Chapter 16 Depression

Mood Disorders and Creativity

Two Major Categories of Mood Disorder Major depressive disorder (unipolar): Lengthy, uninterrupted periods of depressed mood. Manic depressive disorder (bipolar): Cycling between periods of elevated mood (mania) and depression. While sharing the common feature of depression, these are unique and separate disorders.

Major Depressive Disorder Symptoms Depressed mood most of the time Loss of pleasure in normally fun activities Sleep disturbances Eating disturbances Lack of energy or restlessness Difficulty concentrating Feelings of hopelessness, worthlessness Suicidal thoughts

Major Depressive Disorder is the “Common Cold” of Mental Disorders As many as 12% of men and 21% of women may experience major depressive disorder during their lifetimes. Most patients with MDD are women. –Prior to adolescence, boys and girls are equally likely to experience depression. –In adults, about 2/3 of patients with depression are female. Most patients experience 5–6 episodes during their lifetimes.

Bipolar Disorder Periods of mania alternate with depression. Mania is characterized by: –Inflated self-esteem (grandiosity) –Reduced need for sleep –Talkativeness –Racing thoughts –Distractibility –Goal-oriented behavior –Excessive involvement in pleasurable activities

Risk Factors Genetics: Concordance rate for mood disorders among identical and fraternal twins

Risk Factors Stress: The HPA Axis

Antidepressants Monoamine oxidase inhibitors (nardil) Classic tricyclics (elavil) Selective reuptake inhibitors (prozac, zoloft, paxil) Atypical antidepressants (wellbutrin)

Therapies for Affective Disorders Acute and long-term effects of MAO-Is on synaptic function Acute effects Chronic effects Normal

Therapies for Affective Disorders Tricyclic antidepressants

Therapies for Affective Disorders Selective serotonin reuptake inhibitors (SSRIs)

Therapies for Bipolar Disorders Lithium

Theories on Affective Disorders monoamine hypothesis

Theories on Affective Disorders glucocorticoid hypothesis

Neurochemical Bases of Mood Disorders Effect of stress and antidepressant treatment on BDNF in hippocampal cells