1. Anxiety, Mood, and Bipolar Disorders
Fall 2016
Andrea Mejia

2. 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

3. 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

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

5. 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

6. 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

7. 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

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

9. 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

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

11. 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