Psychology 2042A/B Chapter Notes - Chapter 10: Major Depressive Disorder, Bipolar Disorder, Mania
30 Apr 2018
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Chapter 10- Depressive and Bipolar Disorders:
• Mood disorder (affective disorder)- disturbance in mood central feature- mood= feeling/
emotion- suffer extreme, persistent/ poorly reg emotional states
• Mood disorders one most common, chronic and debilitating illnesses young people
Overview of mood disorders:
• Dysphoria- state prolonged bouts of sadness
• Feel little joy in anything do and lose interest in nearly all activities- anhedonia
• Some may express depression through irritable mood= easy annoyance and touchiness,
characterized by angry mood and temper outbursts- being around dif b/c any little thing
can set them off (irritability one most common co-occurring symptoms of depression)
• May also exp mania- abnorm elevated/ expansive mood, increased goal-directed activity
and energy and feelings euphoria= exagg sense well-being
• Suffer from ongoing combination extreme highs and extreme lows= bipolar disorder
(BP)/ manic-depressive illness- highs may alternate w lows/ feel both same time
Depressive disorders:
• Everyone feels sad some point- sometimes sadness norm reaction unfortunate event in
our lives like losing friend/ job and may feel dep w/o knowing why- feelings pass resume
norm activities
• When children become sad, irritable/ upset, parents often attribute neg moods temp
factors- lack sleep/ not feeling well- and expect moods pass- long time thought didn’t get
depressed/ it was short-lived- now know not true
• Children dep cannot seem shake sadness and begins interfere w daily routines, social
relationships, school perf and overall functioning- often accompanying probs such as
anxiety/ oppositional/conduct disorders (pervasive, disabling, long-lasting and life-
threatening)
History:
• Doubted existence dep in children= rooted psychoanalytic theories, viewed dep hostility/
anger turned inward- kids lacked suff superego permit agg directed against self, believed
incapable exp dep
• May falsely be considered norm and passing expressions certain stages dev
• Pop view emerged kids express dep much dif ways adults= indirect and hidden- masked
depression- any known clinical symptoms could be sign underlying masked dep (too
encompassing be useful= rejected)
• Dep in kids not masked but simply may be overlooked b/c frequently co-occurs more
visible disorders, such as conduct probs
Depression in young people:
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• Display lasting dep mood while facing real/ perceived distress and exp disturbances
thinking, physical functioning and social behavior- suicidal behav among teens v serious
concern
• 90% youngsters w dep show sig impairment daily functs and even when recover from
dep, likely exp recurrent bouts dep and cont impairments
Depression and development:
• Infant may show sadness being passive and unresp, preschooler may appear withdrawn
and inhibited, school age child may be argumentative and combative/ complain feeling
sick, teen may express feelings guilt and hopelessness, sulk/ feel misunderstood- rep dif
stages in dev course dep
• No one pattern fits all kids within part age group/ dev period and dep not clearly
recognizable as clinical disorder using DSM criteria until children older- dep kids under 7
diffuse and less easily ident
• Anaclitic dep- infants raised clean but emotionally cold institutional env displayed
reactions resembled dep- weeping, withdrawal, apathy, weight loss and sleep disturbance
and overall decline dev and some cases death
• Attributed dep absence mothering and lack opp form attachment, other factors, such as
physical illness and sensory deprivation may also have played role
• Even young children exposed institutional neglect and later adopted may display
emotional and behav disturbances place heightened risk dep and other internalizing
disorders
• Sim symptoms could occur noninstitutionalized infants raised severely disturbed fams
mom dep, psych unavail/ physically abusive= exp sleep disturbance, loss appetite,
increased clinging, apprehension, social withdrawal, crying and sadness
• Preschool kids may appear extremely somber and tearful, excessive clinging and whiny
behav around moms, as well fears abandonment and separation; get upset things don’t go
way and irritable no apparent reason; neg and self-destructive verbalizations and physical
complaints like stomachaches common
• School-age kids many symptoms preschoolers in addition increased irritability, disruptive
behav, temper tantrums and combativeness- sad but unwilling speak about prob
