Download Ch. 18 Section 4: Somatoform Disorders

Ch. 18 Section 5: Mood
Disorders
Obj: Describe how psychologists
attempt to explain mood disorders
Most people have mood changes that reflect the
normal ups and downs of daily life. They feel
down when things go wrong, such as failing an
important test, and they feel up when good
things happen.
Some people, however, experience mood changes
that seem inappropriate for or inconsistent with
the situations to which they are responding.
These people feel sad when things are going well,
or they feel elated for no apparent reason. People
who have abnormal moods such as these may
have a mood disorder.
Mood disorders fall into two general categories.
Depression typically involves feelings of
helplessness, hopelessness, worthlessness,
guilt, and great sadness. Bipolar disorder
involves a cycle of mood changes from
depression to wild elation and back again.
Mood disorders – particularly depression – are
very common psychological disorders. In any
six-month period, about 8 percent of women
and 4 percent of men are likely to be
diagnosed with some level of depression.
Types of Mood Disorders
The DSM-IV classifies
mood disorders into
several different types
of depressive and
bipolar disorders.
• Major Depression – Depression is by far the
most common of all the psychological
disorders. It has been estimated that
depression affects more than 100 million
people worldwide and that between 8 and 18
percent of the general population will
experience depression in their lifetime.
According to the DSM-IV, major depression is
diagnosed when an individual experiences at
least five of the following nine symptoms of
depression.
• Persistent depressed mood for most of the day
• Loss of interest or pleasure in all, or almost all,
activities
• Significant weight loss or gain due to changes in
appetite
• Sleeping more or less than usual
• Speeding up or slowing down of physical and
emotional reactions
• Fatigue or loss of energy
• Feelings of worthlessness or unfounded guilt
• Reduced ability to concentrate or make
meaningful decisions
• Recurrent thoughts of death or suicide
For a diagnosis of major depression to be made, at
least one of the individual's five symptoms must
be one of the first two symptoms in the list.
Additionally, the symptoms must be present for
at least two weeks, and occur nearly every day
during that period.
Severely depressed individuals may become
consumed by feelings of worthlessness or guilt.
Severe depression calls for immediate treatment
– as many as 15 percent of severely depressed
individuals eventually commit suicide.
• Bipolar Disorder – Formerly called manic
depression, bipolar disorder is characterized
by dramatic ups and downs in mood. Periods
of mania, or extreme excitement
characterized by hyperactivity and chaotic
behavior, can change into depression very
quickly and for no apparent reason.
The manic phase is characterized by a mood that is
persistently and abnormally elevated. In some
people, however, this phase may be characterized
by irritability instead of elation. Manic moods are
also characterized by at least some of the
following traits:
• Inflated self-esteem
• Inability to sit still or sleep restfully
• Pressure to keep talking and switching from topic
to topic
• Racing thoughts (referred to as “flight of ideas”)
• Difficulty concentrating
Individuals in the manic phase may appear highly excited
and act silly or argumentative. In severe cases, they
may have delusions (beliefs that have no basis in
reality) about their own superior abilities or about
others being jealous of them. They may also
experience hallucinations (sensory perceptions that
occur in the absence of sensory stimuli) such as
hearing imaginary voices or seeing things that are not
really there. These individuals ma also engage in
impulsive behaviors, such as going on wild spending
sprees, quitting their jobs to pursue wild dreams, or
making foolish business investments. Thus, the manic
phase of bipolar disorder can be very disruptive to an
individual’s life.
Explaining Mood Disorders
Psychological and
biological theories have
been proposed to
explain why such a large
number of people
experience mood
disorders, particularly
depression.
• Psychological Views – The psychoanalytic
view of depression is that some people are
prone to depression because they suffered a
real or imagined loss of a loved object or
person in childhood. According to this view,
the child feels anger toward the lost object or
person but, instead of expressing the anger,
internalizes it and directs it toward himself or
herself. This leads to feelings of guilt and loss
of self-esteem, which in turn leads to
depression.
