List TEN goals that you have.

Complete TEN sentences starting with “I am….”

DO NOW!

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Affective Disorders

DEPRESSION

Affective (Emotional)

- Loss of interest/pleasure

- Worthlessness- Guilt

Behavioral- Passivity- Lack of initiative

Cognitive (Thinking)- Difficulty

concentrating- Negative thoughts- Misplaced blame- Low self-esteem- Hopelessness- Indecisiveness

Somatic (Physical)- Insomnia/hypersomnia- Appetite change

- Weight loss/gain- Loss of energy- Low libido (sex drive)

Symptomology

Client must present one A list symptom and at least 4 others: A LIST SYMPTOMS:

Depressed mood Loss of interest in activities that used to be enjoyed

B LIST SYMPTOMS: Insomnia/hypersomnia Appetite change Loss of energy Feeling worthless Difficulty concentrating Suicidal thoughts

Symptomology

Major Depressive Disorder what we normally

think of! Dystemia

‘lite’ depression Seasonal Affective

Disorder (S.A.D.) winter =

Bipolar Disorder- ½ depression, ½

mania.. Different types!

TYPES

AT RISK POPULATIONS 2-3x more common in women 15% of the population is depressed at one point

in their lifetime Higher in lower economic bracket Higher in Jewish males (= to women) 17 million Americans a year

PROGNOSIS Reccurent in 80% of those who experience at

least one depressive episode Average of 4 episodes

Prevalance Rates

Role of Genetics Moffit (2006): followed 1000+ NZ subjects from 1972-

2006. Recorded life stressors. Looked at LONG vs SHORT serotonin transporter gene (5-HTT)

Depression after 4+ stressful experiences in 5 years: 33% with short gene depressed 17% with long gene depressed So… Long gene works BETTER!

Role of Neurotransmitters ↓ serotonin = ↑ chance of depression

Role of Hormones Diathesis Stress Model

Stress releases the hormone CORTISOL, which is linked with depression

Vulnerability (genes, prenatal effects) + STRESS = ↑ chance of depressionBiological Etiology (Cause)

Role of Cognitions Thoughts of hopelessness, pessimistic thinking,

low self esteem. Depresses cognitions, cognitive distortions, and

irrational beliefs produce disturbances in mood. Alloy (1999)

Followed Americans in their twenties. Thinking style was tested and students were placed into positive or negative thinking groups

After 6 years, only 1% of those in the positive thinking group had developed depression, 17% of the negative thinking group

Cognitive Etiology

Thoughts

ActionsFeelings

Role of Culture Individualistic Cultures: value the individual

over the group Symptoms: sad, hopeless, worthless, loss of interest

Collectivist Cultures: value the group/whole over the individual Symptoms: headache, tired, stomachache, backacheSociocultural Etiology

Drug Therapy Types of medication

Mood stabilizers- help even out highs/lows Antidepressants- help lift the symptoms of

depression Antipsychotics- primarily treat symptoms of

mania Thase (2003)

Meta-analysis of 7 clinical trials looking at remission of depression rates SSRIs (Prozac) = 35% SNRI (Effexor) = 45% Placebo = 25%

Significance: placebo effect almost as effective! We haven’t perfected antidepressants….

Treatment Options: Biological!

Electroconvulsive Therapy (ECT) Applies a small amount of electrical

current to the brain Causes mild seizures, which changes brain

chemistry Effective in treating SEVERE depression Controversial!!

Side effects- confusion and memory loss

Treatment Options: Biological!

Cognitive Behavioral Therapy (CBT) Combines cognitive and behavioral therapy Goal: change the automatic thoughts that

contribute to negative emotions Cognitive Therapy:

Focuses on how thought affect emotions and behaviors Behavioral Therapy:

Concentrates on changing a person’s reaction to challenging situations

Hollon (2005) Patients relapsed when stopped meds = 76% Patients relapsed when given CBT = 31% Significance:

CBT helps people learn to COPE Medicine covers symptoms, doesn’t cure/treat the CAUSE.Treatment Options:

Cognitive!