MOOD DISORDERS

DYSTHYMIA

n      Most common form of depression

n       Experience mild but persistent depression

n       Low energy

n       Disturbance in sleeping and eating

n       Tendency toward low self esteem

n       Suicidal ideation

n      Easiest to treat

n      Slow gradual onset in adolescence

n      Has relatives with dysthymia

Bipolar I Disorder

n      Times of depression altered normal times and then with manic episodes, normal…

n      Only have to have one manic/mixed episode to qualify for manic depression

n      At least one depressive episode

n      Chemically driven

n      Psychotic features during manic episodes

Bipolar II Disorder - Cyclothymia

n      Experience cycle every 3-4 months

n      Gentle roller coaster distinction

n      One depressive episode

n      One hypomanic episode/ criteria not met for manic or mixed episode

n      More predictable

n      Chemically driven

n      Cyclothymic = chronic pattern

Symptoms of Depression–

n      Cognitive

n       Low self-esteem, self-blame, hopeless, helpless

n       Inability to concentrate, suicidal/homicidal

n      Emotional

n       Sadness

n       Loss of interest

n       Loss of pleasure

Motivational Symptoms

n      Lack of response and initiation

n      Difficulty making decisions

n      Motor activity

Somatic symptoms

n      Appetite disturbance – over/under eating

n      Sleep disturbance

n      Psychomotor retardation – reflexes don’t work

Course of  Depression

n      Time does not do all of the healing

n      Complete recovery in 70-95% of cases

n      Three patterns

n      Recovery without recurrence 50%

n      Recovery, but some recurrence 40%

n      Chronic depression 10 % of the time

Treatment of Major Depression

n      Drugs

n       Prozac

n       Paxil – very effective, but not liked

n       Zoloft

n       Elevil – Amitriptoline (given for back pain)

Theoretical Perspective of Depression

n      Psychodynamic Model

n      Views depression as anger turned inward

n      Treatment relies on catharsis

n      Cognitive Model

n      Views depression as cognitive distortions

n      Challenge faulty belief system

n      Beliefs influence attitude and behavior

Suicide

n      Depression and stress is most common reason for suicide

n      Preceded by exit events – giving away…

n      Hopelessness – useful predictor

n      Attempters do not wish to die but are communicating intensity of feeling

n      Suicide notes express suffering

Elements of Suicide Scenario

n      Pain – related to unmet psychological needs

n      Self-denigration

n      Constriction of mind

n      Sense of isolation

n      Hopelessness

n      Decision that egression only solution to problem