Question

Abnormal Psychology: Depressive & Bipolar Disorders

Answer 1

Note: This is a reference for educational/studying purposes, not a question, please save all comments or questions for the end.

Answer 2

\({\bf{Basic~Terminology}}\)

-depression: low state marked by sadness, guilt, low self-worth, low energy, and related symptoms
-mania: high state marked by energy and heightened activity
-unipolar depression: depression w/o mania
-bipolar disorder: marked by periods of alternating/mixed periods of mania and depression
-major depressive episode: 2 weeks + w/ 5+ symptoms including sadness/ahedonia
-reactive/exogenous depression: depression following clear, stressful events
-endogenous depression: depression as a result of internal factors

\({\bf{Unipolar~Depression}}\)

- affects about 9% in the United States per year (severe) 5% (mild)
- 18% of adults have an episode at least once
- affects women more than men
- 85% recover w/o treatment
- headaches, dizziness, general pain

- symptoms:
emotional (sad, dejected, ahedonia)
lack of motivation
lack of activity/productivity
low self-esteem, pessimism

- diagnoses:
- major depressive disorder: major depressive episode w/o mania, can be seasonal, catatonic, peripartum, melancholic (marked by extreme ahedonia)
- persistent depressive disorder: long-lasting, can be marked by major depressive episodes or dysthmic symptoms
- pre-menstraul dysphoric disorder: clinically significant symptoms the week before menstruation

Answer 3

\({\bf{Factors~of~Unipolar~Depression}}\)

Biological:
- genetic, chromosome abnormalities
- low levels of serotonin/norepinephrine
- abnormal endocrine system, release of cortisol and melatonin
- activity w/in neurons, deficiencies of proteins/other molecules
- abnormal brain circuit involving prefrontal cortex, hippocampus, amygdala, Brodmann Area 25
- abnormal immune system/lymphocyte production

Psychodynamic:
- regression to early stages of development/dependency
- redirection of feelings towards a lost loved one towards oneself
- symbolic/imagined loss: equation of tragic events to the loss of a loved one

Behavioral:
- positive rewards in life dwindle over time if not actively sought out/reinforced
- lack of social rewards

Cognitive:
- learned helplessness: people become depressed when they 1) lack control over their reinforcements and 2) believe that they are responsible for their state
- attribution-heplessness theory: attributing lack of control to an internal, global, and stable cause, they are more likely to experience depression/hopelessness
- negative thinking/maladaptive attitudes from the cognitive triad: experiences, themselves, and their futures are interpreted negatively
- automatic thoughts: hopeless, steady thoughts that happen by reflex

Sociocultural:
- lack of social networks
- interpersonal conflicts

Multicultural: seeks to explain why women are more diagnosed than men + why certain racial/ethnic demographics are diagnosed more than others
- artifact theory: men and women are equally prone to depression but diagnosing is harder in men because they tend to mask their depression
- hormone explanation: hormonal changes in a woman's development can be attributed to hormonal changes such as puberty/pregnancy/menopause
- life stress theory: women are more subject to poverty/have to bear disproportionate share of childcare/housework
- body dissatisfaction: higher expectations of appearance, lower satisfaction with one's body/weight
- lack of control theory: women feel like they have less control over their lives than men do, are more likely to be victims of sexual assault/child abuse
- rumination theory; women are more likely to ruminate on negative emotions/thoughts

- rates of depression among ethnic groups are similar but certain minorities (Hispanic and African Americans) are more likely to experience recurrence in depression b/c of limited treatment options/economic instability

Answer 4

\({\bf{Treatments~of~Unipolar~Depression}}\)

Biological:
- ECT
- MAO inhibitors: slow the production of MAO (monoamine oxidase) from destroying norepinephrine
- trycyclics: slowing the reuptake of norepinephrine/serotonin
- ssRIs: selective serotonin reuptake inhibitors, increase serotonin
- antidepressants fail for 35% of the population and can cause side effects like drowsiness, weight gain, decreased sex drive
- vagus nerve stimulation: attaching pulse generator to chest and delivering electric signals to the vagus nerve
- transcranial magnetic stimulation: placing electromagnetic coil on patient's head to send current into prefrontal cortex
- deep brain stimulation: drilling small holes in skull and implanting electrodes to sent small pulse to Area 25

Psychodynamic:
- Psychotherapy to address trauma caused by losses in youth
- short-term seems to be more effective because depressed patients may lack the motivation/attention span required for long-term psychotherapy

Behavioral:
- introducing positive, pleasurable activities (behavioral activation)
- reinforcing positive behaviors instead of negative ones
- social skills training
- effective only when multiple of these treatments are combined

Cognitive:
- increasing activities and elevating mood
- challenging automatic thoughts
- identifying negative thinking/biases
- changing primary attitudes

Sociocultural:
- family therapy/couples therapy
- interpersonal psychotherapy: addressing interpersonal loss, interpersonal role dispute (conflict between expectations of oneself and how to resolve them), interpersonal role transition, and interpersonal deficits (lack of certain social skills)

Multicultural:
- culture-sensitive therapy: recognizing the effect of one's own culture and the dominant culture on their self-esteem and behaviors

Answer 5

\({\bf{Bipolar~Disorder}}\)

- full manic episode: 1+ week of heightened mood, increased energy, 3+ symptoms of mania
- symptoms of mania: heightened emotions (can be happiness but also anger/irritability), active behavior, flamboyance, poor judgment, energetic, lack of sleep, need for constant excitement
- rapid cycling: 4 + episodes w/in a year
- tends to recur without treatment


\({\bf{Types}}\)
- bipolar I: full manic and depressive episodes which can be alternating or mixed
- bipolar II: hypomanic alternating with major depressive episodes
- cyclothymic: hypomania with mild depressive symptoms
- milder symptoms can escalate into type I or II

- types I and II are equally common in men/women
- usually begins in adolescence/early adulthood

Answer 6

\({\bf{Factors}}\)

- overactivity of norepinephrine, low serotonin
- abnormal ion activity w/in neurons
- structural abnormalities in basal ganglia,cerebellum, amygdala, hippocampus, prefrontal cortex
- genetics

\({\bf{Treatments}}\)
- lithium
- antibipolar drugs (carbamazepine and valproate) that act on second messengers and increase the production of neuroprotective proteins
- adjunctive psychotherapy: improving social skills/coping mechanisms, can be used in addition to medications to reduce the rate of relapse

Answer 7

Anyway, that's all for this topic, I hope it was of use to you! If you have any questions I will address them to the best of my ability (you may have better luck contacting me on my main account, Vocaloid)

Source: Fundamentals of Abnormal Psychology, Eighth Edition, Ronald J. Comer