Mood Disorders

Mood Disorders

Diagnosing Depression
1. depressed mood, reoccuring thoughts of death, faigue or loss of energy everyday, insomnia or hyposomnia everyday, feelings of worthlessness or excessive or innapropriate guilt, diminished ability to think or concentrate, diminished interest or pleasure in most things, singnificant weight loss
  1. five or more symptoms in a 2 week period for unipolar depression
2. Bipolar depression- symptoms of both depression and mania must be experiences, patients are unaware that anything wrong in the manic phase and four or more symptoms are experience
  1. Cognitive symptoms- delusional ideas, auditory or visual hallucinations, makes reckless or irrational decisions showing little regard for the effects on others, though patterns are severely disrupted
  2. Emotional symptoms- feeling euphoric, strongly denies there is anything wrong, may become irritable with those around them that try to interfere and shows a lack of guilt
  3. Behavioural symptoms- a marked increase in work, sexual or social activity, may become more talkative or speak faster, an inability to stay still of quiet, can be a loss of social inhibition and may become reckless
  4. Physical symptoms- sleep very little and have lots of energy
Biological
1. Genetics
  1. Family studies
    1. Winokur (1995) rate of unipolar depression was 10.4% in 1st degree relatives of probates compared to the 4.9% in controls
    2. Weissman et al (1987) found that approximately 50% of the offspring of depressives display depressive symptoms
    3. Gershon (1990) found that the rates if depression in 1st degree relative ranged from 7% and 30%
      1. The younger the person is that is diagnosed the higher the chance that a relative also has depression
    4. Weissman (1984) found relatives of people diagnosed with depression before the age of 20 have an 8X greater chance of being diagnosed themselves
    5. genes may only increase the susceptibility that the person has to develop depression
  2. Twin studies
    1. McGuffin et al (1996) found that there was a 46% concordance rate for MZ twins and 20% for DZ twins
    2. Twin studies cannot rule out the environment like adoption studies can
  3. Adoption studies
    1. Prince et al (1968) found concordance rates of 68% for DZ twins that were raised together and 67% when raised apart.
2. Neurochemical
  1. depression is caused by a deficiency in monoamines (noradrenaline, dopamine and serotonin )
  2. Lemonick (1997) drugs used to treat depression raise levels of noradrenaline and serotonin
  3. Cooper at al (1988) Resopine, used to treat high blood pressure led to a reduction in the availability of noradrenaline leading to depressive symptoms
3. Structure and function
  1. the limbic system and frontal lobes are implicated in depression
  2. CT scans and MRI scans have found enlarged ventricles and decreased volume in the hypocampus and basal ganglia
  3. PET scans have found changed in cerebral blood flow in the pre frontal cortex, amygdala and thalamus
Cognitive
1. Beck's Dysfunctional Thinking Theory
  1. Negative self schema: the information that we take in will confirm the negative belief and ignore evidence of the contrary
    1. Schema: can process info selectively and fast due to expectation
  2. The triad of impairments: refers to the automatic negative cognitions that a person prone to depression emphasises about themselves, the world and the future
  3. Faulty information processing: individuals selectively attend interpretations and overgeneralise and magnify adversity
  4. Dysfunctional thinking only causes depression if there has been a critical life event
2. Cognitive biases
  1. Minimisation: bias towards minimising success
  2. Magnification: bias towards magnifying even trivial failures
  3. Negative abstraction: bias towards focusing on only the nagative aspects of life and ignoring the wider picture
  4. All or nothing: see life in terms of black and white, you are either a success or a failure, there is not middle ground
Behavioural
1. Ferster (19974) when a persons responses are no longer positively reinforced it can lead to depression e.g. the death of a relative
2. Learned Helplessness Theory: Seligman (1974) suggested that people suffer from depression because they have developed a learned belief that they are not in control of their own lives. Deficits occur in different areas
3. Lewinson and Gotlib (1995) suggested that a failure to recieve positive reinforcement leads to a reduction in effort and then to even less reinforcement
4. the disorder may lead to the concern of others and therefore reinforcing depressive behaviour
Psychodynamic
1. potential to become depressed is created in the oral stage who suffer from low self esteem and become overly dependent on others
2. following the loss of a loved one the person goes through a stage of introjection, this process results in the person taking into themselves any negative feeling towards the loved one and resenting their desertion and feeling guilty
  1. the following period of mourning allows for a separation to be made, in overly dependent people the emotional bonds cannot be broken and anger continues to be turned inwards, resulting in depression

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