Abnormal Psych, mood disorders
Abnormal Psych, mood disorders Psych 385
U of L
Popular in Abnormal Psychology
Popular in Psychlogy
This 6 page Class Notes was uploaded by Caroline Pirtle on Monday April 18, 2016. The Class Notes belongs to Psych 385 at University of Louisville taught by Dr. Irby in Fall 2015. Since its upload, it has received 8 views. For similar materials see Abnormal Psychology in Psychlogy at University of Louisville.
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Date Created: 04/18/16
Mood Disorders Monday, November 2, 2015 2:02 PM I. Mood Episodes = time-limited period during which mood is impaired a. Dysphoria = sadness b. Euphoria = elation c. What makes them a disorder is the mood lasting an abnormal amount of time that others do not experience II Specifiers: a. Severity - mild, moderate or severe i. Threshold between what's modern and what's severe is hard to determine a lot of time b Nature of symptoms - specific mood features c Course - longitudinal nature of episodes II Major depressive episode a Over a two week period, 5 of the following 9 sxs are present i. Depressed mood (must be present) ii. Loss of interest/pleasure (must be present) iii. Unintentional weight change or appetite change iv. Sleep disturbance - insomnia/hypersomnia v. Psychomotor agitation/retardation vi. Fatigue/energy loss vii. Feelings of worthlessness/guilt viii. Inattention/indecisiveness 1. A distorted, negative self-appraisal 2. Fell like a bad or ineffective type of person ii Recurrent thoughts of death/suicide b Reactive depression i How do we know its not a character flaw? 1. Not just overly sensitive II Manic Episode a For a one week period, elevated mood with 3 of following 7 sxs i Inflated self-esteem ii Decreased sleep iii Pressured speech 1. Mouth always trying to catch up with thoughts 2. Disruptive at times ii Flight of ideas, racing thoughts iii Distractibility iv Psychomotor agitation/increased goal directed activity v Increased pleasure-seeking potentially risky b Makes a lasting impression; pushes you to one extreme rather than the both we see with depression II Hypomanic episode a Over a four day period, sxs od manic episode present BUT.. i Sxs not severe enough to cause marked impairment ii Sxs are evident to others (but maybe not the person) iii Other people seem to be more able to evaluate disorder than the person themselves II Mixed episode a Over one week period, sxs of both Manic and Depressive episode are evident daily II Major depressive disorder a Single episode = presences of one depressive episode b Recurrent = presence of two or more depressive episodes c Specifiers for depressive disorders: i Catatonia 1. Tend to repeat what you're saying ii Anxious 1. Common state of restlessness 2. Difficulty concentrating 3. Worries that something bad will happen to them that they cannot avoid ii Atypical 1. Characterized by heightened mood reactivity (really sensitive) 2. Weight gain 3. Sleep more (hypersomnia) 4. Leaden paralysis=you're body is too heavy to move 5. Sensitive to rejection ii Psychotic 1. Delusions that are magnifications of mood 2. Are they congruent with depression or incongruent with mood? ii Melancholic 1. Think they are bad people 2. guilty ii Peripartum 1. Pregnant women 4 weeks prior to or post pregnancy 2. More anxiously depressed before delivery and more psychotic depression after delivery 3. Tends to be recurrent and get more severe ii Seasonal 1. Clear pattern associated with change in seasons b Prevalence: 17% of population, twice as common in females than males c Course: increased risk with recurrent episodes i Slightly more than half of people who meet criteria for single episode will meet criteria for recurrent episodes II Persistent depressive disorder (Dysthymia) a Sad mood persisting for two years, with MDE sxs, plus b Low self-esteem and/or feelings of hopelessness c Prevalence: lifetime 6%, greater risk in middle adulthood d Course: early onset in late childhood/early adolescence e Increased risk for MDE (major depressive episode), with poorer chance of post-episode remission (won't recover from major depressive episode) and increased chance of recurrence. II Premenstrual Dysphoric Disorder a 5 mood sxs present prior to onset of menses, improve during menses, absent/minimal post- menses i A(1): affective liability, irritability, depressed mood, anxiety ii B(1): decreased activity, concentration, lethargy, appetite change, sleep disturbance, feeling overwhelmed, physical sxs b Prevalence: 1.8% of women c Course: onset any time after menarche. Risk of worsening prior to menopause. i Birth control can be helpful II Beck a People that have depression convince themselves of certain things b Depression isn't seeing the world differently but seeing it as it really is II Seligman a Lab research with dogs that recreated an experience of being in a cage b Dogs exposed to painful electric shocks when trying to get to food bowl or water bowl c Dogs eventually reached a depressed state that he coined as learned helplessness d The randomness of shocks caused dogs to be immobilized and would not move in cage e Illustration of negative common triad identified by Beck II Lewinsohn a When depressed you don't do things to lift your mood b May not go to the party or cook a good meal for yourself or initiate conversation with someone c One way to illustrate that the caged door is not locked is to encourage them to seek out a positive experience = behavioral activation. i Encourage to make eye contact and smile at them and see what kind of response you get ii List things you’ve done in the past that you really enjoyed vs. what are you doing now II Benjamin a Interpersonal Therapy approach (IPT) i All engaged in a network of social interactions with people and in those relationships we can sometimes get shocked. ii Being hurt by certain relationships iii Looking at scripts - the way in which you have expectations as to how it is going to go b Indicate interest in others II Bipolar Disorder a Bipolar I Disorder i History of at least one Manic Episode ii May have had depressive episodes that did not meet criteria for MDE iii As you age, manic episodes become more frequent but do not last as long; also are not as intense b Bipolar II Disorder i History of at least one MDE, with intervening hypomanic episodes. ii May not have met criteria for manic episode. iii When trying to treat for major depression, they actually would produce onset for major manic episode b Prevalence i Lifetime 4% ii Even gender distribution, but difference in course iii Decreased incidence of onset with age b Course i Males = onset with manic episode ii Females = onset with MDE, followed by manic or hypomanic episode iii Increased risk of recurrent manic episodes iv Lifetime pattern of mood cycles v Rapid cycling people tend to have overactive thyroid b Neuroscience i Genetic vulnerability ii Biological rhythms iii Abnormal brain metabolism iv Neurochemical imbalances II Treatment of major depressive disorder a MAO-I i Inhibit function of enzymes that elevate levels norepinephrine b Tricyclic Antidepressants i Block reuptake of norepinephrine ii Slow acting 1. 4-6 weeks or maybe even 10 weeks ii Fairly sedating b SSRI's i Selective serotonin uptake inhibitors ii Block reuptake of different molecules of serotonin iii Use those molecules in combination with other molecules that also effect norepiniephrine iv Welbutrin block uptake of serotonin and norepinephrine II Treatment of Bipolar Disorder a Lithium i Reduces mania in 70% of cases ii Less effective on depressive symptoms b Anti-convulsants
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