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Transcript 
Mood Disorders
Lesson 25
Mental Illness: Definition
Characteristically Controversial
 *Disorder vs socially unacceptable
 Deviations from normal
 *Behavior, Cognition & Affect
 Harmful dysfunction

Distress

Impairment
 Magnitude & duration ~

Mood Disorders
Unipolar depression
 Mania
 Bipolar disorder
 Seasonal Affective Disorder (SAD) ~

Unipolar Depression
Extreme sadness & despair
 extent & duration important
 Prevalence
 females 9-26%
 males 5-12%


2:1 females
Genetic component
 Concordance twins: DZ (25%), MZ (70%)
 Endogenous vs. reactive ~

Diagnosis & Symptoms
Disrupted eating & sleeping
 increased or decreased
 Impaired concentration
 Changes in activity
 increased or decreased
 Feelings of guilt / worthlessness
 Preoccupation w/ death or suicide ~

Diagnosis & Symptoms
NOT
 uncomplicated bereavement
 organic
 Diagnosis
 5 of 9 symptoms



not complete list
duration > 2 weeks ~
Treatment
Psychotherapy
 Drug Therapy
 Electroconvulsive-shock Therapy
 Sleep Deprivation
 Light Therapy ~

Etiology
Evidence from drug side effects
 Produce depression
 reserpine – monoamines
 propranalol - NE antagonist
 Catecholamine hypothesis
 DA & NE
 Deficiency ~

Drug Treatment: 1st Generation
Monoamine oxidase inhibitors – MAOIs
 more NT in synapse
 Cheese effect - tyramine
 risk of cerebral hemorrhage
 Tricyclic Antidepressants
 Block monoamine reuptake
 Sympathetic arousal
 Possible overdose ~

2d Generation: SSRIs

Selective serotonin reuptake inhibitors
 Prozac (fluoxetine)



Zoloft (sertraline)
Paxil (paroxetine)
Luvox (fluvoxamine)
Blocks 5HT reuptake
 Less effect on NE & DA
 5HT modulates others?
 Monoamine Hypothesis
 5HT, NE, DA ~

Criticisms
Immediate effects on NT level
 Therapeutic effects  2-4 weeks
 Explanation?
 Compensatory responses
 Autoreceptor desensitization
 Tetracyclic Antidepressants
 Block reuptake & autoreceptors
 Faster therapeutic effects
 but still a delay ~

Mania & Bipolar
Mania Symptoms
 Euphoria
 grandiose plans
 reduced need for sleep
 high risk activities
 Bipolar Disorder
 Cycling between mania &
depression ~

Etiology
Induced by drugs
 Monoamine agonists
 cocaine, amphetamine, antidepressants
 Mostly NE & DA
 Treatment
 Lithium – mechanism unknown
 Anticonvulsants & atypical neuroleptics ~

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