Understanding Major Depressive Disorder: Symptoms, Etiology, and Treatment

1. Mood Disorders Chapter 7

2. Mood Disorders

3. Mood Disorders • Major Depressive Disorder; Persistent Depressive Disorder

4. Mood Disorders • Major Depressive Disorder; Persistent Depressive Disorder • Bipolar Affective Disorder

5. Major Depressive Disorder • Prevalence

8. Major Depressive Disorder • Symptoms

9. Major Depressive Disorder • Symptoms • Emotional – sadness, anhedonia, crying, anxiety, anger, agitation, irritability

10. Major Depressive Disorder • Symptoms • Emotional – sadness, anhedonia, crying, anxiety, anger, agitation, irritability • Motivational – loss of initiative, drive, spontaneity

11. Major Depressive Disorder • Symptoms • Emotional – sadness, anhedonia, crying, anxiety, anger, agitation, irritability • Motivational – loss of initiative, drive, spontaneity • Behavioral – less active, less productive, move and speak slowly

12. Major Depressive Disorder • Symptoms • Emotional – sadness, anhedonia, crying, anxiety, anger, agitation, irritability • Motivational – loss of initiative, drive, spontaneity • Behavioral – less active, less productive, move and speak slowly • Cognitive – self-blame, low self image, pessimism and hopelessness, confusion and distractibility, can’t make decisions

13. Major Depressive Disorder • Symptoms • Emotional – sadness, anhedonia, crying, anxiety, anger, agitation, irritability • Motivational – loss of initiative, drive, spontaneity • Behavioral – less active, less productive, move and speak slowly • Cognitive – self-blame, low self image, pessimism and hopelessness, confusion and distractibility, can’t make decisions • Physical – many physical ailments, sleep and eat too much or too little

14. Major Depressive Disorder • Symptoms • Emotional – sadness, anhedonia, crying, anxiety, anger, agitation, irritability • Motivational – loss of initiative, drive, spontaneity • Behavioral – less active, less productive, move and speak slowly • Cognitive – self-blame, low self image, pessimism and hopelessness, confusion and distractibility, can’t make decisions • Physical – many physical ailments, sleep and eat too much or too little • Self-injury – cutting, thoughts of death, suicide

15. Major Depressive Disorder How does cutting and self-harm help? (Helpguide.org) • “It expresses emotional pain or feelings that I’m unable to put into words. It puts a punctuation mark on what I’m feeling on the inside!” • “It’s a way to have control over my body because I can’t control anything else in my life.” • “I usually feel like I have a black hole in the pit of my stomach, at least if I feel pain it’s better than feeling nothing. ” • “I feel relieved and less anxious after I cut. The emotional pain slowly slips away into the physical pain.”

17. Major Depressive Disorder • Ashley Judd • Billy Joel • Brooke Shields • Buzz Aldrin • Delta Burke • Diana, Princess of Wales • Drew Carey • Emma Thompson • Harrison Ford • Heath Ledger • Hugh Laurie • J. K. Rowling • Jim Carrey • Mark Roget • Olivia Newton-John • Owen Wilson • Pete Wentz • Richard Jeni • Rosie O'Donnell • Sheryl Crow • Terry Bradshaw

18. Major Depressive Disorder • Etiology and treatment

19. Major Depressive Disorder • Etiology and treatment • Biological view: Endogenous depression. Strong evidence for inherited characteristics such as low norepinephrine and serotonin; high cortisol

20. Major Depressive Disorder • Etiology and treatment • Biological view: Endogenous depression. Strong evidence for inherited characteristics such as low norepinephrine and serotonin; high cortisol. Treatment: antidepressants, ECT, brain stimulation

22. Major Depressive Disorder • Etiology and treatment • Biological view: Endogenous depression. Strong evidence for inherited characteristics such as low norepinephrine and serotonin; high cortisol. Treatment: antidepressants, ECT, brain stimulation • Psychodynamic view: turn feelings toward oneself in reaction to real or symbolic loss.

23. Major Depressive Disorder • Etiology and treatment • Biological view: Endogenous depression. Strong evidence for inherited characteristics such as low norepinephrine and serotonin; high cortisol. Treatment: antidepressants, ECT, brain stimulation • Psychodynamic view: turn feelings toward oneself in reaction to real or symbolic loss. Treatment: uncover and work through losses

24. Major Depressive Disorder • Etiology and treatment • Biological view: Endogenous depression. Strong evidence for inherited characteristics such as low norepinephrine and serotonin; high cortisol. Treatment: antidepressants, ECT, brain stimulation • Psychodynamic view: turn feelings toward oneself in reaction to real or symbolic loss. Treatment: uncover and work through losses • Behavioral view: loss of reinforcement, especially social rewards.

