25 Things To Know. mood. disorders

Transcription

1 25 Things To Know mood disorders

2 Mood Disorders Depression Bipolar Anxiety

3 Depression Major Depressive Disorder Lasts for weeks at a time

4 Depression Symptoms Lack energy & pleasure Helpless Sad

5 Depression Symptoms Little pleasure from sex or food Trouble concentrating Trouble sleeping Suicidal thoughts

6 Depression Symptoms Thoughts of suicide or death Don t enjoy usual activities Feel worthless, sad, guilty Pull away from friends

7 Depression Findings React normally to sad images React normally to fearful images Rarely smile are happy images Rarely laugh at jokes Decreased R to likely reward

8 Depression 5% of US adults Childhood depression Equal for boys and girls Beyond 14, more common in females

9 Depression Range Long-term depression More common to have episodes periods of normal mood

10 Depression Range First episode longest More intense first episode Easier to start another

11 Depression Causes Genetics Infection Estrogen Brain abnormalities

12 1. Genetics Early-onset (before age 30) More relatives with depression Bulimia, irritable bowel syndrome Alcohol or marijuana abuse Anxiety & migraines ADHD & OCD

13 1. Genetics Late onset (after 45 to 50) Relatives have circulatory problems

14 2. Infections Viral infections in farm animals? Borna disease 1/3 have it

15 2. Infections Borna disease Infectious neurotropic virus Abnormal behavior Death

16 3. Estrogen Estrogen connection More women than men Postpartum depression 20% of mothers Recover quickly

17 4. Brain Abnormalities Hemisphere Dominance Decreased activity in left hemisphere Increased activity in right prefrontal cortex

18 Treatments Untreated Recover within few months Episodes

19 Drugs Some respond to one drug and not another Antipsychotic drugs Antidepressant drugs

20 Drugs Takes effect minutes to hours weeks before mood elevation

21 Antidepressant Drugs 1. Tricyclics Prevent reuptake of serotonin+ 2. SSRIs Prevent reuptake of serotonin fluoxetine (Prozac)

22 Antidepressant Drugs 3. SNRIs Block reuptake of serotonin & norepinephrine 4. MAOIs Monoamine oxidase inhibitors Block enzyme from metabolizing

23 Antidepressant Drugs 5. Atypical antidepressants bupropion (Wellbutrin) inhibits reuptake of dopamine & some norepinephrine

24 Drugs Placebo vs drug Mild to moderate depression No clear benefit Severe depression Drugs don t always work

25 Drugs Placebo results often overlap with drug group mild to moderate depression no benefit of drug over placebo severe depression antidepressants don t always work

26 Treatments ECT Electroconvulsive Therapy Seizures with electric shock Every other day for two weeks

27 Treatments ECT Invented by Ladislas Meduna 1930 s for schizophrenia ineffectual on schizophrenia Overused in 1950 s

28 Treatments ECT Major side effect = memory loss Lasts for several months 50% relapse within 6 months If used alone

29 Treatments Altered Sleep Patterns Sleep problems precede mood changes More eye movements in REM Enter REM within 45 minutes 80 minutes for non-depressed Like jet lag

30 Treatments Change sleep cycle Stay awake all night Alternate sleep schedule

31 Treatments Exercise Regular, non-strenuous exercise increase blood flow to brain

32 Unipolar vs Biploar Unipolar Between depression & normal Bipolar disorder (also called manic-depressive) between depression & mania

33 Mood Disorders Manic Side effects of steroids & SSRIs Drug intoxication (cocaine & amphetamine) Tumors Mood disorder

34 Mood Disorders Manic Presence of mania = bipolar Don t need to have been depressed

35 Mood Disorders Manic Cyclical changes in mood Even if never hit depression Sleep (too much, too little)

36 Bipolar I Large swings Switch between good moods (happy, highly active, up) bad moods (irritable, angry, depressed)

37 Bipolar I Men & women (about equal) Starts early: years old

38 Bipolar I Also called manic-depression At least 1 manic episode Often many depressive episodes Mania can last for day or months

39 Bipolar I Cause Unknown More likely among relatives

40 Bipolar I Triggers Medications (antidepressants, steroids) Sleeplessness Drug abuse Childbirth

41 Bipolar I Manic Symptoms Elevated mood; boost of energy Don t sleep much (not tired) Easily distracted Racing thoughts

42 Bipolar I Manic Symptoms Bursts of cleaning, doing Talking more or faster Overestimate abilities

43 Bipolar I Manic Symptoms Poor self control Binge eating, drinking or drugs Promiscuity Spending Temper

44 Bipolar I Manic Symptoms Restless activity Excitement & laughter Self-confidence Rambling speech Loss of inhibitions

45 Mood Disorders Bipolar I = large swings II = sad and guilty Cyclothmia = bipolar light

46 Bipolar II Alternate between Sad and guilty Never had manic episode

47 Bipolar II Alternate between High energy-impulsiveness Depression Milder episodes Also called hypomania

48 Bipolar II More common in women More depression More mixed episodes mania & depression at same time

49 Bipolar II Women 3x more likely to also have: Alcoholism Anxiety disorder

50 Bipolar II Women more likely to be rapidcyclers 1+ episode per year

51 Bipolar II Genetics Strong hereditary basis Twin studies Two genes increase probability of bipolar II

52 Bipolar II Genetics Same genes predispose major depression predispose bipolar disorder

53 All Types High risk of suicide Both when manic & depressed Manic & depressive moods can overlap

54 Treatment Drugs for mood stabilization Carbamazepine (anti-convulse) Lamotrigine (anti-seizure) Lithium (anti-manic) Valproic acid (anti-seizure)

