Mood Disorders

• Mood disorders


  Constant lows (depression) and highs of mania
• What are mood disorders


  • Depression - Constant lows, sad state
  • Mania - State of breathless euphoria or frenzied energy
• MDD/Unipolar


  Major Depressive Disorder
• WHO (2008) - MDD is the 2nd leading cause of disability
• 19.7% in UK show symptoms of depression (Evans, Macrory & Randall, 2016)
• Prevalence of MDD has steadily increased since 1915 (Gonzalez et al, 2010)
• Women are twice as likely as men to experience MDD (Astbury, 2010)
• 50% of people with MDD recover within six weeks, and 90% recover within a year
• 40% of people with MDD will have at least one other episode of depression later in their lives (Monroe, 2010)
• Symptoms of MDD


  • 5 areas of functioning affected
• Diagnosing Unipolar Depression


  1. Criteria 1: Major depressive episode marked by five or more symptoms lasting two or more weeks

  2. Criteria 2: No history of mania
• Genetics


  Inherit a predisposition to develop MDD
• Family pedigree studies: MDD will have 20% of relatives with depression, compared with 10% relatives (ND)
• Twin Studies: MZ 46%, DZ 20% (McGuffin et al 1996)
• Adoption studies: genetic basis for severe than mild MDD (Levinson & Nichols, 2014)
• Biochemical


  Neurotransmitters: serotonin and norepinephrine
• High blood pressure meds found to cause depression
• Brain anatomy/circuits

  Emotional reactions are tied to brain circuits - prefrontal cortex, hippocampus, amygdala, Brodman Area 25
• Electroconvulsive Therapy


  1. Brain seizures

  2. 6 to 12 treatments

  3. Remission? Up to 50%-80% relapse within 6 months

  4. Side effects: transient cognitive problems, headaches, fatigue, permanent amnesia
• Psychodynamic view


  • Link between depression and grief
  • Introjection is temporary; if grief is severe and long-lasting-MDD
  • Oral stage > risk for developing depression
  • Symbolic (or imagined) loss instead
• Psychodynamic view strengths


  • Depression may be triggered by a major loss
  • Early losses set the stage for later depression
• Psychodynamic view limitations


  • Early losses and inadequate parenting may not be responsible for MDD development
  • Findings are inconsistent
  • Hard to test (e.g., symbolic loss)
• Behavioural view


  Depression results from changes in rewards and punishments people receive in their lives
• Behavioural view strengths


  • Significant research support. E.g., Social rewards
• Behavioural view limitations


  • Research relied heavily on self-reports
  • Largely correlational
• Cognitive view


  Negative thinking: 1-Maladaptive attitudes; 2-Negative Thinking; 3-Errors in Thinking; 4-Automatic Thoughts
• Cognitive view strengths


  • High correlation depression & maladaptive attitudes held
  • Cognitive triad
  • Errors in logic
• Cognitive view limitations


  • No causality?