25. Major Depressive Disorder • Etiology and treatment • Biological view: Endogenous depression. Strong evidence for inherited characteristics such as low norepinephrine and serotonin; high cortisol. Treatment: antidepressants, ECT, brain stimulation • Psychodynamic view: turn feelings toward oneself in reaction to real or symbolic loss. Treatment: uncover and work through losses • Behavioral view: loss of reinforcement, especially social rewards. Treatment: reintroduce pleasurable activities and reinforce behaviors. Build social skills.

26. Major Depressive Disorder • Etiology and treatment • Cognitive view: • Negative thinking (Beck) – negative interpretations of life/self/future, automatic self-criticisms, ruminate on negative

27. Major Depressive Disorder • Etiology and treatment • Cognitive view: • Negative thinking (Beck) – negative interpretations of life/self/future, automatic self-criticisms, ruminate on negative • Learned helplessness (Seligman) – feel a lack of control over life, attribute negative events to internal, global, stable causes

28. Major Depressive Disorder

29. Major Depressive Disorder • Etiology and treatment • Cognitive view: • Negative thinking (Beck) – negative interpretations of life/self/future, automatic self-criticisms, ruminate on negative • Learned helplessness (Seligman) – feel a lack of control over life, attribute negative events to internal, global, stable causes • Treatment: Cognitive Therapy – increase activities and improve mood; challenge automatic thinking; identify and change negative thoughts; change unhealthy attitudes

30. Major Depressive Disorder • Etiology and treatment • Cognitive view: • Negative thinking (Beck) – negative interpretations of life/self/future, automatic self-criticisms, ruminate on negative • Learned helplessness (Seligman) – feel a lack of control over life, attribute negative events to internal, global, stable causes • Treatment: Cognitive Therapy – increase activities and improve mood; challenge automatic thinking; identify and change negative thoughts; change unhealthy attitudes • Sociocultural view: lack of social support or conflicted relationships; gender differences; minority populations with constant stressors and lack of access to treatment.

31. Major Depressive Disorder • Etiology and treatment • Cognitive view: • Negative thinking (Beck) – negative interpretations of life/self/future, automatic self-criticisms, ruminate on negative • Learned helplessness (Seligman) – feel a lack of control over life, attribute negative events to internal, global, stable causes • Treatment: Cognitive Therapy – increase activities and improve mood; challenge automatic thinking; identify and change negative thoughts; change unhealthy attitudes • Sociocultural view: lack of social support or conflicted relationships; gender differences; minority populations with constant stressors and lack of access to treatment. Treatment: Interpersonal therapy, couple therapy, culture-sensitive therapy

32. Bipolar Disorder

33. Bipolar Disorder • Symptoms

34. Bipolar Disorder • Symptoms • Emotional – euphoria, overinflated mood • Motivational – seek stimulation • Behavioral – very active, move and speak quickly, risky/flamboyant • Cognitive – poor judgement, overly optimistic, grandiose • Physical – very energetic, need little sleep

36. Bipolar Disorder • Virginia Woolf • Axl Rose • Edgar Allen Poe • Charley Pride • Rosemary Clooney • Linda Hamilton • Sting • Robert Downey, Jr. • Kurt Cobain • Margot Kidder • Carrie Fisher • Sylvia Plath • Vivien Leigh • Robin Williams • Jonathan Winters • Dick Cavett • Ben Stiller • Catherine Zeta-Jones • Ludwig Von Beethoven • Vincent Van Gogh • Jean-Claude Van Damme • Mark Twain

37. Bipolar Disorder • Etiology and treatment

38. Bipolar Disorder • Etiology and treatment • Biological view: Strong evidence for inherited characteristics such as genetic abnormalities; high norepinephrine, low serotonin; neuron or brain structure dysfunction.

39. Bipolar Disorder • Etiology and treatment • Biological view: Strong evidence for inherited characteristics such as genetic abnormalities; high norepinephrine, low serotonin; neuron or brain structure dysfunction. Treatment: mood stabilizing medications

40. Bipolar Disorder • Etiology and treatment • Biological view: Strong evidence for inherited characteristics such as genetic abnormalities; high norepinephrine, low serotonin; neuron or brain structure dysfunction. Treatment: mood stabilizing medications • Other supportive treatments to focus on education about the disorder and prevention of further episodes, social skills, problem-solving skills

41. Quiz