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Chapter 6

PSYC 168 Chapter Notes - Chapter 6: Major Depressive Disorder, Major Depressive Episode, Hypomania

Course Code
PSYC 168
Dani L Binegar

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Ch. 6 Depressive and Biopolar Disorders
Famous Figures
- Bible speaks of severe depressions of Nebuchadnezzar, Saul, and Moses
- Queen Victoria of England and Abraham Lincoln have suffered from recurring depression
Disorders of Mood
- There are 2 key emotions
- Depression
- Low, sad state in which life seems dark and its challenges overwhelming
- Mania
- state of breathless euphoria or frenzied energy
- Mood problems have always captured interest and impacted many across time, culture,
and situations
- Unipolar depression
- Only depression, no mania
- Normal mood when
Unipolar Depression
- Def: General sadness or unhappiness
- This loose of the term confuses a normal mood swing with a clinical syndrome
- Lay reference to depression is not the same as a mood swing
- Long-lasting psychological pain that may intensify as time goes by
- Prevalence
- Women: 2x unipolar depression
- U.S.: 9% any given year; 18% of adults at least one episode in lifetime; rates similar
in many in other countries
- Higher among poor than wealthy
- Among children, similar among boys/girls
- Recovery
- Approx. 85%
- 40% will experience another episode
What Are the Symptoms of Depression?
- 5 main areas of affected function
- Emotional symptoms (sad, anger, anhedonia)
- Motivational symptoms
- Behavior symptoms
- Cog. symptoms
- Physical symptoms
- Symptoms may vary from person to person
- Episode
- 2 week period
- 3-4 of the following: weight/appetite change, insomnia, hypersomnia,
agitation, decrease in motor activity, fatigue, lethargy, worthlessness, excessive guilt,
reduction in concentration, focus on death, suicide, suicide plan
- Distress
- Major Depressive Disorder
- Presence of a major depressive episode
- no pattern of mania or hypomania
- Persistent Depressive Disorder (Dysthymia)
- Symptoms of major depressive disorder for at least 2 years
- Symptoms not absent for more than 2 months at a time
- No history of mania or hypomania

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Diagnosing Unipolar Depression: DSM5
- Major Depressive Episode
- 2+ weeks by 5+ symptoms
- In extreme cases, symptoms are psychotic
- Hallucinations or delusions
- Major Depressive Disorder
- People who experience major depressive episode with no history of mania
- Seasonal
- Catatonic (immobility or excessive activity)
- Peripatrum (During pregnancy or within 5 weeks of giving birth)
- Melancholic (person totally unaffected by pleasurable events)
- Premenstrual Dysphoric Disorder
- Women experience severe depression during the week before menstruation
- Must improve within a few days after onset of menses
- Disruptive Mood Regulation Disorder
- Combo of persistent depressive symptoms and recurrent outbursts of severe temper
- Diagnosis should not be made before 6 or after 18
Sadness at the Happiest of Times
- 10-30% of new mothers
- Postpartum
- Typically within 4 weeks- up to a year and include extreme sadness, despair,
tearfulness, insomnia, anxiety, intrusive thoughts, compulsions, panic attacks, feelings of
inability to cope, and suicidal thought
- Cause
- Hormonal changes accompany childbirth
- Psychological and sociological changes
- Treatment
- Self-help support group; antidepressants, cog. therapy, interpersonal
psychotherapy, or combo of these
Stress and Unipolar Depression
- Stress may trigger for depression
- Greater number of stressful life events during the month just before symptom onset
- Reactive/exogenous depression (follow clear-cut stressful events)
- Endogenous depression (response to internal factors)
Bio Model of Unipolar Depression
- Brain anatomy and brain circuits
- Bio researchers have determined that emotional reactions of various kinds are tied
to brain circuits
- Researchers believe that the brain circuit involved in unipolar depression include:
Prefrontal, hippocampus, amygdala, Brodmann Area 25
- One of the most controversial treatments
- Targeted electrical stimulation causes brain seizure
- Effective in unipolar treatment, especially severe depression with delusions
- Antidepressants
- MAO inhibitors
- Tricyclics
- 2nd gen antidepressants
- Do not work for everyone
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