Neurological Disorders
Psychological Disorders
10 million people suffer from depression
Mood Disorders
Mood Disorders•Unipolar Disorder (2 wks to 9 mos)
•Major Depressive Disorder, Single Episode (MDDSE)•rare
•Major Depressive Disorder, Recurrent (MDDR)•family history is common
•Dysthymic Disorder (DD)•milder symptoms•chronic occurrence (2-30yrs)
•Double Depression•combination or MDDR and DD
•Bipolar Disorder (2 wks to 9 mos)•Bipolar I Disorder•Bipolar II Disorder (hypomania)
•Dysphoric Mania•manic episodes with simultaneous depression
•Cyclothymic Disorder (mild bipolar)
Major Depressive
Episode Characteristics
•Onset is in early to mid 20’s•but not age specific
•Onset age has been dropping
•16% of population experienceMDD in their lifetime
•2:1 women to men ratio
•41% occurs just before or justafter menstruation
Depression: Etiology
Biological Influencegenetic predispostionneurochemical imbalancestress hormones
Psychological/Behavioral Influencelearned helplessness/hopelessnessdepressive attributional styledisturbed sleep habits
Social Influencestressful events serve as triggers
Mood Disorders among Twins
Depression and Neurochemistry
Depression and Stress Hormones
Depression and Sleep
Phase advanced body temperature rhythms
Enter REM sleep earlier in the night
Spend little time in SWS
Depression: Treatment
MedicalChemicalElectroconvulsive Shock Therapy
PsychotherapyCognitive Behavioral TherapyInterpersonal Therapy
Chemical Treatment•Tricyclic Antidepressants
•imipramine (Tofranil)•prevents monoamine reuptake•64% respond well•many side effects
•Monoamine Oxidase Inhibitors•phenelzine (Nardil)•blocks MAO enzyme
•which breaks down monoamines•<64% respond well•several lethal side effects
•Selective Serotonin Reuptake Inhibitors (SSRIs)•fluoxetine (Prozac)•blocks reuptake of serotonin•minor side effects
Electroconvulsive Shock Therapy
•for patients where drugs are ineffective or that can’t wait for drugs to take effect•electric shock to the cortex for less than 1 second•creates seizure and mild convulsions•takes about 6-10 sessions every other day•some short term memory loss•50-70% beneficial•60% relapse rate
(ECT)
Cognitive Behavioral Therapy
•make patient examine thought process and recognize errors•arbitrary interference•overgeneralization
•try to correct cognitive errors•concentrate on less depressive thoughts - be more realistic
•target negative cognitive schemes•use journals to identify faulty thinking•do hypothesis testing•put fun back into the patients life•increase exercise•takes about 10-20 sessions
Interpersonal Therapy
•resolve problems in existing relationships•identify life stressors•work on interpersonal disputes
•role disputes•loss of a relationship•acquiring new relationships•identifying and correcting deficits in social skills
•takes about 15-20 sessions
Depressions Vicious Cycle
Must control brain chemistry
e.g., Prozac
Must reshape the negative thought processes
e.g., CBT
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