated/blunted
Psychological Theories of Mood Disorders:
Behavioural
The behavioural theory of depression (Lewinsohn): life stress
reduces positive reinforcerswithdrawalfurther reduction in
reinforcersmore withdrawalso forth; moist likely in those
with poor social skills
Ex. men having difficulty in relationship with wifeless
interactions worsens communicationwithdrawal further
HPA Axis
Hypothalamus
CRH
Pituitary Gland
ACTH
Adrenal Glands
Cortisol
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