• Weight loss, headaches and sleep disturbances, academic and peer probs and suicide
threats may also begin occur
• Preteens and teens display many symptoms younger kids, in add increasing self-blame
and exp low SE, persistent sadness and social inhibition- feelings isolation from fam
common, sleep (too much/little) and eating disturbances
• Teens increased irritability, loss feelings pleasure/ interest and worsening school perf,
fights parents, neg body image and self-consciousness, excessive fatigue and energy loss,
feelings loneliness, guilt, worthlessness and suicidal thoughts, plans and attempts
• Presence sad mood, diminished interest/ pleasure/ irritability essential diagnosing dep and
regardless age symptoms must reflect change behav, persist over time and cause sig
impairment in functioning
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Anatomy of depression:
• As a symptom, dep refers feeling sad/ miserable- often occur existence serious prob and
rel common all ages- most kids temp, related events in env and not part any disorder
• As syndrome= more than sad mood- along w sadness may display reduced interest/
pleasure in activities, cog, motivational changes and somatic and psychomotor changes
• Occurrence as syndrome far less common isolated dep symptoms anxiety and dep, tend
cluster on single dimension neg affect
• 3 types depression as disorder:
o Major dep disorder (MDD)- min duration 2 weeks and ass w dep/ irritable mood,
loss interest/ pleasure, other symptoms (sleep disturbances, dif concentrating,
feelings worthlessness) and sig distress/ impairment in funct
o Persistent depressive disorder (P-DD)/ dysthymia- ass dep/ irritable mood, gen
fewer, less severe but longer-lasting symptoms (year/ more kids) than MDD and
sig impairment funct
o Disruptive mood dysregulation disorder- frequent and severe temper outbursts
extreme overreactions to sit/ provocation and chronic, persistently irritable/ angry
mood present b/w severe temper outbursts
• Common characteristic all dep disorders presence sad, empty/ irritable mood, along w
somatic and cog symptoms interfere w individs funct
Major depressive disorder (MDD):
• Diagnosis MDD depends presence major dep episode plus exclusion other conds, such as
prior occurrence manic episode (bipolar diagnosis) and ruling out physical factors such as
physiological effects substance, another medical cond may caused/ prolonged dep, dep
part norm bereavement and underlying thought disorders
• Symptoms must cause clinically sig distress/ impairment imp areas life funct (social,
academic)
• Mild, moderate and severe based on number symptoms in excess those required make
diagnosis, amount symptom distress and manageability and extent impairment life funct
caused by symptoms
• Other specifiers used designate single/ recurrent dep episode; previous episode partial/
full remission; whether episode includes psychotic features (delusions and/or
hallucinations)/ accompanied by other features ex: anxious distress (feeling tense,
restless/ something awful may happen)
• 3 important points about diagnosis MDD kids and adolescents:
o Same DSM-5 criteria diagnosing adults can be used diagnose school-age kids and
teens
o Disruptive behavs attract more attention/ more easily observed as compared w
internal, subj suffering, dep in kids can be easily overlooked
o Some feats dep more common kids and teens than adults- irritable mood (can
substitute dep mood diagnosing dep in kids- irritable mood alone rare)
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Document Summary
Chapter 10- depressive and bipolar disorders: mood disorder (affective disorder)- disturbance in mood central feature- mood= feeling/ emotion- suffer extreme, persistent/ poorly reg emotional states, mood disorders one most common, chronic and debilitating illnesses young people. Prevalence and comorbidity: 1-5% adolescents display disorder- most co-occurring diagnosis is mdd and 50% have. 1/more co-occurring non-affective disorders preceded p-dd, including anxiety, cd and. Family problems: less supportive and conflictual relationships, feel socially isolated from fams and prefer be alone (may be desire avoid conflict)- probs persist even no longer clinically dep. Interactions can be quite neg toward parents and parents may respond neg, dismissing/ harsh manner= adversely affect fam relationships- little positive reinforcement and frustrate desire sat in parenting roles. Psychodynamic: dep conversion agg instinct into dep affect- result loss love object (mom)= actual, death parent/ symbolic= emotional deprivation, rejection/ inadequate parenting- sub rage toward love object turned against self.