Learning theorists have suggested other
explanations for depression. Some believe that
learned helplessness makes people prone to
depression. Psychologist Martin Seligman
demonstrated the concept of learned
helplessness in a classic experiment in which he
taught dogs that they were helpless to escape
from electric shock. First, he placed a barrier in
the dogs’ cage to prevent them from leaving
when shock was administered. Later the barrier
was removed. However, when shocks were again
administered, the dogs made no effort to escape.
They had apparently learned there was nothing
they could do to prevent the pain.
This helpless behavior has been compared to
the helplessness often seen in people who are
depressed. Learning theorists argue that
people prone to depression have learned
through experience to believe that previous
events in their lives were out of their control.
This leads them to expect that future events
will be out of their control as well. As a result,
whenever a negative event occurs, these
people feel helpless, and this leads to
depression.
In contrast, cognitive theorists have suggested that
some people are prone to depression because of
their habitual style of explaining life events.
According to this view, people assign different
types of explanations to most events – internal or
external, stable or unstable, and global or
specific. These attributional styles affect people’s
self-esteem and self-efficacy. These styles also
relate to expectancy – what people expect based
on prior experiences. Suppose, for example, that
someone goes on a date that does not work out.
Different ways to explain this might include the
following:
• “I really messed up” (internal explanation, places
blame on self.)
• “Some people just don’t get along” (external
explanation, places the blame elsewhere).
• “It’s my personality” (stable explanation, suggests
problem cannot be changed.)
• “It was my head cold” (unstable explanation,
suggests problem is temporary).
• “I have no idea what to do when I’m with other
people” (global explanation, suggests problem is
too large to deal with).
• “I have difficulty making small talk” (specific
explanation, suggests problem is small enough to
be manageable).
Research shows that people who are depressed are more
likely than other people to explain their failures on
internal, stable, and global causes – causes they feel
helpless to change. Cognitive theorists argue that such
explanations give rise to feelings of helplessness, which
in turn lead to depression.
Another cognitive theory was proposed by Aaron Beck,
who suggested that people who are depressed have a
negative view of themselves, their experiences, and
their future. According to Beck, this is because people
who are depressed have negative self-schemas,
developed from negative experiences in early
childhood. This leads them to filter out positive
information and perceive negative information as more
negative than it really is. Such negativity, Beck argued,
makes people prone to depression.
• Biological Views – Other researchers have
investigated biological factors in mood disorders.
Mood disorders, like anxiety disorders, tend to
occur more often in the close relatives of affected
individuals than they do in the general
population. Between 20 and 25 percent of people
with mood disorders have a family member who
is affected by a similar disorder. Moreover,
identical twins of affected individuals are more
likely to be affected than fraternal twins. These
studies seem to indicate that mood disorders
have genetic basis.
Scientists believe that two neurotransmitters, or
chemical messengers, in the brain – serotonin
and noradrenaline – may at least partly explain
the connection between genes and mood.
Serotonin and noradrenaline both play a role in
mood regulation. Low levels, or deficiencies, of
serotonin may create a tendency toward mood
disorders in general. Deficiencies of serotonin
combined with deficiencies of noradrenaline,
however, may be linked to depression specifically.
These findings have been important in the
development of drug therapy for the treatment
of mood disorders.
• Biological and Psychological Factors – many cases of
depression may reflect the interaction of biological
factors such as neurotransmitter levels and
psychological factors such as learned helplessness. This
has been demonstrated with laboratory animals.
Seligman and Weiss found that dogs that learned they
were helpless to escape electric shocks also had less
noradrenaline activity in their brains. Helplessness is
thus linked to specific neurotransmitter deficiencies.
The relationship may result in a vicious cycle. A
depressing situation may slow down the activity of
noradrenaline in the brain; in turn, the chemical
changes may then worsen the depression.