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Chapter 43

PSYC 1010 Chapter Notes - Chapter 43: Major Depressive Disorder, Major Depressive Episode, Bipolar Disorder

Course Code
PSYC 1010

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Depressive Disorders, Bipolar Disorder, Suicide and Self- injury
Depression slows us down and tells us to conserve the energy
Mild sadness helps people process and recall faces more accurately
Major depressive disorder:
When a person experiences, in the absence of drugs or another medical condition, 2 or more
weeks with 5 or more symptoms, one of which must be depressed mood or loss of interest or
Adults who are diagnosed with depressive disorder are called dysthymia
o Experiencing a mildly depressed mood more often than two or more years
o Difficulty with decision making and concentration
o Feeling hopeless
o Poor self-esteem
o Reduced energy levels
o Problems regulating sleep
o Problems regulating appetite
Top cause of disability in the world today
Sometimes is seasonal and happens more often during winter
Bipolar disorder:
Person alternates between the hopelessness of depression and the overexcited state of mania
Bouncing from one emotional extreme to another
Mania: hyperactive, wildly optimistic state in which dangerously poor judgement is common
o When depressive episode ends, a euphoric, overly talkative, wildly energetic and optimistic
comes to play
Before long the mood either returns to normal or plunges into depression
During the maniac phase, people with bipolar disorder have little need for sleep
o Thinking fast feels good but also increases risk taking
High creativity increases the likelihood of having bipolar disorder and risk factors for developing
bipolar disorder predict greater creativity
Those who rely on precision and logic suffer less from bipolar disorder than those who rely on
emotional expression and vivid imagery
Less common than major depressive disorder, it is more dysfunctional, taking twice as many days
off of work
The children and adolescent who are persistently irritable and who have frequent and recurring
behavior outburst are now diagnosed with disruptive mood dysregulation disorder
Understanding depressive disorders and bipolar disorder:
Behavioural and cognitive changes accompany depression
o People trapped in a depressed mood become inactive and feel alone, empty and without a
bright and meaningful future
o Avoid positive information and attend selectively to negative events
More often recall the negative information
o When depression lifts, these behavioral and cognitive accompaniments disappear
o Half of the time they also exhibit symptoms of another disorder like anxiety or substance
Depression is widespread
o 350 million people have major depressive disorder
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o 11% of Canadians 15-24 are affected
Women's risk of major depressive disorder is nearly double men's
o Women experiencing depression is 1.7 times greater than men
o Trend begins in adolescence
o After puberty girls are more prone to eating disorders, self-injury and anxiety than boys
o Women's disorders tend to be internalized whereas for men it's externalized such as alcohol
use disorder and disorders related to antisocial conduct and lack of impulse control
Most major depressive episodes self-terminate
o Therapy can help put people back on their feet but even without therapy people recover
from depression and return to normal
o When depression goes for more than half of the people it comes back
Stressful events related to work, marriage, and close relationships often precede depression
o Anxiety is a threat of future loss
o Depression is often a response to past and current events
o Child abuse double's a person's risk of adult depression
o Moving to new cultures can also increase risks for depression especially among younger
people who have not formed their identities
o Impact of daily stressors can also impact mental health
Compared to generations past, depression strikes earlier (now often in the late teens) and affects
more people, with higher rates among young adults in developed countries
o Most teens who said they had depression hid it from their parents and 90% of whom
perceived their depressed teens as not suffering from depression
Biological perspective:
Genetic influences:
Depressive disorders and bipolar disorders run in families
Risk of being diagnosed with one of these disorders increases if your parents or siblings has the
Even if twins are raised separately, if one has a disorder than the other one is most likely to be
diagnosed with it as well
Linkage analysis
o Geneticists find families in which the disorder appears across several generations
o Examine DNA from affected and un-affected family members
In depression many genes work together and produce a mosaic of small effects that interact with
other factors to put some people at greater risk
The depressed brain:
Diminished brain activity during slowed- down depressive states and more activity during periods
of mania
Depression can cause the brain's reward center to become less active
In positive emotions, the left frontal lobe and an adjacent reward centre becomes more active
People with bipolar disorder have altered brain structures
o Decreased white matter (myelinated axon) ad enlarged fluid-filled ventricles
Neurotransmitter systems also influence depressive disorders and bipolar disorder
o Increase arousal and boosts mood, scarce during depression and overabundant during
o Drugs that reduce mania reduce norepinephrine
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