Mood Disorders

1. Mood Disorders A Closer Look at Psychological Disorders

2. Mood Disorders • Mood disorders are disturbances of emotions that are severe or prolonged enough to cause impairment of functioning. • These conditions are magnifications of our normal reactions. • The magnified states in mood disorders are maniaand depression. • Mania – a period of abnormally high emotion and activity • Depression – a period of extreme sadness and helplessness

3. Types of Mood Disorders

4. Major Depressive Disorder (Unipolar Depression) • The most common mood disorder, and one of the more common psychological disorders in general. • Everyone gets depressed, so how do we know when normal depression crosses the line into major depressive disorder?

5. Major Depressive Disorder (cont.) • A person may be suffering from major depressive disorder when five of the following nine symptoms have been present for two or more weeks: • Depressed mood most of the day, nearly every day • Little interest or pleasure in almost all activities • Significant changes in weight or appetite • Sleeping more or less than usual • Agitated or decreased level of activity • Fatigue or loss of energy • Feelings of worthlessness or inappropriate guilt • Diminished ability to think or concentrate • Recurrent thoughts of death or suicide

6. Major Depressive Disorder (cont.) • The symptoms must also produce distress or impaired functioning to qualify as indicators of MDD. • Also, with MDD, there is no apparent reason, or trigger, for the emotions.

7. Major Depressive Disorder (cont.) • Research suggests that the lifetime prevalence rate of depression is between 7 and 18%. • Evidence suggests that the prevalence of depression is increasing, particularly in more recent age cohorts, and that it is 2X as high in women as in men.

8. Dysthymic Disorder • Dysthymic disorder shares many of the symptoms of MDD, but doesn’t quite have the same overwhelming feel. • Sufferers of this disorder may feel the same symptoms, but less intensely and for a longer period(at least 2 years). • They rarely require hospitalization.

9. Bipolar Disorder • People with bipolar disorder also experience the oppressive down periods of MDD; however, these periods alternate with manic episodes in which the person is unrealistically optimistic and displays wildly hyper behavior. • During mania, a person may go long periods without sleeping, experience changeable, racing thoughts, be easily distracted, and set impossible goals. • Mania is sometimes also associated with bouts of creative energy. • Bipolar disorder affects a little over 1%-2% of the population and is equally as common in males and females.

10. The Depressed Brain • PET scans show that brain energy consumption rises and falls with manic and depressive episodes. Courtesy of Lewis Baxter an Michael E. Phelps, UCLA School of Medicine

11. Victims of Bipolar Disorder? • No one knows for sure, but some people suspect that Vincent van Gogh was bipolar. • His life alternated between periods of blazing creativity – sometimes he finished more than a painting a day – and periods of deep depression. He committed suicide in 1890. • The world's most famous nurse, Florence Nightingale, is believed to have suffered from a bipolar disorder that caused long periods of depression and remarkable bursts of productivity.

12. Whitman Hemingway Bipolar Disorder and Creativity • Many great writers, poets, and composers suffered from bipolar disorder. • During their manic phase creativity surged, but not during their depressed phase. Earl Theissen/ Hulton Getty Pictures Library George C. Beresford/ Hulton Getty Pictures Library The Granger Collection Bettmann/ Corbis

13. Famous People with Bipolar Disorder ?

14. Bipolar I vs. Bipolar II Disorder • Bipolar I Disorder • Manic Episodes, plus: • Usually with at least one Depressive Episode • Bipolar II Disorder • Depressive Episodes, plus: • At least 1 Hypomanic Episode Hypomanic: Same criteria for mania, except: – Lasts at least 4 days – Not severe enough to cause impairment in functioning, no hospitalization needed, no psychotic features… although there is a clear change in behavior or functioning that is not the person’s “normal” and is noticeable to others 

15. Cyclothymic Disorder • Cyclothymia is basically borderline bipolar disorder (milder than bipolar) • Includes • Hypomanic symptoms (not full mania), plus: • Depressive symptoms (not full depression) • Lasts for at least 2 years Hypomanic: Same criteria for mania, except: – Lasts at least 4 days – Not severe enough to cause impairment in functioning, no hospitalization needed, no psychotic features… although there is a clear change in behavior or functioning that is not the person’s “normal” and is noticeable to others 

