Mood Disorders

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Mood Disorders

• Major Depressive Disorder

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Diagnostic criteria must have two major
depressive episodes which last two weeks or more
and include at least six of the following
symptoms

• sad mood
• 5 weight loss or dramatic change in appetite
• insomnia or hypersomnia
• lethargy or agitation
• loss of interest

• loss of energy
• negative self concept
• sense of worthlessness
• lack of concentration
• thoughts of death
• suicide ideation

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Manic Disorder (mania)

• elevated or irritable mood
• increased activity
• rapid speech
• flight of ideas
• lack of sleep
• inflated self esteem
• inflated sense of ones power or abilities
• easily distracted
• overspending, gambling, investing

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Bipolar Disorder

• formerly known as manic-depression
• Type I mood swings from manic to depressive
  phases
• Type II swings from depression to hypomania
  (less severe manic phase)

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Dysthymic Disorder

• Mild depression
• Symptoms lasting two years or more
• Symptoms persist longer than in major depressive
  disorder but are not as severe

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Other Mood Disorders

• Depression with Seasonal Pattern
• AKA Seasonal Affective Disorder
• related to lack of sunlight
• Light therapy for treatment
• Depression with Postpartum Onset
• severe depression within one month of childbirth
• Premenstrual Dysphoric Disorder
• DSM labeling controversy

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Theories of Depression

• Psychoanalytic
• depressed people are like mourners
• not consciously aware of what they have lost

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Theories (continued)

• Behavioral
• Improper levels of rewards and punishments
• Failure to learn coping skills
• studies of children with depressed mothers
• Cognitive
• Learned Helplessness
• Self defeating schemas
• locus of control
• pessimism

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Biological Factors

• Genetics
• MZ twins 50 - 93 concordance rate
• DZ twins 0 - 40 concordance rate
• Brain Abnormalities
• Left hemisphere disturbance
• low GSR response in right hand
• left hemisphere damage (eg. Strokes) leads to
  depression

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More Biological Factors

• Catecholamine hypothesis
• low levels of seratonin and/or norepinephrine
• Hormonal factors
• Cortisol
• stress hormone elevated in depressed people
• Sleep disorders
• increased REM activity early in sleep cycle

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Antidepressant Drugs

• MAOIs (monoamine oxidase inhibitors)
• Block MAO enzyme from mopping up norepinephrine
  and seratonin
• Nardil and Parnate
• Side effects dizziness, insomnia, impotence,
  high blood pressure
• dirty drug

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More Antidepressant Drugs

• Tricyclics (TCAs)
• Blocks reuptake of norepinephrine and seratonin
• Trofanil, Elavil, Norpramin
• Side effects interactions with foods, low blood
  pressure, sluggishness dizziness, blurred vision,
  constipation, weight gain
• No standard dose
• Requires blood monitoring

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Still More Antidepressants

• SSRIs (Selective Seratonin Reuptake Inhibitor)
• Fluoxetine (Prozac), Zoloft, Paxil, Luvox
• Targets seratonin
• less dirty
• easier to regulate dosage
• Side Effects headache, nausea, insomnia, weight
  loss, loss of sexual interest, loss or delay of
  orgasm

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Herbal Remedy

• St. Johns Wort
• widely used in Europe
• little known about long term risks
• may be placebo effect

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Lithium Carbonate

• a salt compound used to treat Bipolar Disorder
• blood monitoring required
• patients often refuse to take
• side effects weight gain, tremors, drowsiness,
  damage to heart, kidneys, thyroid