What are mood disorders?
Are composed of different types of mood episodes
Periods of depressed or elevated mood lasting days or week
Major depressive episodes, persistent depression, manic and hypomanic episodes
What are the two depressive disorders?
Major depressive disorder and persistent depressive disorder
New: premenstrual dysphoric disorder, disruptive mood dysregulation disorder
What are some of the symptoms of a major depressive episode?
- Anhedonia
- Obsessive sense of guilt and grief
- Psychomotor retardation
- Early morning wakening
- Loss of appetite
- Lack of “approach behavior” like motivation
- Increased stress hormone
- Poor concentration
- Suicidal ideations/ attempts
How is the brain metabolism affected by depression?
There is a profound decrease in brain metabolism in depressed patients
How do patients with major depression compare to those with a frontal lobe tumor?
- Both had performance deficits
- No significant difference was found
- They concluded that executive functioning is abnormal in patients with depression and compares to the patients with frontal damage due to tumors
What are some stress responses during a depressive episode?
- Dysregulation of HPA: too much cortisol
- Damages hippocampus and surrounding brain areas
- Changes the shape, size, and number of neurons
- Suppresses nerve cell growth in a part of the hippocampus
- Damages prefrontal cortex and the amygdala - smaller in people with recurrent depression
What is the learned helplessness theory of depression?
- Lack of perceived control over life events leads to decreased attempts to improve own situation
- Negative cognitive styles are a risk factor for depression
What is the depressive attributional style?
- Internal attributions: negative outcomes are one’s own fault (It’s me, my fault)
- Stable attributions: believing future negative outcomes will be one’s fault (it’s going to last forever)
- Global attribution: believing negative events will disrupt many life activities (it’s going to undermine everything i do)
All three contribute to a sense of hopelessness
What are negative coping styles in the cognitive theory?
- depressed persons engage in cognitive errors such as arbitrary inference and overgeneralization
- tendency to interpret life events negatively
What is arbitrary inference?
Overemphasize the negative aspects of mixed situations
What is overgeneralization?
Negatives apply to all situations
What is the depressive cognitive triad?
- Thinking negatively about oneself
- Thinking negatively about the world
- Thinking negatively about the future
What is the habenula?
- It “talks” to the systems that control the neurotransmitters on the pleasure pathways and activation of the stress response
- It is associated with reward processing, motivational behavior, and behavioral adaptation
- It controls thinking about things as “disappointment”
- It fires when we have a feeling of disappointment
How is deep brain stimulation of the lateral habenula used in the treatment of major depression?
- There is an overactivation of the habenula in human major depression episodes
- It has anti-depressive properties
What is ketamine?
- It is a very old drug that was first manufactured in the 1960s
- The FDA approved it as an anesthetic during the Vietnam War in 1970
- It was abused because people liked the psychosis
- Used for anesthesia - dissociative anesthetic
- In the 1990s low doses were used for chronic pain
- An ideal alternative to other sedation medications because it maintains cardiovascular stability
What is suicide?
- Suicide represents an escape from an intolerable situation
- Suicide can be an act of aggression
- Suicide can be an act of sacrifice or in relation to some higher values
- Suicide performed in the context of games or undergoing an ordeal in order to prove oneself
