Mood Disorders PDF

MOOD DISORDERS  MOOD DISORDERS DEPRESSIVE BIPOLAR DISORDERS DISORDERS DEPRESSION SYMPTOMS: ▪ Depressed mood that is out of proportion to any cause ▪ Anhedonia ▪ Changes in sleep, appetite, and activity levels: Loss of appetite or eating more, even...

MOOD DISORDERS  MOOD DISORDERS DEPRESSIVE BIPOLAR DISORDERS DISORDERS DEPRESSION SYMPTOMS: ▪ Depressed mood that is out of proportion to any cause ▪ Anhedonia ▪ Changes in sleep, appetite, and activity levels: Loss of appetite or eating more, even binge eating Insomnia or hypersomnia Psychomotor retardation or psychomotor agitation ▪ Thoughts may be filled with feelings of worthlessness, guilt, hopelessness, or even suicide ▪ Delusions and hallucinations that are mostly negative (in severe cases) DIAGNOSING DEPRESSIVE DISORDER ▪ MAJOR DEPRESSIVE DISORDER (MDD)- characterized by either a depressed mood or lost of interest in usual activities, plus at least four other symptoms of depression, chronically for at least two weeks. MAJOR DEPRESSIVE DISORDER, SINGLE EPISODE- diagnosed to people who experienced only one depressive episode. MAJOR DEPRESSIVE DISORDER, RECURRENT EPISODE- diagnosed to people who experienced two or more episodes of depression, separated by at least two consecutive months without symptoms. NOTE: A normal and expected depressive response to a negative event should not be diagnosed as a MDD, unless other more atypical symptoms are present: worthlessness, suicidal ideas, psychomotor retardation, and severe impairment. DIAGNOSING DEPRESSIVE DISORDER COMPLICATED GRIEF- shown by 10 to 15% of bereaved people according to research. -characterized by strong yearning for the deceased person and occupation with the loss, persistent regrets about one’s own or other’s behavior towards the deceased, difficulty accepting the finality of the loss, and the sense that life is empty and meaningless (Horowitz et al., 1997). -they are more likely to be functioning poorly two to three years after the loss. DIAGNOSING DEPRESSIVE DISORDER ▪ PERSISTENT DEPRESSIVE DISORDER -formerly dysthymic disorder and chronic major disorder in the DSM-IV. -depressed mood for most of the day, for more days than not, for at least two years. -for children, it requires depressed or irritable mood for at least one year duration. -it requires the presence of two or more of the following symptoms: Poor appetite Insomnia or hypersomnia Low energy or fatigue Low self-esteem Poor concentration Hopelessness NOTE: During this two year (one year for children), the symptoms must never have been without symptoms of depression for longer than a two-month period. When a person is given a diagnosis of MDD, he/she is also given a diagnosis of persistent depressive disorder. DIAGNOSING DEPRESSIVE DISORDER The most common comorbid disorders with depression are: ▪ Substance abuse disorders ▪ Anxiety disorder ▪ Eating disorders DIAGNOSING DEPRESSIVE DISORDER PREMENSTRUAL DYSPHORIC DISORDER- their symptoms are often a mixture of depression, anxiety, and tension, and irritability and anger which may occur in mood swings during the week before the onset of menses. -these women often report: Breast tenderness or swelling Bloating and weight gain Joint and muscle pain SUBTYPES OF DEPRESSION ANXIOUS DISTRESS -anxiety is extremely common, and people with this subtype have prominent anxiety symptoms as well as depressive symptoms. MIXED FEATURES -meets the criteria of MDD and have at least three symptoms of mania, but they do not meet the criteria for a manic episode. MELANCHOLIC -physiological symptoms of depression are FEATURES particularly prominent. PSYCHOTIC FEATURES -people who experience delusions and hallucinations which are mood-congruent and mood incongruent. SUBTYPES OF DEPRESSION CATATONIC FEATURES -people show strange behaviors collectively known as catatonia which can range from complete lack of movement to excited agitation. ATYPICAL FEATURES -an odd assortment of symptoms. SEASONAL PATTERNS -also referred as seasonal affective disorder (SAD.) -have a history of at least two years of experiencing and fully recovering from MDE. -they become depressed when the daylight hours is short and recover when the daylight hours is long. PERIPARTUM ONSET -given to women when the onset of a MDE occurs during pregnancy or four weeks following childbirth.  