Transcript Anxiety and Mood Disorders - California State University

Mood Disorders
 Also known as affective disorders
 Depression, mania, or both
 Definition of depression
 Definition of mania

Hypomania
Types of Mood Disorders
 Unipolar Mood Disorder

Technically could mean either depression or
mania only, but almost exclusively used for
depression
 Bipolar Mood Disorder
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
Alternates Between Depression and Mania
Often referred to as manic-depression
Patterns of Depression
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Patterns of Manic Depression
Normal Mood Fluctuations
Bipolar II
Bipolar I
Cyclothymia
Major Depression
 Extremely Depressed Mood

Lasting at least 2 weeks
 Anhedonia
 Cognitive Symptoms
 Vegetative Symptoms
 Single or Recurrent Episode
Dysthymic Disorder
 Milder Symptoms than Major Depression
 But Longer Lasting
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At least 2 years
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With no more than two weeks without symptoms
Can last a lifetime
Double Depression
 Suffer from both
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Major Depression
Dysthymia
 Dysthymia Typically First
Bipolar Disorder
 Manic-Depression
 “Roller Coaster” of Mood
 Manic Episode
 Elevated Mood
 Grandiosity
 Increased Activity


Often Reckless
Varied Impairment
Bipolar Disorder
 Bipolar I
 Major Depressive Episode(s) and Manic Episode(s)
 Bipolar II
 Major Depressive Episode(s) and Hypomanic
Episode(s)
 Cyclothymia
 Dysthymic Episode(s) and Hypomanic Episode(s)
Familial and Genetic Influences
Table 6-2, p. 217
Additional Aspects
 Lifetime Prevalence
 See previous chart
 Sex Differences
 Females are twice as likely to have a mood disorder
compared to men
 The gender imbalance in depression disappears after
age 65
 Bipolar disorders are distributed equally between
males and females
 Comorbidity, especially with Anxiety
 Seasonal Pattern (aka Seasonal Affective Disorder)
Social and Cultural Dimensions
 Marriage and Interpersonal Relationships

Marital dissatisfaction is strongly related to
depression
 Gender Imbalances
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Occur across all mood disorders, except
bipolar disorders
Gender imbalance likely due to socialization
Fig. 6-5, p. 231
Social and Cultural Dimensions
 Social Support
 Grief/Bereavement
 Age
 Oppression and poverty
 Creativity
 Life Stress
Tricyclic Antidepressants
 Widely Used (e.g., Tofranil, Elavil)
 Block Reuptake of Norepinephrine and Other
Neurotransmitters
 Takes 2 to 8 Weeks to Take Effect
 Negative Side Effects Are Common
 May be Lethal in Excessive Doses
Monoamine Oxidase (MAO)
Inhibitors
 Monoamine Oxidase (MAO)

Enzyme that breaks down
serotonin/norepinephrine
 MAO Inhibitors Block Monoamine Oxidase
 MAO Inhibitors Are Slightly More Effective
than Tricyclics
 Must Avoid Foods Containing Tyramine (e.g.,
beer, red wine, cheese)
Selective Serotonergic
Reuptake Inhibitors (SSRIs)
 Specifically Block Reuptake of Serotonin
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Fluoxetine (Prozac) is the most popular SSRI
Paxil and others becoming more popular
 SSRIs Pose No Unique Risk of Suicide or
Violence

Disclaimer about Adoloescents
 Negative Side Effects Are Common, but
Fewer than Other Antidepressants
Herbal/OTC Treatments
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St. John’s Wort
SAMe
Some evidence of effectiveness, but beware
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Lack of supervision
Interactions
Lithium
 Lithium Is a Common Salt
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Traditional mood stabilizer for bipolar
disorders
However, does not help everyone
 Side Effects May Be Severe

Dosage must be carefully monitored
 Why Lithium Works Remains Unclear
Lithium (cont.)
Table 6-5, p. 235
Electroconvulsive Therapy (ECT)
 ECT
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Brief electrical current applied to the brain
Results in temporary seizures
Several treatments are often required
 ECT Is Effective for Cases of Severe
Depression (When All Else Fails)
 Side Effects Include Short-Term Memory
Loss
 Uncertain Why ECT Works and Relapse Is
Common
Psychological Treatment of
Mood Disorders
 Cognitive Therapy
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Addresses cognitive errors in thinking
Also includes behavioral components
 Behavioral Activation
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Increased contact with reinforcing events
 Interpersonal Psychotherapy
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Focuses on problematic interpersonal
relationships
 Outcomes with Psychological Treatments Are
Comparable to Medications
pp. 256-257
Suicide
 Facts and Statistics
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30,000+ Kill Themselves Annually
8th Leading Cause of Death
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Higher among Young Adults
More Men Kill Themselves
More Women Attempt
Pattern in Adolescents (see graph)
Fig. 6-10, p. 245
Fig. 6-9, p. 245
Suicide Risk Factors
 Past Suicidal Behavior
 Suicide in the Family
 Age
 Gender
 A Psychological Disorder
 Alcohol Use and Abuse
 Low Serotonin Levels
 Publicity about Suicide and Media Coverage