Depression and Depression and BiPolar Disorder BiPolar Disorder

““I am now the most miserable man I am now the most miserable man living. If what I feel were distributed to living. If what I feel were distributed to the entire human family there would not the entire human family there would not be one happy face on earth.” -Abraham be one happy face on earth.” -Abraham

LincolnLincoln

Abe and Mary Lincoln: Case Abe and Mary Lincoln: Case studies in depression and bipolar studies in depression and bipolar

disorderdisorder Lincoln’s early life was beset by tragedy including Lincoln’s early life was beset by tragedy including

watching his mother dies from a horrible illness watching his mother dies from a horrible illness and helping to make her coffinand helping to make her coffin

Throughout his adult life Lincoln was plagued by Throughout his adult life Lincoln was plagued by depression, which he was open about calling it depression, which he was open about calling it “hypo” short for hypochondria“hypo” short for hypochondria

Lincoln suffered two nervous breakdowns-so Lincoln suffered two nervous breakdowns-so severe that both times his friends mounted suicide severe that both times his friends mounted suicide watcheswatches

As a young man Lincoln stopped carrying a knife As a young man Lincoln stopped carrying a knife because he feared he would commit suicide because he feared he would commit suicide

Abe and Mary Lincoln: Case Abe and Mary Lincoln: Case studies in depression and bipolar studies in depression and bipolar

disorderdisorder

As teenager Lincoln watched one of his friends go As teenager Lincoln watched one of his friends go mad and attempt to kill his mother, for years mad and attempt to kill his mother, for years afterward he was plagued by the fear he would afterward he was plagued by the fear he would do this too. He eventually wrote a poem about itdo this too. He eventually wrote a poem about it

Even in the White House, Lincoln frequently Even in the White House, Lincoln frequently spoke of his fear that he may commit suicidespoke of his fear that he may commit suicide

In the days before he was assassinated he had a In the days before he was assassinated he had a dream of his own assassination and told he wife dream of his own assassination and told he wife and his cabinet about itand his cabinet about it

DepressionDepression

More women than menMore women than men Most episodes will last less than 6 Most episodes will last less than 6

months and will cure themselvesmonths and will cure themselves Number one reason people seek Number one reason people seek

psychological helppsychological help

Genetic FactorsGenetic Factors

Genetic predispositionGenetic predisposition Depletion of norepinephrine and Depletion of norepinephrine and

serotoninserotonin Goal of drug therapy to block Goal of drug therapy to block

reuptake or chemical breakdownreuptake or chemical breakdown EXERCISE also naturally increases EXERCISE also naturally increases

serotonin levelsserotonin levels

CognitionCognition

Self-defeating beliefs can arise Self-defeating beliefs can arise from learned helplessness (being from learned helplessness (being in a situation where an in a situation where an individual’s actions have no individual’s actions have no effect on the outcome)effect on the outcome)

ATTRIBUTIONAL STYLE!ATTRIBUTIONAL STYLE!

How does a person explain How does a person explain events- Pessimistic explanation events- Pessimistic explanation can lead to depressioncan lead to depression

GlobalGlobal StableStable InternalInternal

Mary Lincoln: BiPolar?Mary Lincoln: BiPolar?

In the early years and continuing throughout In the early years and continuing throughout the years in the White House Mary Lincoln’s the years in the White House Mary Lincoln’s tantrums were legendary. She was frequently tantrums were legendary. She was frequently seen physically attacking Lincolnseen physically attacking Lincoln

Mary Lincoln obsessively bought material for Mary Lincoln obsessively bought material for curtains while First Lady. She hid her curtains while First Lady. She hid her excessive spending and spent sleepless nights excessive spending and spent sleepless nights before the second election fearing that if before the second election fearing that if Lincoln were not reelected her excessive Lincoln were not reelected her excessive spending would be revealed. Congress spending would be revealed. Congress eventually investigated.eventually investigated.

In the White House Mary Lincoln In the White House Mary Lincoln conducted séances to speak to her conducted séances to speak to her two dead sonstwo dead sons

She spent days on end locked in her She spent days on end locked in her room cryingroom crying

After the assassination Mary went After the assassination Mary went into a deep depression, lost her into a deep depression, lost her ability to care for herself and reason ability to care for herself and reason and was eventually committed to an and was eventually committed to an institution in Batavia, ILinstitution in Batavia, IL

Bi-Polar DisorderBi-Polar Disorder

Less common than major depressionLess common than major depression Occurs equally between women and Occurs equally between women and

menmen Milder forms seem attractiveMilder forms seem attractive Worsens without medicationWorsens without medication Most commonly treated with lithiumMost commonly treated with lithium

Symptoms of Mania in BiPolar Symptoms of Mania in BiPolar DisorderDisorder

MoodMood- Expansive, euphoric, elevated- Expansive, euphoric, elevated

CognitionCognition- Grandiose- no limits to what - Grandiose- no limits to what can be accomplished, flight of ideas can be accomplished, flight of ideas BUT can be delusional and unrealisticBUT can be delusional and unrealistic

Actions-Actions- intrusive, dominating quality, intrusive, dominating quality, reckless, compulsive (often spending reckless, compulsive (often spending $)$)

Physical-Physical- Needs little sleep until the Needs little sleep until the crash sets in usually within dayscrash sets in usually within days