1. Mood Disorders and Schizophrenia

2. Mood Disorders Mood Disorders Two major forms of mood disorders:
Disorders characterized by emotional extremes
Two major forms of mood disorders:
Major Depression – prolonged state of hopeless depression
Bipolar Disorder – Alternation between depression and overexcited hyperactivity (mania)

3. Major Depressive Disorder
Signs of depression that last for at least two weeks
Not caused by drugs or a medical condition
Symptoms:
Extreme lack of energy (lethargy)
Feelings of worthlessness
Loss of interest in family, friends or activities you used to enjoy
Depression is the number one reason people seek out mental health services
In any given year 5.8% of men and 9.5% of women will be diagnosed with a depressive episode

4. DSM-V Depression Criteria
Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure. Note: Do not include symptoms that are clearly attributable to another medical condition.

5. DSM-V Depression Criteria
1. Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad, empty, hopeless) or observation made by others (e.g., appears tearful). (Note: In children and adolescents, can be irritable mood.)
2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation.)
3. Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. (Note: In children, consider failure to make expected weight gain.)
4. Insomnia or hypersomnia nearly every day.

6. DSM-V Depression Criteria
5. Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down).
6. Fatigue or loss of energy nearly every day.
7. Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick).
8. Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others).
9. Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

7. Major Depressive Disorder
One of TWO disorders found worldwide (across cultures)
The other disorder is schizophrenia
Usually the result of a specific cycle
1.) Stressful event interpreted negatively
2.) Creates a hopeless, depressed state
3.) Depressed state hinders how a person thinks and acts appropriately in situations
4.) Hampering how we think and respond appropriately usually leads to more negative events, such as social rejection, which starts the cycle all over again

8. Major Depressive Disorder
Women are twice as likely as men to develop depression in their lifetime
The trend begins in adolescence
Females have the tendency to ruminate– or overthink past events, in a negative manner
Sensitivity to hormonal fluctuations (menstruation, pregnancy, menopause) may have an impact as well

9. Bipolar Disorder
Bipolar disorder – Person alternates between the hopelessness and lethargy of depression and the overexcited state of mania
Formally known as manic depressive disorder
2.6% of the U.S. population is diagnosed with bipolar disorder
Afflicts just as many women as men – No gender differences

10. Bipolar Disorder
When a depressive episode ends, an intensely happy, hyperactive, wildly optimistic mania occurs
Mania
Overtalkative, overactive, elated
Little need for sleep
Fewer sexual inhibitions
Extreme optimism and high self esteem
Easily irritated/annoyed

11. Schizophrenia
Schizophrenia – Group of severe disorders characterized by disorganized and delusional thinking, disturbed perceptions and inappropriate emotions and actions
Schizophrenia is a cluster of disorders that have some commonalities
Broken up by positive and negative symptoms
The symptoms may have various causes

12. Positive Symptoms: Schizophrenia
Positive symptoms of schizophrenia means that inappropriate symptoms are present
Examples:
Hallucinations
Speaking in a disorganized manner (word salad)
Laughing, crying, lashing out during an inappropriate time

13. Negative Symptoms
Negative symptoms are actions or feelings that are absent when you might expect them to be present
Examples:
Toneless voices
Expressionless faces
Mute (Not speaking)
Rigid bodies

14. Disorganized Thinking
“This morning, when I was at Hillside [Hospital], I was making a movie. I was surrounded by movie stars…I’m Mary Poppins. Is this room painted blue to get me upset? My grandmother died four weeks after my eighteenth birthday.”
This stream of thought illustrates the person with schizophrenia as having thinking that is fragmented and distorted with delusions
Delusion – False belief. Believing you are Mary Poppins is a delusion

15. Disturbed Perceptions
Hallucinations – false perceptions; sensing things that aren’t really there.
People with schizophrenia can see, feel, taste, hear, or smell things that do not exist
Hearing voices is the most common hallucination

16. Inappropriate Emotions and Actions
Laughing after recalling a grandparent’s death
May start to cry when others are laughing
Some may lapse into what is called flat affect
Zombielike state with no apparent feeling
Inappropriate movements may also occur
Rocking, rubbing an arm, remaining motionless for hours (catatonia)

17. Possible Causes of Schizophrenia
Neurotransmitters
Dopamine overactivity
Patients with schizophrenia tend to have a high number of dopamine receptors
Could be the cause of the positive symptoms, such as hallucinations
Drugs that block dopamine activity tend to lessen the positive symptoms
Brain Activity
Abnormally low activity in frontal cortex
Reasoning, judgement, and problem solving may be impaired

18. Possible Causes of Schizophrenia
Brain Activity
Hallucinations are associated with activity in the thalamus (sensory processing) and amygdala(emotion and fear processing)
Cerebrospinal fluid
Ventricles (spaces) within the brain are overfilled with CSF and become enlarged

19. Prenatal Viral Exposure and Schizophrenia
Increased risk of schizophrenia if in the middle of fetal development, a flu epidemic broke out
3 separate studies concluded this finding
Increase risk for people who are born in densely populated areas where viral diseases are spread more readily
Study included 1.75 million people
Babies born after flu season are at an increased risk for developing schizophrenia (5-8% more likely)
In the southern hemisphere, seasons are reversed, and babies are still at risk when born after the southern hemisphere flu season

20. Activity Look up causes of major depression and bipolar disorder
Must include:
Biological causes
Which neurotransmitters are involved in depression and bipolar disorder
Any brain abnormalities?
Genetics (are bipolar and depression genetically linked?)
Can you inherit traits that make you more likely to develop bipolar disorder or depression?
Must bring to me to read before you get credit!!!
HOMEWORK: Identify schizophrenia, bipolar and depression on your psychological disorders case studies worksheets