Mood Disorders

Mood Disorders

• A category of mental disorders in which significant and chronic disruption in mood is the predominant symptom, causing impaired cognitive, behavioral, and physical functioning
• Major depression
• Dysthymic disorder
• Bipolar disorder
• Cyclothymic disorder

Persistent Depressive Disorder

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Persistent Depressive Disorder �(Formerly Dysthymic Disorder)

• Chronic, low-grade depressed feelings �that are not severe enough to be major depression

• Symptoms lasting for over 2 years (1 year in children/adolescents)
• May develop in response to trauma, but does not decrease with time
• Some people with dysthymic disorder experience double depression, characterized by one or more episodes of major depression on top of their ongoing dysthymia.

Seasonal Affective Disorder

• Cyclic severe depression and elevated mood
• Seasonal regularity – Sad in winter, OK in summer

Major Depression

A mood disorder characterized by extreme and persistent feelings of despondency, worthlessness and hopelessness

• Prolonged, very severe symptoms
• Passes without remission for at least 2 weeks
• Global negativity and pessimism
• Very low self-esteem

Symptoms of Major Depression�Must Exhibit for 2 Weeks or Longer

Prevalence and Course�of Major Depression

• Most common reason people seek treatment.
• Sadness warns us to stop and take appropriate measures
• Depression is psychic hibernation – slows us down, defuses aggression, helps us let go of unattainable goals, restrains risk taking
• Women are twice as likely as men to be diagnosed with major depression
• Untreated episodes can become recurring and more serious
• Seasonal affective disorder (SAD)—onset with changing seasons

Self-Rating Depression Scale

Scoring Your Self-Rating Depression Scale

• Reverse Your responses (1=5, 2=4, 3=3, 4=2, 5=1) to items: 2, 5, 6, 11, 12, 14, 16, 17, 18, 20
• Now add up all your numbers (including the new reversed scores) to find you total score.
• Range of total scores will be 20 to 80.
• Scores of 50-59 suggest mild to moderate depression
• Scores of 60-69 indicate moderate to severe depression
• Scores 70 and above indicate severe depression.

Explaining Mood Disorders

Depression Facts�Finding the cause for Depression means having to explain the following:

• Behavioral & Cognitive changes accompany depression
• Depression is widespread
• Women’s risk of depression is double men’s
• Most major-depression episodes go away with time
• Stressful events usually preceed depression
• With each new generation, depression is striking earlier, affecting more people with the highest rates in developed countries
• Today’s youth 3X more likely to suffer depression

Biological Factors

• Hereditary may be a factor:
• Risk increases if parent or sibling have disorder
• Identical twins:
• 50% chance for depression if one has it
• Linkage Analysis – scientists looking at families with a history of depression or bipolar and searching for differences in their genes versus those without the disorder

The Depressed Brain

• Depressed individuals tend to have depressed brains.
• PET scans indicate less activity during periods of depression

Biologically Explaining Mood Disorders

• Depression seems to come out of an interaction of a stressful environment and genetic susceptibility
• Frontal lobe is 7% smaller than normal in severe depression
• Neurotransmitter theories
• Norepinephrine (lacking in depression, too much in mania)
• Serotonin
• Antidepressants (block reuptake) increase the availability of norepinephrine and serotonin.
• They relieve the symptoms of major depression in about 80% of the people who take them

Effect of stress was greater for those who were more genetically predisposed for depression (based on the status of their twin sisters, as shown in the key) than for those who were less genetically predisposed. �(Adapted from Kendler & others, 1995)

The Role of Stress & Genetics

Cognitive Bases for Depression

• Self-defeating beliefs & negative explanatory style feed depression’s cycle
• A.T. Beck: depressed people hold pessimistic views of
• themselves
• the world
• the future
• Depressed people distort their experiences in negative ways
• exaggerate bad experiences
• minimize good experiences
• Self-Defeating Beliefs can create Learned Helplessness

Cognitive Bases for Depression

• Ruminating – staying focused on the negative
• Hopelessness theory
• depression results from a pattern of thinking
• person loses hope that life will get better
• negative experiences are due to stable, global reasons
• e.g., “I didn’t get the job because I’m stupid �and inept” vs. “I didn’t get the job because the interview didn’t go well”

Social-Cognitive Factors

• Depression may be a variation of learned helplessness.
• Negative Explanatory Style - Depressed individuals attribute events using the following characteristics:
• Stable: the bad situation will last for a long time
• Internal: they are at fault
• Global: all of life is bad

Negative Explanatory Style

Negative Explanatory Style

Negative Explanatory Style

Attributions

Negative Explanatory Style Example

Negative Automatic Thoughts�Finding Your Score

• Add up your total score.
• Scores will fall from 30 (no depression) to 150 (maximum depression).
• Mean (average) score is 79.6 for depressed people and 48.6 for nondepressed people.
• This “test” looks for specific measures of depression:
• Personal dissatisfaction & desire for change (items 14 & 20)
• Negative Expectations (items 3 & 24)
• Low Self-Esteem (items 17 & 18)
• Helplessness (items 29 & 30)

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Seriously depressed moods result from a combination of factors, which affect each other. Altering any one component can alter the others.

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Bio-Psycho-Social Model of Depression

Depression’s Vicious Cycle

Bad moods feed on themselves: When we experience a stressful event it can cause us to feel down, we think negatively & remember bad experiences which then can effect our behaviors.