Mood Disorders:

- Depression

- Bipolar Disorder (Manic Depression)

Depression Prevalence Estimates:

Nearly 1 in 5 Americans will experience at some point in their lives

1 in 20 Americans are severely depressed at any time.

Sex difference in prevalence

Why? (we don't really know)

- Biological theories

- Cultural theories: women ruminate; men distract?

Comorbidity - co-occurrence of more than one disorder

Major depression has to persist beyond a few days; not given as diagnosis for someone who has just experienced death of love one.

Feeling down has to extend beyond what is considered "normal" and interfere with ability to function.

Symptoms:

• -discouraged, sad, lacking hope, irritable

- lethargic (lack of energy, motivation, feel tired)

- loss of enthusiasm

- low self-esteem

- sleep changes (sleeping more or can't sleep)

- appetite changes (eating more or less)

- loss of interest in sex

Course of depression - Majority of cases of depression will dissipate in 5-10 months, even without treatment.

40% of people experiencing depression will recover, but will experience depression again.

10% of people experiencing depression stay accutely depressed.

(Remaining 50% of people experiencing depression will not have it again)

Many questions about why depression is cyclical: Is there biological vulnerability that led them to get depressed to begin with, and makes them depressed again?

Or, does having depression itself make you more likely to get depressed?

Multiple triggers/vulnerability factors for similar outcome:

- Early childhood loss, esp. death of a parent

- Depressive thinking style - Negative thoughts about self, the world and one's future and

Depressive attributional thinking (internal, stable and global for negative outcomes)

- Depressive spiral - initial depressing event prevents person from getting positive reinforcement.

Treating mood disorders

Antidepressant drugs

Mononamine Oxidase drugs (MAO) -- elevate levels of serotonin and norepinephrine, by blocking the enzyme that deactivates these neurotranmitters.

Tricylcic antidepressants prevent reuptake of these neurotransmitters

Selective serotonin reuptake inhibitors (SSRIs) - work selectively prevent reuptake of serotonin more than other neurotransmitters (Prozac, Paxal and Zoloft)

Various side effects - among them:

- gastrointestinal problems

- weight gain

- decreased sexual desire

"brand new person" result of SSRIs

Tardive dyskinesia - set of involuntary ticlike movements in hands and feet associated with many psychotropic drugs

Lithium - prescribed for bipolar disorder, can cause kidney & thyroid problems.

cognitive-behavioral therapy - aimed at helping clients identify beliefs and expectations that might be prolonging their unhappiness and problems, and at changing behavior.

"practical therapy"

Beck

Ellis

therapeutic alliance

- Better than nothing

- The less serious the problem, the better it works.

- The more the person in therapy wants to change, the more it works.

Seasonal Affective Disorder (SAD) - related to short days

- light helps set ciradian rhythms, affect hormone melatonin

- treated with special therapeutic lights

Post-partum Depression

- 2/3 of women experience "baby blues" (first few days or weeks)

- True postpartum depression, 10-20%, and interferes more

- associated with very high expectations

- other changes in life at same time

- lacking support network

Suicide --

risk seen in bipolar and depression (and to some extent, paranoid schizophrenia)

In Western society, roughly 1 in 5000 successful suicides;

Probably 10 attempts for every successful suicide.

In our culture -- white men are highest risk, but women attempt more than men.

Men choose more successful methods

Recent estimate - 3rd leading cause of death among young people (age 15-34) after accidents and homicide.

Most suicides do it as ultimate escape

Less than 15% estimated to commit suicide for attention

75% of suicides are committed by people who are depressed.

Most suicide victims give cues beforehand

Suicides may be most likely to occur as person is coming out of depth of depression

What should you do if friend talks about suicide?

Take it seriously.

Don't be afraid to ask if friend is feeling suicidal - you will not "give them idea"

Don't leave them alone; listen unjudgmentally

You are not qualified to "talk them out" of it.

Call a health professional