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Chapter 7

Psychology 46-228 Chapter 7: Notes on Mood Disorders

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Department
Psychology
Course
46-228
Professor
Scoboria
Semester
Fall

Description
Chapter 7, pp 213 - 223 Mood Disorders Overview of Depression and Mania  Mood disorders  group of disorders involving severe and enduring disturbances in emotionality ranging from elation to severe depression  Major depressive episode  (DSM-IV criteria) o extremely depressed mood state that lasts at least two weeks and includes cognitive symptoms (ex. feelings of worthlessness and indecisiveness) o disturbed physical functions (ex. altered sleeping patterns, significant changes in appetite and weight, or notable loss of energy) to the point that even the slightest activity or movement requires an overwhelming effort o Episode usually accompanies by  loss of interest and of ability to experience any pleasure from life (aka anhedonia) o Average duration  9 months  Mania  abnormally exaggerated elation, joy, or euphoria (finds pleasure in every activity o Becomes extraordinary active (hyperactive), requiring very little sleep o Duration  one week; (untreated)  2-6 months  Hypomanic episode  less severe manic episode that does not cause marked impairment in social or occupational functioning The Structure of Mood Disorders  Unipolar mood disorder  their mood remains at one "pole" of the usual depression- mania continuum  Bipolar mood disorder  travelling from one "pole" of the depression-elation continuum to the other and back again (ex. alternates between depression and mania)  Dysphoric manic/mixed episode  an individual experiencing manic symptoms but feel somewhat depressed or anxious at once (ex. being out of control or dangerous, becomes anxious or depressed about them) Depressive Disorders  Major depressive disorder (single episode)  the absence of manic or hypomanic episodes before or during the episode  Major depression disorder (recurrent)  two or more major depressive episodes occurred and were separated by at least two months during which the individual was not depressed (usually have a family history of depression, unlike people with single episodes; average duration  5 months)  Average lifetime number of major depressive episodes  4  Dysthymic disorder  a persistently depressed mood that continues for at least two years, while patient cannot be symptom-free for more the two months o (major depressive disorder) symptoms are somewhat milder but remain relatively unchanged over long periods of time (20, 30 years or more) o Differs from major depressive episode only in severity, chronicity, and number of its symptoms (milder and fewer but last longer)  Double depression  people who experienced both major depressive episodes AND dysthymic disorder o Dysthymic disorder develops first, then one or more major depressive episodes occur later Onset and Duration  Average age for major depressive disorder  25 (not in treatment); 29 (in treatment)  Typical age of onset estimated to be in the early 20s, adolescent onset of depression is associated with: o Greater chronicity (lasts longer) o Relatively poor prognosis (response to treatment) o Stronger likelihood of the disorder running the family of the affected individual  Average duration of dysthymic disorder  5 years in adults; 4 years in children  Pathological grief reaction/impacted grief reaction  extreme reaction of the death of a loved one Bipolar Disorders  Bipolar disorders  tendency of manic episodes to alternate with major depressive episodes in an unending roller coaster ride from pecks to bottoms  Bipolar II disorder  major depressive episodes alternate with hypomanic episodes rather than full manic episodes  Bipolar I disorder  criteria is same as bipolar II, but the individual experiences a full manic episode  During manic or hypomanic phases, patients often deny they have a problem  Cyclothymic disorder  chronic alternation of mood elevation and depression that doesn't reach the severity of manic or major depressive episodes o Tend to be in one mood state or the other for many years with relatively few periods of neutral mood o Must last for at least 2 years (one year for children and adolescents) Onset and Duration  Average age of onset for bipolar I  18; for bipolar II  22 P. 223 - 242 Postpartum Depression  Characterized by severe manic or depressive episodes that first occur during the postpartum period (the first four weeks after childbirth)  1 in 1000 deliveries; 50% chance to have another episode with subsequent births  Specifiers describing course of mood disorders Longitudinal course specifiers  when the individual has had major episodes of depression or mania in the past is important, whether the person fully recovered between past episodes (patient will require a long and intense course of treatment to maintain a normal mood state after recovering) Rapid-cycling specifiers  people with bipolar disorder who experience at least four manic or depressive episodes within a year  considered to have a rapid-cycling pattern temporal specifier only applies to bipolar I and bipolar II disorders Does not respond well to standard treatments Higher probability of suicide attempts Seasonal pattern spec
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