1 / 41

Mood Disorders

Mood Disorders. An Overview of Mood Disorders. Gross Deviations in Mood Depression: “The Low” The “Common Cold” of Mental Illness Major Depressive Episode is Most Common Mania: “The High” Abnormally Exaggerated Elation, Joy, or Euphoria. An Overview of

acton-buck
Download Presentation

Mood Disorders

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Mood Disorders

  2. An Overview of Mood Disorders • Gross Deviations in Mood • Depression: “The Low” • The “Common Cold” of Mental Illness • Major Depressive Episode is Most Common • Mania: “The High” • Abnormally Exaggerated Elation, Joy, or Euphoria

  3. An Overview of Mood Disorders Mania Depression

  4. The Structure of Mood Disorders • Unipolar Mood Disorder • Either Depression or Mania • Bipolar Mood Disorder • Alternates Between Depression and Mania • Important to Determine the Course • Temporal Patterning of the Episodes

  5. The Nature of Mood Disorders • Depressive Disorders • Major Depression • PDD, formerly Dysthymic Disorder • “Double Depression” - - dysthymia punctuated by period of major depression • Bipolar I and Bipolar II Disorders • Cyclothymic Disorder

  6. Depressive Disorders Major Depressive Episode • Clinical Description • Extremely Depressed Mood • Lasting at Least 2 Weeks • Cognitive Symptoms • Anhedonia • Vegetative Symptoms • Single or Recurrent Episode • No Manic or Hypomanic Episodes

  7. Depressive Disorders PDD-Dysthymia • Clinical Description • Similar to Major Depression BUT With a Different Course • Symptoms are Milder • Symptoms can Last 20-30+ Years • Persistently Depressed Mood for 2+ Years • Cannot be Symptom Free > 2 Months

  8. Depressive Disorders Persistent Depressive Disorder (Dysthymia) • Facts and Statistics • Mean Age of Onset Early 20s • Onset Prior to Age 20 • Greater Chronicity • Poor Prognosis • Major Depressive Episodes are Common

  9. Depressive Disorders Double Depression • Clinical Description • Suffer From Both • Major Depression Episodes • PDD - Dysthymic Disorder • Dysthymia Usually Begins First • Associated With Severe Pathology • A Problematic Future Course

  10. Depressive Disorders Double Depression • Clinical Description Dysthymia Dysthymia Major Depression

  11. Bipolar Disorders • Major Features • Experience Both • Manic Episodes • Major Depressive Episodes • Roller Coaster of Mood • What are Manic Episodes?

  12. Bipolar Disorders • Mania and Hypomania • Elevated Mood • Grandiosity • Increased Activity • Varied Impairment

  13. Bipolar Disorders: Bipolar I • Clinical Description Mania Major Depression

  14. Bipolar Disorders: Bipolar II • Clinical Description • Major Depressive Episodes Alternate With • Hypomanic Episodes

  15. Bipolar Disorders: Cyclothymia • Clinical Description • Milder Depressive Episodes Alternate With • Hypomanic Episodes

  16. Bipolar Disorders: Cyclothymia • Clinical Description Hypomania Dysthmia

  17. Bipolar Disorders • General Facts and Statistics • Bipolar I • Onset Around 18 Years • Bipolar II • Onset Around 22 Years • 16% Commit Suicide • Cyclothymia • Typically Chronic

  18. Feature Specifiers in Mood Disorders • Descriptions of Recent Episode and PatternVaries • 1. Atypical • Pertains to Depressive Episodes and Dysthymia, not Manic Episodes • Typically Overeat and Oversleep

  19. Feature Specifiers in Mood Disorders • Recent Episode and Pattern • Atypical (overeat, oversleep, wght gain – keep interested, can experience pleasure) • 2. Melancholic • Pertains to Major Depressive Episode Only • More Severe Symptoms • Strong Biological Component

  20. Feature Specifiers in Mood Disorders • Recent Episode and Pattern • Atypical • Melancholic • 3. Mixed Features • With some mania symptoms

  21. Feature Specifiers in Mood Disorders • Recent Episode and Pattern • Atypical • Melancholic • 4. Catatonic • Can be part of Major Depression and Mania • Very Serious Condition • Catalepsy (“Muscle Rigidity”) • Mixed

