Understanding Depressive and Bipolar Disorders: Causes, Symptoms, and Treatment

Depressive and Bipolar Disorders - Depression: Low, sad state market by significant levels of sadness, lack of energy, low self- Worth, guilt, or related symptoms - Mania: State or episode of euphoria or frenzied activity in which people may have an Exaggerated belief that the world is theirs for the taking. - Depressive disorders: Group of disorders marked by unipolar depression - Unipolar depression: Depressing without a history of mania - Bipolar disorder: Disorder marked by alternating or intermixed periods of mania and Depression Unipolar Depression: The Depressive Disorders - How common is unipolar depression? - 8 percent of U.S adults suffer from severe unipolar depression in any given year; 5 Percent suffer from mild forms. - 20 percent of all adults experience unipolar depression at some time in their lives - Average age of onset is 19 years - Higher rate among chronically ill elderly people - Symptoms - Emotional symptoms - Motivational symptoms - Behavioral symptoms - Cognitive symptoms - Physical symptoms

- DSM-5 lists several types of depressive disorders - Major depressive disorder - Persistent depressive disorder - Premenstrual dysphoric disorder - Major depressive episode - For a 2-week period, person displays an increase in depressed mood for the majority Of each day and/or a decrease in enjoyment or interest across most activities for the Majority of each day - For the same 2 weeks, person also experiences at least 3 or 4 of the following Symptoms - Considerable weight change or appetite change - Daily insomnia or hypersomnia - Daily agitation or decrease in motor activity - Daily fatigue or lethargy - Daily feelings of worthlessness or excessive guilt - Daily reduction in concentration or decisiveness - Repeated focus on death or suicide, a suicide plan, or a suicide attempt - Significant distress or impairment - Major depressive disorder - Presence of a major depressive episode - No pattern of mania or hypomania - Persistent depressive disorder

- Person experiences the symptoms oof major or mild depression for at least 2 years - During the 2-year period, symptoms do not absent for more than 2 months at a time - No history of mania or hypomania - Significant distress or impairment Psych Watch: Sadness at the Happiest of Times - Postpartum depression - Symptoms may last up to year or more - Extreme sadness, despair, tearfulness, insomnia, anxiety, intrusive thoughts, Compulsions, panic attacks, inability to cope, suicidal thoughts. - Impact on mother-infant relationship and child well-being - Causes - Triggered by hormonal changes of childbirth - Genetic predisposition - Psychological and social change - Treatment - Self-help groups - Antidepressant medications, cognitive-behavioral therapy, interpersonal Psychotherapy, or combination of these - Treatment helps most women if it is sought What Causes Unipolar Depression? - Biological view - Studies of genetic factors, biochemical factors, brain circuits, and the immune system

Suggest unipolar depression has biological causes. - Genetic factors - Family pedigree studies - Twin studies - Gene studies - Molecular biology - Biochemical factors - Low activity of two neurotransmitters: serotonin and norepinephrine - Early studies on high blood pressure and antidepressant drugs - Later neurotransmitter interaction research - Hormones and HPA pathway - Stress studies - Dracula hormone: seasonal affective disorder - Brain circuits - Brain circuit dysfunction - Brain imaging studies - subgenual cingulate makes a distinct contribution - Abnormal activity and flow rate in various brain locations - Structure problems: interconnectivity - Abnormal neurotransmitter activity - Immune system - Under intense stress, dysregulation of the immune system occurs and

Contributes to depression. - Slower functioning of lymphocytes, increased CRP production, and Greater inflammation - Higher incidence of migraines, irritable bowel syndrome, chronic fatigue Syndrome, rheumatoid arthritis, and other illnesses caused by CPR production. And body inflammation - Psychological view: psychodynamic view - Freud and Abraham: when some people experience real or imagined losses - Regression to an earlier stage of development - Introjection of feelings for the lost object - Eventually becoming depressed - Object relations theorists: Depression results when people ’ s relationships leave Them feeling unsafe and insecure. - Strengths - General research support: Depression may be triggered by major loss. Early losses set the stage for later depression. - Depression after loss related to poorly met childhood needs - Limitations - Early losses and inadequate parenting sometimes lead to depression but May not be typically responsible for development of the disorder. - Many research findings are inconsistent - Certain features of the model are nearly impossible to test

- Psychological views: cognitive-behavioral view - Depression results from problematic behaviors and dysfunctional thinking - Theoretical perspectives - Behavioral dimension - Number of life rewards related to presence or absence of Depression - Large reduction in positive life rewards may cause increasingly Fewer positive behaviors, even lower positive rewards rate, and Eventual depression - Social rewards are important in downward depression spiral - Negative thinking - Beck: Unipolar depression is produced by a combination of Maladaptive attitudes, cognitive triad, errors in thinking, and Automatic thoughts - Seligman learned helplessness theory: Depression occurs when People feel loss of control over life reinforcements - Complex cognitive and behavioral factor interplay Mind Tech: Texting; A Relationship Buster? - Texting is the leading communication medium for most people - Some researchers suggest texting may negatively affect relationships - Avoidance of direct communication of possible confrontations - Reduction of emotional connections

- Misunderstandings and relationship damage - Broader feelings of stress and unhappiness