PSY 247, Mood Disorders and Suicide
PSY 247, Mood Disorders and Suicide PSY 247
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This 6 page Class Notes was uploaded by Joy Mizrahi on Wednesday February 24, 2016. The Class Notes belongs to PSY 247 at University of North Carolina - Wilmington taught by Robert McNamara in Summer 2015. Since its upload, it has received 26 views. For similar materials see abnormal psychology in Psychlogy at University of North Carolina - Wilmington.
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Date Created: 02/24/16
PSY 247—Notes 2.11.16 Mood Disorders Depression and Mania -Mood disorders=gross deviations in mood -Composed of different type of mood “episodes” (periods of depressed or elevated mood lasting days or weeks including: Major depressive episodes Manic and hypomanic episodes Persistent depression -Episodes are NOT disorders -Face valid: on the surface it looks logical, like it’s a good test, but it’s not (people could easily sway their answers) DSM-5 Depressive disorders -Major depressive disorder -Persistent depressive disorder (dysthymia) -New to dsm-5 Premenstrual dysphemic disorder Disruptive mood dysregulation disorder DSM-5 Bipolar Disorders -Bipolar 1 disorder -Bipolar II disorder -Cyclothymic disorder Annedonia -Opposite of hedon, not getting interest or pleasure from anything Types of mood episodes -Hypomanic episode -Shorter, less sever version of manic episodes -Last at least four days -Have fewer and milder symptoms -Associated with less impairment than manic episodes (less risky behavior) -May not be problematic in and of itself -Mixed features-term for a mood episode with some elements reflecting the opposite valence of mood Depressive episode w/ some manic features Major Depressive Disorder: An Overview -Clinical features One or more major depressive episodes separated by periods of remission Single episode- highly unusual Recurrent episodes- more common -Episodes Major depressive Manic Hypomanic Mixed features -Depressive disorders Major depressive disorder Persistent depression -Dys -Double -Major Persistent Depressive Disorder: An Overview -At least two years of depressive symptoms Depressed mood most of the day or more than 50% of days No more than two months symptom free -Types of PDD Mild depressive symptoms without any major depressive episodes (with pure dysthymic syndrome) Mild depressive symptoms with additional major depressive episodes occurring intermittently (previously called “double depression”) Major depressive episode lasting 2+ years (“with persistent major depressive episode”) -Premenstrual Dysphoric Disorder Significant depressive symptoms occurring prior to menses during the majority of cycles, leading to distress or impairment Controversial diagnosis -Advantage: Legitimizes the difficulties some women face when symptoms are very severe -Disadvantage: Pathologies an experience many consider to be normal Bipolar 1 Disorder: An overview -Defining features Alterations between full manic episodes and major depressive episodes Can be diagnosed after manic episode only -Facts and statistics Average age of onset is 15-18 years Cyclothymic disorder: An overview -Defining features Chronic version of bipolar disorder Alternating between periods of mild depressive symptoms and mild hypomanic symptoms Prevalence of mood disorders -Worldwide lifetime prevalence 26% for major depression -Sex differences Females are twice as likely to have major depression Bipolar disorders approximately equally affect males and females -Occurs less often in prepubertal children -Rapid rise in adolescents -Adults over 65 have about 50% less prevalence than general population -Prevalence of depression seems to be similar across subcultures Mood Disorders-An Integrative Theory -Shared biological vulnerability -Inadequate coping and depressive cognitive style -Biological, psychological and social factors all influence the development of mood disorders -Exposure to stress Medication -Antidepressants SSRIs Tricyclic antidepressants Monoamine oxidase inhibitors SNRIs -Approximately equally affective Selective Serotonin Reuptake Inhibitors -Called SSRIs -Specifically block reuptake of serotonin so more serotonin is available in the brain Prozac, Celexa, Lexapro, Zoloft -SSRIs pose some risk of suicide particularly in teenagers -Negative side effects are common Mixed Reuptake Inhibitors -Block reuptake of norepinephrine as well as serotonin -Best known venlafaxine (Effexor) -Less side effects than SSRIs Tricyclic Antidepressants -Include Tofranil, Elavil -Mechanisms not well understood -Negative side effects are common -May be lethal in excessive dose MAO Inhibitors -Block monoamine oxidase -This enzyme breaks down serotonin/norepinephrine -As effective as Tricyclic with less side effects -Dangerous in combination with certain foods Beer, wine, cheese, cold medicines Lithium -Lithium carbonate= a common salt -Treatment for Bipolar -Considered a mood stabilizer because it treats depressive and manic symptoms -Toxic in large amounts Electroconvulsive Therapy -Effective for medication-resistant depression -The nature of ECT Brief electrical current applied to the brain Results in temporary seizures Usually 6-10 outpatient sessions are required -Side effects Short-term memory loss which is usually restored Some patients suffer long-term memory loss -Mechanism is unclear Transcranial Magnetic Stimulation -Uses magnets to generate a precise localized electromagnetic pulse -Few side effects; occasional headaches -Less effective than ECT Psychosocial Treatment for Depression -Cognitive behavioral therapy Address cognitive errors in thinking Also includes behavioral components -Interpersonal psychotherapy Focus: Improving problematic relationships -Prevention Preemptive psychosocial care for people at risk -Has longer lasting effectiveness than medication Psychosocial Treatment for Bipolar Disorder -Medication is the first line of defense -Psychotherapy helpful in managing the problems that accompany bipolar disorder -Family therapy can be helpful PSY 247—Notes 2/16/16 Suicide Facts and Statistics th -11 leading cause of death in USA Underreported; actual rate may be 2-3x higher -Most common among white and native Americans -Particularly prevalent in young adults Third leading cause of death among teenagers Second leading cause of death in college students 12% of college students consider suicide in a given year -Gender Differences Males complete more suicides than females Females attempt suicide more often than males Exception: Suicide more common among women in China -May reflect cultural acceptability; suicide is seen as an honorable solution to problems Risk Factors -Suicide in the family -Low serotonin levels -Preexisting psychological disorder -Alcohol use and abuse -Stressful life event, especially humiliation -Past suicidal behavior -Plan and access to lethal methods Suicide Contagion -Some research indicates that a person is more likely to commit suicide after hearing about someone else committing suicide -Media accounts may worsen the problem by Sensationalizing/romanticizing suicide Describing lethal methods of committing suicide Prevention -In professional mental health Clinician does risk assessment (ideation, plans, intent, means, etc.) Clinician and patient develop safety plan (e.g., who to call, strategies for coping with suicidal thoughts) -Preventative programs for at-risk groups -Important: removing access to lethal methods -If you think someone is at risk, talk to them and ensure they’re getting needed support Talking to someone about suicide is not likely to place them at greater risk or ‘plant the idea’ In contrast, the risk of not providing support to someone who may be in need is huge Emergency services and suicide hotlines
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