1. Ch. 18 Section 5: Mood Disorders Obj: Describe how psychologists attempt to explain mood disorders

2. Most people have mood changes that reflect the normal ups and downs of daily life. They feel down when things go wrong, such as failing an important test, and they feel up when good things happen. Some people, however, experience mood changes that seem inappropriate for or inconsistent with the situations to which they are responding. These people feel sad when things are going well, or they feel elated for no apparent reason. People who have abnormal moods such as these may have a mood disorder.

3. Mood disorders fall into two general categories. Depression typically involves feelings of helplessness, hopelessness, worthlessness, guilt, and great sadness. Bipolar disorder involves a cycle of mood changes from depression to wild elation and back again. Mood disorders – particularly depression – are very common psychological disorders. In any six-month period, about 8 percent of women and 4 percent of men are likely to be diagnosed with some level of depression.

4. Types of Mood Disorders The DSM-IV classifies mood disorders into several different types of depressive and bipolar disorders.

5. Major Depression – Depression is by far the most common of all the psychological disorders. It has been estimated that depression affects more than 100 million people worldwide and that between 8 and 18 percent of the general population will experience depression in their lifetime. According to the DSM-IV, major depression is diagnosed when an individual experiences at least five of the following nine symptoms of depression.

6. Persistent depressed mood for most of the day Loss of interest or pleasure in all, or almost all, activities Significant weight loss or gain due to changes in appetite Sleeping more or less than usual Speeding up or slowing down of physical and emotional reactions Fatigue or loss of energy Feelings of worthlessness or unfounded guilt Reduced ability to concentrate or make meaningful decisions Recurrent thoughts of death or suicide

7. For a diagnosis of major depression to be made, at least one of the individual's five symptoms must be one of the first two symptoms in the list. Additionally, the symptoms must be present for at least two weeks, and occur nearly every day during that period. Severely depressed individuals may become consumed by feelings of worthlessness or guilt. Severe depression calls for immediate treatment – as many as 15 percent of severely depressed individuals eventually commit suicide.

8. Bipolar Disorder – Formerly called manic depression, bipolar disorder is characterized by dramatic ups and downs in mood. Periods of mania, or extreme excitement characterized by hyperactivity and chaotic behavior, can change into depression very quickly and for no apparent reason.

9. The manic phase is characterized by a mood that is persistently and abnormally elevated. In some people, however, this phase may be characterized by irritability instead of elation. Manic moods are also characterized by at least some of the following traits: Inflated self-esteem Inability to sit still or sleep restfully Pressure to keep talking and switching from topic to topic Racing thoughts (referred to as “flight of ideas”) Difficulty concentrating

10. Individuals in the manic phase may appear highly excited and act silly or argumentative. In severe cases, they may have delusions (beliefs that have no basis in reality) about their own superior abilities or about others being jealous of them. They may also experience hallucinations (sensory perceptions that occur in the absence of sensory stimuli) such as hearing imaginary voices or seeing things that are not really there. These individuals ma also engage in impulsive behaviors, such as going on wild spending sprees, quitting their jobs to pursue wild dreams, or making foolish business investments. Thus, the manic phase of bipolar disorder can be very disruptive to an individual’s life.

11. Explaining Mood Disorders Psychological and biological theories have been proposed to explain why such a large number of people experience mood disorders, particularly depression.

12. Psychological Views – The psychoanalytic view of depression is that some people are prone to depression because they suffered a real or imagined loss of a loved object or person in childhood. According to this view, the child feels anger toward the lost object or person but, instead of expressing the anger, internalizes it and directs it toward himself or herself. This leads to feelings of guilt and loss of self-esteem, which in turn leads to depression.

13. Learning theorists have suggested other explanations for depression. Some believe that learned helplessness makes people prone to depression. Psychologist Martin Seligman demonstrated the concept of learned helplessness in a classic experiment in which he taught dogs that they were helpless to escape from electric shock. First, he placed a barrier in the dogs’ cage to prevent them from leaving when shock was administered. Later the barrier was removed. However, when shocks were again administered, the dogs made no effort to escape. They had apparently learned there was nothing they could do to prevent the pain.

14. This helpless behavior has been compared to the helplessness often seen in people who are depressed. Learning theorists argue that people prone to depression have learned through experience to believe that previous events in their lives were out of their control. This leads them to expect that future events will be out of their control as well. As a result, whenever a negative event occurs, these people feel helpless, and this leads to depression.

15. In contrast, cognitive theorists have suggested that some people are prone to depression because of their habitual style of explaining life events. According to this view, people assign different types of explanations to most events – internal or external, stable or unstable, and global or specific. These attributional styles affect people’s self-esteem and self-efficacy. These styles also relate to expectancy – what people expect based on prior experiences. Suppose, for example, that someone goes on a date that does not work out. Different ways to explain this might include the following:

16. “I really messed up” (internal explanation, places blame on self.) “Some people just don’t get along” (external explanation, places the blame elsewhere). “It’s my personality” (stable explanation, suggests problem cannot be changed.) “It was my head cold” (unstable explanation, suggests problem is temporary). “I have no idea what to do when I’m with other people” (global explanation, suggests problem is too large to deal with). “I have difficulty making small talk” (specific explanation, suggests problem is small enough to be manageable).

17. Research shows that people who are depressed are more likely than other people to explain their failures on internal, stable, and global causes – causes they feel helpless to change. Cognitive theorists argue that such explanations give rise to feelings of helplessness, which in turn lead to depression. Another cognitive theory was proposed by Aaron Beck, who suggested that people who are depressed have a negative view of themselves, their experiences, and their future. According to Beck, this is because people who are depressed have negative self-schemas, developed from negative experiences in early childhood. This leads them to filter out positive information and perceive negative information as more negative than it really is. Such negativity, Beck argued, makes people prone to depression.

18. Biological Views – Other researchers have investigated biological factors in mood disorders. Mood disorders, like anxiety disorders, tend to occur more often in the close relatives of affected individuals than they do in the general population. Between 20 and 25 percent of people with mood disorders have a family member who is affected by a similar disorder. Moreover, identical twins of affected individuals are more likely to be affected than fraternal twins. These studies seem to indicate that mood disorders have genetic basis.

19. Scientists believe that two neurotransmitters, or chemical messengers, in the brain – serotonin and noradrenaline – may at least partly explain the connection between genes and mood. Serotonin and noradrenaline both play a role in mood regulation. Low levels, or deficiencies, of serotonin may create a tendency toward mood disorders in general. Deficiencies of serotonin combined with deficiencies of noradrenaline, however, may be linked to depression specifically. These findings have been important in the development of drug therapy for the treatment of mood disorders.

20. Biological and Psychological Factors – many cases of depression may reflect the interaction of biological factors such as neurotransmitter levels and psychological factors such as learned helplessness. This has been demonstrated with laboratory animals. Seligman and Weiss found that dogs that learned they were helpless to escape electric shocks also had less noradrenaline activity in their brains. Helplessness is thus linked to specific neurotransmitter deficiencies. The relationship may result in a vicious cycle. A depressing situation may slow down the activity of noradrenaline in the brain; in turn, the chemical changes may then worsen the depression.