55 Treatment Lithium salts Most effective therapy Don t know why

56 Treatment Consistent sleep schedule

57 SAD Seasonal Affective Disorder (SAD) Usually in winter Most common closest to poles

58 SAD Seasonal Affective Disorder Treatment Expose to very bright lights for about an hour early in morning or evening

59 Anxiety Disorders Generalized Anxiety Disorder Obsessive-Compulsive Panic Disorder Social Phobia PTSD

60 Generalize Anxiety Extremely worried Little or no reason to worry Anxious about getting thru day Fear things will go bad

61 Generalize Anxiety Develops slowly Often starts as teen Symptoms come & go Worse under stress

62 Generalize Anxiety Symptoms Headaches Trouble falling asleep Excessive worry Aware you re worrying Easily startled, can t relax

63 Generalize Anxiety Symptoms Unexplained pain Stomach aches Difficulty swallowing Tremors, twitches

64 Generalize Anxiety Can run in families No clear genetic link

65 Generalize Anxiety Treated with combo of: Medications Anti-anxiety Anti-depressants Therapy Thinking, breathing

66 Anxiety Disorders Generalized Anxiety Disorder Obsessive-Compulsive Panic Disorder Social Phobia PTSD

67 OCD Episodes Obsessions: upsetting thoughts Compulsions: stress reducers

68 OCD Development Starts in childhood or teen Most diagnosed by age 19

69 OCD Symptoms Need to repeatedly check things Repeated thoughts or images Fear of dirt, gems, intruders Routines & rituals Spend 1+ hrs per day

70 OCD Symptoms Prefer round numbers (lucky) Count lines in paragraph Wash hair three times Morning routine

71 OCD Runs in families No direct genetic link

72 OCD Cognitive therapy fear without obsessive thoughts Exposure-Response prevention See image, change response

73 OCD Medication Anti-anxiety medications Antidepressants Work better than anti-anxiety 2-3 months to work

74 Anxiety Disorders Generalized Anxiety Disorder Obsessive-Compulsive Panic Disorder Social Phobia PTSD

75 Panic Disorder Frequent periods of anxiety Occasional attacks Rapid breathing Increased heart rate Sweating

76 Panic Disorder Symptoms Fear for several minutes Fear of disaster Fear losing control May feel like heart attack Worry about next attack

77 Panic Disorder Young Women More common in women More in adolescent & young adult

78 Treatment GABA main inhibitory NT in amygdala GABA blockers induce panic

79 Treatment Benzodiazepines Diazepam Chlordiazepoxide Alprazolam

80 Treatment Benzodiazepines bind to GABAA receptor receptor changes shape attach easily & bind more

81 Treatment Benzodiazepines Affect amygdala, midbrain & hypothalamus+ Can be addictive

82 Treatment Benzodiazepines Temporary relief Beta-blockers Less sweat & pounding heart

83 Treatment Propranolol Drug Affects synapses in amygdala Interferes with protein synthesis Weakens emotional R Persisting decrease in fear intensity

84 Panic Disorder Runs in families No direct genetic link

85 Anxiety Disorders Generalized Anxiety Disorder Obsessive-Compulsive Panic Disorder Social Phobia PTSD

86 Social Phobia Strong fear of being judged Strong feeling of embarrassed Fear gets in way of work, etc

87 Social Phobia Afraid of doing common things in front of others sign a check in front of a cashier eat or drink in front of others use a public restroom

88 Social Phobia Know its irrational Can't control the fear

89 Social Phobia Starts as child-adolescent Diagnoses if symptoms last 6 months+ Can last for many years

90 Social Phobia Symptoms Anxious being with other people Hard time talking to others Self-conscious Afraid others will judge them Worry for days before an event

91 Social Phobia Symptoms Avoid groups & crowds Blush or sweat around people Feel nauseous when with others

92 Social Phobia Afraid of being called on in school Hate to meet with my boss Don t eat lunch with co-workers Worried about being stared at Heart pounds if go to meeting Can t eat or sleep for days before staff meeting

93 Anxiety Disorders Generalized Anxiety Disorder Obsessive-Compulsive Panic Disorder Social Phobia PTSD

94 PTSD Anxiety disorder Some get, not most See event (observer) In event (participant)

95 PTSD Who gets PTSD? Anyone Any age

96 PTSD Symptoms Three categories: 1. Re-experiencing symptoms Flashbacks Bad dreams Frightening thoughts

97 PTSD Symptoms 2. Avoidance symptoms Stay away from places, events Avoid reminders of experience Emotionally numb Guilty, depressed or worried

98 PTSD Symptoms 2. Avoidance symptoms Loss of interest hobbies, etc Difficulty remembering event

99 PTSD Symptoms 3. Hyperarousal symptoms Relatively constant symptoms Not triggered

100 PTSD Symptoms 3. Hyperarousal symptoms Easily startled Feel tense or on edge Trouble sleeping Angry outbursts

101 PTSD Diagnosis 1 month+ 1+ re-experiencing symptom 3+ avoidance symptoms 2+ hyperarousal symptoms

102 PTSD Some get it but not all Most don t Risk factors Resilience factors

103 PTSD Risk factors Previous dangerous events History of mental illness Getting hurt Seeing people hurt or killed Lack of social support after event

104 PTSD Resilience factors Support group Feeling did right thing Coping strategies Respond even though afraid

105 PTSD Medications 1. Zoloft 2. Paxil

106 PTSD Both are antidepressants sadness, worry, anger & numb Side effects annoying but go away (few days) headaches, nausea, sleepy

107 PTSD Other medications Benzodiazepines relax and sleep may cause memory problems or become dependency

108 PTSD Other medications Antipsychotics Tend to gain weight Other antidepressants Prozac & Celexa Feel less tense or sad Co-occurring depression

109 Biological Psych.com