MOOD DISORDERS DEPRESSIVE BIPOLAR DISORDERS DISORDERS MAJOR DEPRESSIVE DISORDER PERSISTENT DEPRESSIVE DISORDER PREMENSTRUAL DYSPHORIC DISORDER BIPOLAR DISORDER SYMPTOMS OF MANIA: ▪ Have an unrealistically positive and grandiose (inflated) self-esteem ▪ May speak rapidly and forcefully ▪ Engaged in a variety of impulsive behavior: sexual promiscuity, or spending sprees ▪ Often frenetically pursue grand plans and goals ▪ Mood can be elated, but the elation is often mixed with irritation and agitation  BIPOLAR DISORDER MANIC EPISODE Must show an elevated, expansive, or irritable mood for at least one week as well as three other symptoms: NOTE: The symptoms must impair the individual’s functioning. ▪ BIPOLAR I DISORDER- people who experienced and meet the criteria of a manic episode. -almost all these people will eventually fall into a depressive episode. *Mania without any depression is rare. -some people with Bipolar I Disorder have mixed episodes in which they experience a full criteria for manic episodes and at least three symptoms of Major Depressive Episode in the same day, every day, for at least one week.  BIPOLAR DISORDER ▪ BIPOLAR II DISORDER- experiences severe episodes of depression that meet the criteria for major depression, but their episodes of mania are milder and are known as hypomania. ▪ CYCLOTHYMIC DISORDER- less severe but more chronic form of bipolar disorder. -alternates between hypomania and periods of depressive symptoms, chronically over at least a two-year period. NOTE: People diagnosed with Cyclothymic Disorder are at increased risk of developing a Bipolar Disorder. About 90% of people with Bipolar Disorder have multiple episodes or cycles during their lifetime. ▪ RAPID CYCLING BIPOLAR I OR BIPOLAR II DISORDER- four or more mood episodes that meet the criteria for manic, hypomanic, or major depressive episode within one year.  BIPOLAR DISORDER ▪ DISRUPTIVE MOOD DYSREGULATION DISORDER- a new diagnosis for youth age six and older who displays classic bipolar disorder. -a young person must show severe temper outburst that are grossly out of proportion in intensity and duration and situation and inconsistent with developmental level. -a child must have at least three temper outburst per week for at least twelve months and at least two settings.  DIFFERENTIATING BIPOLAR I FROM BIPOLAR II CRITERIA BIPOLAR I BIPOLAR II Major Depressive Episodes Can occur but are not necessary Are necessary for diagnosis for diagnosis Manic Episodes Full criteria are necessary for Cannot be present for diagnosis diagnosis Hypomanic Episodes Can occur between severe Are necessary for diagnosis episodes of mania or major depression but are not necessary  MOOD DISORDERS DEPRESSIVE DISORDERS BIPOLAR DISORDERS MAJOR DEPRESSIVE BIPOLAR I DISORDER DISORDER PERSISTENT DEPRESSIVE BIPOLAR II DISORDER DISORDER RAPID CYCLING BIPOLAR I OR II DISORDER PREMENSTRUAL DYSPHORIC DISORDER CYCLOTHYMIC DISORDER DISRUPTIVE MOOD DYSRECULATION DISORDER THEORIES OF DEPRESSION ▪ GENETIC FACTORS First degree relatives of people with major depressive disorder are two times more likely to have depression than are first-degree relatives without the disorder (Levinson, 2010) Higher concordance rate in monozygotic twins than dizygotic twins (Kendler, Myers, Prescott, & Neale, 2001) Depression that begins early in life appears to have a stronger genetic base than depression that begins in adulthood (Levinson, 2010) The serotonin transporter gene may play a role in depression (Saveanu & Nemeroff, 2012) THEORIES OF DEPRESSION ▪ NEUROTRANSMITTER THEORIES Monoamines o Norepinephrine o Serotonin o Dopamine THEORIES OF DEPRESSION ▪ STRUCTURAL AND FUNCTIONAL ABNORMALITIES Prefrontal Cortex- involved in motivation and goal-orientation Anterior Cingulate- associated with problems in attention, in the planning of appropriate responses, and in coping, as well as anhedonia Hippocampus- smaller volume and lower metabolic activity. Amygdala- enlargement and increase activity on this area of the brain in people with depression THEORIES OF DEPRESSION ▪ NEUROENDOCRINE FACTORS o HPA Axis *People with depression tend to show elevated levels of