  22. Feature Specifiers in Mood Disorders • Recent Episode and Pattern • Atypical • Melancholic • Catatonic • Mixed • 5. Psychotic • Hallucinations and Delusions • Very Rare but Serious Condition • Poor Treatment Response

  23. Feature Specifiers in Mood Disorders • Recent Episode and Pattern • Atypical • Melancholic • Catatonic • Mixed • 6. Peripartum • Major Depression and Mania • Prior to…Four Weeks Following Birth…and up to a year: high % • Mood Episodes of a Psychotic Nature Relatively Rare • Psychotic

  24. Feature Specifiers in Mood Disorders • Recent Episode and Pattern • Atypical • Melancholic • Catatonic • Mixed • Psychotic • Peripartum • Anxious Distress

  25. Specifiers Describing Course • Course and Pattern • Rapid-Cycling • Seasonal Pattern • Bipolar and Recurrent Major Depression • Episodes During Certain Seasons

  26. Other Depressive Disorders - new to DSM-5 • Premenstrual Dysphoric Disorder (PMDD) • 2- 5% of women meet criteria • Disruptive Mood Dysregulation Disorder • Children: increased diagnosis for bipolar, up 40% between 1995 and 2005 • Bipolar (NOS)

  27. Mood Disorders: Facts and Prevalence • About 16% Lifetime Global Prevalence MDD • Past Year: Bipolar-.8% Maj Depression-6% • Females > Males • Major Depression and Dysthymia • Females = Males • Bipolar Disorders

  28. Mood Disorders: Biological Causes • Biological Dimensions • Family Studies • Twin Studies • As Severity Increases, so Does the Genetic Connection • No Single Genetic Link

  29. Mood Disorders: Biological Causes • Neurotransmitters • The Serotonin Connection • Endocrine Function • Elevated Cortisol • Dexamethasone Suppression Test: cortisol suppressed in non-depressed people, not in severely depressed….but….

  30. Mood Disorders: Biological Causes • Sleep and Circadian Rhythms • Sleep Disturbances are Common • More intense and earlier start to REM Sleep among the Depressed • Diminished Deep Sleep • Disruption of Circadian Rhythms

  31. Mood Disorders: Psychological Causes • Stressful Life Events; Loss • Learned Helplessness • Attributional Style • Internal • Stable • Global

  32. Mood Disorders: Psychological Causes • NegativeCognitive Biases • Beck’s Cognitive Triad • Negative Schema About Self, World, & Future

  33. Deadlier Side of Mood Disorders: Suicide • In the United States: • About 30,000 Kill Themselves Annually • More Die from Suicide Each Year Than Homicide (about 20,000) • More Common Among Whites, Native Americans • Increasing in Adolescents (3rd leading cause of death) & Elderly (globally, the elderly have highest suicide rate, esp. males) • Males > Females in Killing Themselves • Females > Males in Attempts

  34. Deadlier Side of Mood Disorders: Suicide • Approximately 500,000 people each year require ER treatment as a result of attempted suicide • Suicidal behavior typically occurs in the presence of mental illness or substance use disorders • Firearms account for 59% of all suicide deaths • Website of Extreme and Urgent Interest • suicidology.org

  35. Treatment of Mood Disorders • Medications • Tricyclic Antidepressants Imipramine (Tofranil) Amitriptyline (Elavil) • Block Neurotransmitter Reuptake • Side Effects

  36. Treatment of Mood Disorders • Medications • MAO Inhibitors • Block Enzyme MonoAmine Oxidase • The Result? More Neurotransmitter is Available • Side Effects and Complications

  37. Treatment of Mood Disorders • Medications • SSRIs • Block Reuptake of Serotonin- Prozac • SSNRIs

  38. Treatment of Mood Disorders • Medications - Bipolar • Lithium, Depakote, Lamictal…Effective for Manic Episodes • Lithium Must be Carefully Regulated • Other Medical Treatments • Electroconvulsive Therapy (ECT) • TMS

  39. Treatment of Mood Disorders • Psychological Interventions • Combined Treatments?

More Related