Anxiety, Mood, and Bipolar Disorders Fall 2016 Andrea Mejia

Generalized Anxiety Disorder Excessive anxiety/worry 3+, present more often than not for the past 6 mo. Restlessness Fatigue Difficulty concentrating Irritability Muscle tension Sleep disturbance

Other Anxiety Disorders Separation Anxiety Disorder Often seen in children See behavior for 6 months in adult, 4 weeks for children Social Anxiety Disorder The individual fears embarrassment/humiliation Can be specific to kind of performance Panic Disorder Autonomic nervous system is activated Phobia – of having panic attacks

Hypothesized Causes of Generalized Anxiety Disorder No specific environmental causes have been identified Genetic: 1/3 of the risk of experiencing GAD is genetic

Major Depressive Disorder Mood disorder Five+ (or more) during the same 2-week period and represent a change from previous functioning Depressed mood Markedly diminished interest or pleasure Weight change Motor abilities Sleep change Fatigue Feelings of self worthlessness Inability to concentration/sustain attention Thoughts of death, suicidal ideation

Other Mood Disorders Persistent Depressive Disorder Comes and goes for a long period of times Vague symptoms (compared to MDD) Observing mood for a period of 2 years Depressed 17 days of a month – enough to warrant a diagnosis Premenstrual Dysphoric Disorder Not moody, think RAGE Functioning is significantly impaired The only diagnosis that involves daily ratings

Hypothesized Causes of Depression Genetic findings Higher concordance rates in MZ twins Higher genetic impact in women Likely multigenic Heritability is 40% Neurotransmitters: Permissive hypothesis Low levels of serotonin “permit” wider ranges of other NTs Dysregulation of neurotransmitters Norepinephrine and Dopamine

Hypothesized Causes of Depression Brain abnormalities Increased blood flow to amygdala, prefrontal cortex

Bipolar Disorder I History of at least one Manic Episode Altered mood (elevated, expansive, or irritable) Lasting at least one week Depressed episode Bipolar is seen as the bridge btw psychotic and depressive disorders

Bipolar Disorder II At least one hypomanic episode Depressive episode Lasting at least four days Depressive episode Has never had a manic episode!!!!

Bipolar Disorder: Hypothesized Causes Environmental Greater prevalence in those in higher-income Separated, divorced, widowed > married, not married Biological findings Enlarged lateral ventricles Correlates with # of manic episodes Genetic findings Genetic vulnerability for depression, schizophrenia Likely multigenic Family history is one of the strongest risk factors Directionality is unclear for marrital status

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