Ch 7: Mood disorders and suicide

• Neuroticism: tendency to experience negative mood states
• Mood disorders: syndromes with a predominant feature of disturbance in mood. Distinguished by type and duration of mood
• Euthymic: not depressed nor manic, most people here most of the time
• Depressive episode: period of at least 2 weeks in which 5 symptoms are present
• Symptoms of a depressive episode: depressed mood, loss of interest or pleasure, weight gain/loss, insomnia/hypersomnia, psychomotor retardation/agitation (slow moving and hard to start), fatigue/loss of energy, feeling worthless/experiencing inappropriate guilt, concentration difficulties/difficulty making decisions, recurrent suicidal thoughts
• Anhedonia: loss of interest or pleasure
• Major depressive episode is an experience of a major depressive episode with functional impairment
• MDD is not diagnosed if there is a history of mania/hypomania. Can be a single episode or recurrent (6 months or more), cycle of depressed and euthymic mood.
• MDD is the most common psychiatric disorder in the US. Women are 2x more likely to be diagnosed then men. It can manifest differently by age (EX: somatic in older generations). It is highly comorbid with anxiety disorders
• Persistent Depressive disorder is characterized by chronically depressed mood that lasts at least 2 years. Mood is generally less severe than MDD. Can have periods of PDD and MDD (double depression)
• Monoamine theory: depression related to depleted norepinephrine and serotonin neurotransmitter availability
• Biological factors of depressive disorders: MDD can run in families, monoamine theory, dysregulation of the HPA axis, sleep disturbance and circadian rhythm, inconsistent findings for sex differences (no difference before 12)
• Psychological factors of depressive episodes: stressful life events- depressive disorders are associated with stressful life events prior to and concurrent with depressive episode
• Psychodynamic theory of depressive episodes: depression is the result of anger towards the self after the loss of an important object. This is hard to test
• Behavioral theory: depression results from the withdrawal of (positive) reinforcement. Based on operant conditioning, not enough positive causes MDD
• Cognitive theory: negative thoughts/beliefs cause depressed feelings. Depressed mood maintained by bad thinking patterns. Beck's Cognitive Triad is based on this theory
• Cognitive triad: rigid negative beliefs about self, future, and world. Get stuck in these thoughts
• Learned helplessness: people feel depressed when they feel they have no control and when their emotions are inescapable. Depression is associated with pessimistic attribution style. Internal, global, and stable attributions
• Hopelessness theory: pessimistic attribution style and negative life events can lead to hopelessness which then can lead to depression
• Treatment for Depressive disorders: Cognitive therapy (CT) - based on cognitive theory (cognitive triad) that depression is maintained by bad thinking patterns
• Treatment for Depressive disorders: Behavioral Activation (BA) - based on behavioral theory that depression is maintained by lack of reinforcement
• Treatment for Depressive disorders: Cognitive behavioral therapy (CBT)
• Treatment for Depressive disorders: Interpersonal therapy (IPT) - based on psychodynamic theory
• CT, BA, CBT, and IPT are as good or better than medications and are empirically supported
• Treatment for Depressive disorders: Traditional/1st generation - MAOI and tricyclics. Developed by accident. MAOI have restrictive diet and tricyclics you can overdose if you take too much
• Treatment for Depressive disorders: 2nd generation- SSRI and SNRI. They stop reuptake, increase likelihood to hit synapse but take 6 weeks to go into effect
• Other Biological interventions to mood disorders: electroconvulsive therapy (ECT) - a procedure that involves the application of an electric current to the brain, some memory loss side effects
• Other Biological interventions to mood disorders: Transcranial magnetic stimulation (TMS) - stimulate brain for less depression, newer form, less intense than ECT
• Other Biological interventions to mood disorders: Bright light therapy - combat seasonal depression in winter
• Suicidal ideation: thoughts of death or suicide
• Passive suicidal ideation: thinking about or wishing to be dead, but not thinking about the "how"
• Active suicidal ideation: thinking about or wishing to be dead and thinking about how to do so
• Non-suicidal self injury (NSSI): behaviors associated with causing pain/discomfort without intent to die
• Suicide: Men are much more likely to die by suicide. Women are more likely to attempt suicide
• Risk factors for suicide: familial history of dying by suicide, psychiatric diagnosis, history of previous suicide attempts, access to firearms
• Protective factors against suicide: social support, cultural/religious beliefs
• Interpersonal theory of suicide: perceived burdensomeness, thwarted belonging ("I am alone"), Acquired capacity. All three components often lead to suicide attempts
• Manic Episode (BP 1): Persistently elevated, expansive or irritable mood with increased goal-directed activity/energy lasting at least one week. Grandiosity, decreased need for sleep, pressured speech, flight of ideas, distractibility, increased goal-directed activity, and impulsivity
• Hypomanic Episode (BP 2): persistently elevated, expansive, or irritable mood with increased activity/energy lasting at least 4 days. Does not have psychotic features, does not require hospitalization
• Mixed State episode: experiencing symptoms of mania and depression at the same time. Can include irritability, agitation, suicidal thoughts, changes in appetite. It is hard to diagnose