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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 experience
MDD in their lifetime
•2:1 women to men ratio
•41% occurs just before or just
after menstruation
Depression: Etiology
Biological Influence
genetic predispostion
neurochemical imbalance
stress hormones
Psychological/Behavioral Influence
learned helplessness/hopelessness
depressive attributional style
disturbed sleep habits
Social Influence
stressful 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
Medical
Chemical
Electroconvulsive Shock Therapy
Psychotherapy
Cognitive Behavioral Therapy
Interpersonal 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
(ECT)
•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
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