Abnormal Psychology

1. Abnormal Psychology Chapter 8 Mood Disorders and Suicide

2. Mood Disorders Characterized by emotional extremes Unusually severe or prolonged Impairs one�s ability to function

3. Major Depressive Disorder(MDD) Mood disorder in which a person, for no apparent reason, experiences 2+ weeks of: Depressed moods Feelings of worthlessness Diminished interest/pleasure in most activities Major depression - #1 reason people seek help from mental health specialists

4. Major Depressive Disorder(continued) Symptoms: Poor appetite Insomnia/sleep much of the time Lethargy Feelings of worthlessness Loss of interest in family, friends and activities

5. Major Depressive Disorder(continued) Depression can be brought on by: Situational cues (laid-off/fired, ending of a relationship, etc.) No apparent cause Depressed people are especially: Sensitive to negative happenings Expect negative outcomes Are more likely to recall negative information

6. Major Depressive Disorder(continued) Some facts about major depression: Women are 2x�s as vulnerable as men 10-25% as opposed to 5-12% If untreated, most episodes last (3?) 6 months or less; some episodes have lasted 2+ yrs. Young adults in America are 3x�s more likely to develop depression than their grandparents

7. Major Depressive Disorder(continued) More facts Stressful events (work, marriage, etc.) often precede depression Average age of onset - mid-20�s (can occur at any age); lowest onset � 65 and older 15% of people suffering from severe depression commit suicide

8. Major Depressive Disorder(continued) More facts: Some people experience a single major depressive episode; most experience multiple episodes/lifetime The more episodes you have, the more you are likely to have About 2/3�s of the depressed pop. eventually experience no more episodes; it is chronic in about 1/3 of the depressed pop.

9. Theoretical Perspectives inDepressive Disorders Stress Stressful situations ? depression Loss of job, relationship, financial difficulties, etc. Psychodynamic � self-focusing model In times of loss, some people become self-absorbed Focusing only on one�s loss ? depression

10. Theoretical Perspectives inDepressive Disorders Humanistic Loss of meaning in one�s life ? not striving toward self-actualization ? guilt ? depression Depression can result when our self esteem takes a hit ? Loss of self-worth Learning Lack of reinforcement ? lack of motivation ? depression; Seligman�s learned helplessness

11. Theoretical Perspectives inDepressive Disorders Cognitive Cognitive triad of depression Negative view of oneself Negative view of the environment Excessive demands, things too difficult to overcome, etc. Negative view of the future Biological Less activity in prefrontal cortex

12. Theoretical Perspectives inDepressive Disorders Biological Depression may be caused by abnormalities In metabolism In the release and/or transmission of serotonin or norepinephrine

13. Seasonal Affective Disorder Mood swings that are consistent with the changing of the seasons (esp. from summer to fall and winter) Cause ? unknown Could be related to decrease in serotonin production during fall/winter months Could be a result of less sunlight/more darkness during the fall/winter months

14. Seasonal Affective Disorder(continued) Behavioral characteristics: Fatigue/lethargic Excessive sleeping Craving carbohydrates Weight gain

15. Seasonal Affective Disorder(continued) Standard Treatment: 30 min. of 10,000-lux, diffused white fluorescent lighting Usually admin. daily, early in morning Seems to relieve symptoms, though we don�t know why Full remission in almost 50% of patients Rate climbs to 80% if tailored to sleep-wake cycle

16. Postpartum Depression (PPD) Onset of mood changes after the birth of a child Hormonal changes often cause new mothers to experience mood swings Onset must occur within 4 weeks of childbirth Women with postpartum depression suffer mood swings for months to 1+ yrs (usually not as severe as major depressive disorder)

17. Postpartum Depression(continued) Behavioral characteristics of PPD: Low self-esteem Poor appetite Sleep disturbances Difficulty concentrating/getting motivated

18. Postpartum Depression Potential Psychotic Features Occur in 1-500 to 1-1,000 deliveries Command hallucinations to kill the baby Delusions Child is possessed Has special powers Doomed to a terrible fate Suicidal ideation

19. Postpartum Depression(continued) Risk factors: Financial concerns Troubled marriage Lack of social support (esp. from father) Unwanted/sickly baby Previous history of depression

20. Dysthymic Disorder Chronically depressed mood Occurs for most of the day, more days than not, for at least two years In children, it need only last 1 year to be characterized as dysthymic disorder Person feels down in the dumps most of the time (E.g.: Eeyore from Winnie the Pooh)

21. Dysthymic Disorder(continued) Differs from MDD in that: The onset usually occurs during childhood or adolescence Onset occurs gradually; usually chronic with episodes lasting for years Less severe; usually doesn�t interfere with normal functioning

