Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Mood Disorders ©

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. ____________________: Unpleasant feelings, such as sadness or irritability. __________________: A feeling state that is more cheerful and elated than average, possibly even ecstatic.

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. A time-limited period during which specific symptoms of a disorder are present. ____________ The clinician will: 1. ________________________________. 2. Note whether it’s the first episode or a recurrence. 3. Specify nature of a prominent set of symptoms (e.g., catatonic, postpartum). The clinician will: 1. ________________________________. 2. Note whether it’s the first episode or a recurrence. 3. Specify nature of a prominent set of symptoms (e.g., catatonic, postpartum).

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Depressive Disorders

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. MAJOR DEPRESSIVE DISORDER  Depressed mood.  ____________________.  Disturbed eating and/or sleeping.  Duration: ____________________.  Most cases run their course some time after 6 months.

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Types of Depression In episodes with _________________, people lose interest or pleasure in most daily activities. Clip art copyright © Used with permission. ________________ - develop depressive episode at about the same time each year

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Dysthymic Disorder  Have symptoms of major depression, but not as deeply or as intensely.  Chronic: Have symptoms for at least 2 years, during which they are symptom- free for no more than 2 months.

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Major Depressive Disorder Dysthymic Disorder 5 or more symptoms including sadness or loss of interest or pleasure. 3 or more symptoms including depressed mood. At least 2 weeks in duration. At least 2 years in duration.

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Disorders Involving Alterations in Mood

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. BIPOLAR DISORDER A mood disorder involving manic episodes and very disruptive experiences of heightened mood, possibly alternating with major depressive episodes.

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display.  Suffer mania and sometimes depression  Manic episode _____________ Hyperactivitiy Easily distracted _____________________ May hear voices _________________ BIPOLAR DISORDER Clip art copyright © Used with permission.

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display.  ________________: One or more manic episodes, and maybe depressive episodes.  ___________________: One or more major depressive episodes and at least one hypomanic (mildly manic) episode. TYPES BIPOLAR DISORDER Clip art copyright © Used with permission.

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Prevalence and Course _______of the U.S. population. First episode for men more likely to be _________. First episode for women more likely to be ________________. After a single manic episode, 90% experience subsequent episodes. Under 15% have 4-8 mood episodes in a single year: ___________.

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Cyclothymic Disorder _______________________. Not as intense as bipolar. Chronic condition: Lasts at least ___________. May feel productive and creative but others regard them as moody, irritable. Clip art copyright © Used with permission.

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Bipolar Type I Cyclothymic Disorder Manic episodes and possibly depressive episodes. Hypomania with major depressive episodes. Duration varies. At least 2 years in duration. Bipolar Type II Hypomania with mild depressive episodes. Duration varies.

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Theories and Treatment of Mood Disorders

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. BIOLOGICAL PERSPECTIVES ON MOOD DISORDERS GENETICS  First-degree relatives twice as likely to develop depressive disorders BIOCHEMICAL FACTORS  Catecholamine hypothesis  Indolamine hypothesis  Monoamine depletion model  Stress hormone

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. PSYCHOLOGICAL PERSPECTIVES PSYCHODYNAMIC  __________________________.  Defensive mechanisms. BEHAVIORAL & COGNITIVE  Low response-contingent positive reinforcement.  _____________________.  _______________________.

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Stressor leads to reduction in reinforcers Person withdraws Reinforcers further reduced More withdrawal and depression Lewinsohn’s Behavioral View of Depression

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. LEARNED HELPLESSNESS _____________________: The passive resignation produced by repeated exposure to negative events that are perceived to be unavoidable.

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. COGNITIVE PERSPECTIVES A negative view of 1.the self 2.the world, and 3.the future. A negative view of 1.the self 2.the world, and 3.the future. Drawing erroneous or negative conclusions from experience.

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. SOCIOCULTURAL PERSPECTIVE INTERPERSONAL DISTURBED SOCIAL FUNCTIONING IMPAIRED SOCIAL RELATIONSHIPS SIGNIFICANT INTERPLAY WITH BEHAVIORAL AND COGNITIVE PERSPECTIVES

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. BIOLOGICAL TREATMENT Medications individuals treated with SSRIs exhibit lower suicide rate than those treated with other antidepressants.

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. BIOLOGICAL TREATMENT Electroconvulsive Therapy (ECT) “Shock Treatment” lifesaving in severe depression cases where medications alone were ineffective _____________________________

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Behavioral Treatment 1Assessment  Frequency,  ___________, and  Range of Activities and Social Interactions. 2.Implementation of Treatment  Change _____________.  Change environment.  Develop new behaviors.

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Cognitive Treatment COGNITIVE RESTRUCTURING  identifies and monitors dysfunctional automatic thoughts/assumptions  learns to recognize connection between thoughts, emotions, and actions.  learns to substitute more reasonable thoughts

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Suicide

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. SUICIDE WHO COMMITS SUICIDE?  About _________ Americans a year.  Women attempt more often, but male success rate is 4 times as high.  More _______.  More unmarried.  Associated DSM disorders. Clip art copyright © Used with permission.

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

WHY SUICIDE? BIOLOGICAL  Family history.  Abnormal neurochemical levels.  ____________________________. PSYCHOLOGICAL  Expression of hopelessness.  __________________________.  Plea for interpersonal communication. SOCIOCULTURAL  ____________.

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. ASSESSMENT OF SUICIDALITY ASSESS RISK FACTORS  Suicidal intent.  Suicidal lethality.  Talking about suicide.  Giving away possessions.

Copyright ©2007 The McGraw-Hill Companies, Inc. Permission required for reproduction or display. TREATING SUICIDALITY PROVIDE SOCIAL SUPPORT THERAPY  Cognitive/behavioral techniques.  Suicide prevention centers.  Suicide hotlines.