16. Recap of Mood Disorders

17. Other Types of “Depressions” • Seasonal Affective Disorder • Double Depression (Dysthymia + Major Depression) • Post-partum depression

18. Suicide Facts • People who are deeply depressed rarely kill themselves until after the depression starts to lift. Ironically, this lifting of depression gives the person the energy to execute a plan developed when depression was so overwhelming that it effectively stopped action. • There is a strong link between drug and alcohol use and suicide. The risk of suicide is 100 times greater among alcoholics. • Suicide rates increase with age. In the U.S., the highest rate of suicide is among the elderly (especially elderly men). • Suicide attempts are often help-seeking gestures, not failed efforts to die. • Most people who actually commit suicide made no prior attempts.

19. Suicide Facts (cont.) • In general, Western countries have a higher rate of suicide than non-Western countries, but there is a great deal of variation even among Western countries. The rate in England is about half the U.S. rate, and the rate in Finland is about double. • In most parts of the world, men are more likely than women to commit suicide. • Women, however, are at least twice as likely to attempt suicide. • Men succeed more often because their weapon of choice is firearms, which are more lethal than the drug overdoses preferred by women. • White Americans have a higher suicide rate than other racial groups.

20. Suicide Statistics

21. Suicide Statistics

22. Etiology of Mood Disorders Possible Causes

23. What causes mood disorders? • Again, biology and environment interact as possible contributors to mood disorders. • Stress also seems to play a role, providing a trigger that sparks mood disorders when other factors are present.

24. Biomedical Approach • Heredity – twin studies show that many mood disorders run in families. The rate of depression is higher in identical (50%) than fraternal twins (20%). • Brain function – Depressed people have depressed brains. Brain scans indicate that the brain is less active during major depression. • Also, certain neurotransmitters (serotonin and norepinephrine) are lacking during times of depression. • Prozac and other antidepressant medications help restore proper levels of these neurotransmitters.

25. Social-Cognitive Approach • Attributions– When things go wrong, we try to explain them. Depressed people are likely to believe the following explanations (attributions): • Stable – The bad situation will last for a long time • Internal – This happened because of my actions, not someone else’s, and not because of the circumstances • Global – My explanation applies to many areas of my life

26. Social-Cognitive Factors (cont.) • Learned helplessness – People develop a sense of helplessness when subjected to events over which they have little or no control. As they acquire this feeling of helplessness, they give up and no longer try to improve their situation, because they learned in the past that efforts to improve the situation will not work. This, by itself, can produce depression. • Learned helplessness may also explain why women suffer higher rates of depression than men do. Women are more likely to be abused and twice as likely to feel overwhelmed. This may explain women’s higher levels of learned helplessness and depression.

27. Social-Cognitive Perspective The social-cognitive perspective suggests that depression arises partly from self-defeating beliefs and negative explanatory styles.

28. Humanistic Approach • Not enough life meaning • Not enough authentic choices that lead to self-fulfillment • Connection of personal identity to others’ evaluation of ourselves, or to certain events (e.g., role at work), so that when these persons or events leave, there is loss and depression • Obstacles to self-actualization path  

29. Behavioral Approach • Few rewards in life, many punishments • Interactional theory (James Coyne) • Person acts depressed, which makes others annoyed or stressed by person, which makes others less likely to provide positive reinforcement and rewards to person, which makes person depressed… • Interpersonal inadequacies and poor social skills may lead to a scarceness of life’s reinforcers and frequent rejection.

30. Sociocultural Approach • Cultural differences in symptom expression • Different rates among different groups • Higher rates among women • Higher rates among single, divorced people • Lower rates with social support • Higher rates for younger adults • Higher rates for lower socioeconomic status 

31. Psychodynamic Approach • Parents fail to nurture person or they provide excessive gratification of needs • Actual or symbolic loss of the parent or loved one • Regression to oral stage • Introjection of loved one (Introjection – The process of incorporating the characteristics of a person or object unconsciously into one's psyche, often as a defense mechanism) • Angry feelings towards loved one  guilt + self-hatred  • Shifting dominance between superego (guilt and worthlessness) and ego (asserts its strength and is elated and self-confident).