cortisol and CRH. *Chronic excessive exposure to cortisol may account for the volume reduction in several brain areas, including the hippocampus, the prefrontal cortex, and the amygdala. o Estrogen and Progesterone THEORIES OF DEPRESSION ▪ BEHAVIORAL THEORIES- depression often arises as a reaction to stressful negative events (Hammen, 2005; Monroe, 2010). -life stress leads to depression because it reduces the positive reinforcers in a person’s life (Lewinsohn & Gotlib, 1995). ▪ LEARNED HELPLESSNESS THEORY- suggests that the type of stressful event most likely to lead to depression is an uncontrollable negative event (Seligman, 1975). THEORIES OF DEPRESSION ▪ COGNITIVE THEORIES- Aaron Beck argued that people with depression look at the world through a negative cognitive triad: Negative views about themselves Negative views about the world Negative views about the future ▪ REFORMULATED LEARNED HELPLESSNESS THEORY-according to this theory, people who habitually explain negative events by causes that are internal, stable, and global tend to blame themselves on the negative events, expect negative events to recur in the future, and expect to experience negative events in many areas of their lives. HOPELESSNESS DEPRESSION- develops when people make pessimistic attribution for most important events in their lives and perceive that they have no way to cope with the consequences of these events (Abrmson et al., 1989). THEORIES OF DEPRESSION ▪ RUMINATIVE RESPONSE STYLE THEORY- focuses more on the process of thinking as a contribution to depression (Nolen-Hoeksema, Wisco, & Lyubominsky, 2008). ▪ People who are depressed develop a bias toward negative thinking in basic attention and memory processes -Mark Williams and colleagues (2007) suggests that depressed people develop the tendency to store and recall memories in a general fashion as a way of coping with a traumatic past. THEORIES OF DEPRESSION ▪ INTERPERSONAL THEORIES- the interpersonal relationships of people with depression often are fought with difficulty. -interpersonal difficulties and losses frequently precede depression and are the stressors most commonly reported as triggering depression Hammen, 2005; Rudolph, 2008). -depressed people are more likely than nondepressed people to have chronic conflict in their relationships with family, friends, and co-workers (Hammen, 2005). THEORIES OF DEPRESSION ▪ SOCIOCULTURAL THEORIES- focused on how the differences in the social conditions of demographic groups lead to differences in vulnerability to depression. COHORT EFFECTS- more recent generations are at higher risk for depression than previous generations GENDER DIFFERENCES- women are about as twice as men to suffer from depression. ETHNIC OR RACE DIFFERENCE- in the US, individuals from Hispanic cultures tend to show a higher prevalence of depression than non-Hispanic white individuals -African Americans have lower rates of depression than Caucasian Americans (Anderson & Mayer, 2010; Blazer et al., 1994). -Extreme high rates of depression among Native Americans, especially the youth. CASE ANALYSIS REPORTING ▪ Present the case (with reference and in APA format) ▪ Present the symptoms that ascertains the diagnosis of the subject (present along the DSM criteria) ▪ Present and explain the different theories that encompasses the psychopathology that the subject experiences and how they work in a feedback loop (present with pictures, if possible) ▪ Post your output in the GClassroom to give the class a copy of your output ▪ Do not put unnecessary designs/ animations on your presentation ▪ Indicate the part of each member (who prepared the presentation for a specific topic)  ASSIGNMENT: 1. Read the MH Law, and share your thoughts and inputs about it. 2. Choose a partner and make an observation, history-taking, and clinical interview assessment. The format is as follows: IDENTIFYING INFORMATION NAME: PARTNER’S FULL NAME SEX: Female AGE: 14 CIVIL STATUS: Single ADDRESS: Blah blah NATIONALITY: Filipino RELIGION: Christian OCCUPATION: N/A- Student DATE OF ASSESSMENT: November 1, 2023 REASON FOR ASSESSMENT CASE BACKGROUND PHYSICAL AND BEHAVIORAL OBSERVATION Prepared by: Cristeta M. Ventura, MA, RPm, RPsy License Number: 0001617/0001814 PTR No: 0860287