22. Dysthymic Disorder(continued) Behavioral symptoms: Poor appetite/overeating Insomnia/excessive sleeping Lethargy Low self-esteem Poor concentration/difficulty making decisions Feelings of hopelessness Irritable/cranky (children only)

23. Bipolar Disorder Mood disorder in which a person alternates between: Hopelessness and lethargy of major depression The overexcited state of mania (hyperactive, wildly optimistic state Onset: usually in late 20�s to early 30�s Major depressive episodes previously discussed

24. Bipolar Disorder Bipolar I At least one manic episode May not have had a depressive episode It is assumed one will be had or was overlooked Bipolar II Milder forms of mania More frequent depressive episodes Mixed type Both manic and depressive episodes occur almost daily

25. Bipolar Disorder(continued) During the manic phase the person may display some or all of the following: Over-talkative; rapid speech (pressure speech); speech is loud, flighty (rapid flight of ideas) and difficult to interrupt Overactive (but irritated by others telling them to slow down) Elated Have little need to sleep

26. Bipolar Disorder(continued) Show fewer sexual inhibitions Demonstrate grandiose optimism/self-esteem Demonstrate poor judgment/decision making skills

27. Cycling Through Bipolar Disorder Usually, bipolars will cycle through manic and depressed periods (lasting a few weeks to several months in duration) 2 or 3 times per year Some bipolars are �rapid cyclers;� they experience 2 or more full cycles with no normal mood periods in between (very rare)

28. The Stuff Of Geniuses? In milder forms of mania, the energy and free-flowing thinking can fuel creativity. Many famous people have been diagnosed with bipolar disorder Van Gogh, Ben Stiller, Carrie Fisher, Margot Kidder, Linda Hamilton, Martin Lawrence, Sting, Axl Rose, DMX, Bobby Brown, etc. It has been speculated that Beethoven and Thomas Jefferson also had bipolar disorder

29. Theoretical Perspectives in Bipolar Disorders Psychodynamic Dominance shifts between ego and superego Biological New theory � certain chromosomes may predispose one to bipolar disorder Diathesis-stress model Stress + biological influences + predisposition

30. Cyclothymic Disorder Must last at least 2 yrs: Manic symptoms are not severe enough to be labeled as manic episodes Depressive symptoms are not severe enough to be labeled as major depressive episodes Symptom-free periods last less than 2 months Person is often regarded as temperamental, moody, unpredictable, inconsistent or unreliable

31. Theoretical Perspectives: Additional Factors Genetics: 52% of people with MDD have a relative who suffers from some type of mood disorder 86% of people with bipolar disorder have a relative who suffers from some type of mood disorder When one monozygotic twin has a mood disorder there is a 70% chance the twin will too

32. Suicide: Taking One�s Own Life Myths about suicide: People who talk about suicide aren�t likely to commit the act 90% talk about it prior to the attempt 75% of those who succeed talked about it Why they talk about it Cry for help; taunt others

33. Suicide(myths continued) Suicide is committed without warning They talk about it They start giving cherished possessions away May make statements such as �I can�t go on this way� or �the world�s better off w/out me Suicidal people are fully intent on dying Few want to die (about 3-5%) Unable to see options

34. Suicide(myths continued) The motives for suicide are easily established We really don�t know why people commit suicide A tendency to commit suicide is inherited It does tend to run in families But it may be a learned behavior

35. Suicide(myths continued) Women kill themselves more often then men Women attempt suicide 3x as frequently as men Men kill themselves almost 4x as often as women When a suicidal person has been depressed and suddenly snaps out of it they are less likely to commit suicide

36. A Few Facts About Suicide:General Statistics According to the National Institute of Mental Health (NIMH), in 2004 (latest info) 32,439 people committed suicide in U.S. 11th leading cause of death 10.9 deaths per 100,000 people 14.3 for people aged 65+ For every death by suicide 8-25 are attempted

37. A Few Facts About Suicide:Ethnic Groups & Race Highest rates: Non-Hispanic Whites � 12.9 per 100,000 American Indian and Alaska Natives � 12.4 per 100,000 Lowest rates: Non-Hispanic Blacks � 5.3 per 100,000 Asian and Pacific Islanders � 5.8 per 100,000 Hispanics � 5.9 per 100,000

38. A Few Facts About Suicide:Those Who Are Left Behind No other type of death leaves relatives and friends with such long-lasting feelings of distress, shame, guilt, puzzlement, and general disturbance. Survivors of those who kill themselves have a high mortality rate within the next year of their lives

39. Questions About Suicide What are the most common method used to commit suicide? For both sexes, the most common way of killing oneself is by use of a firearm Men: firearms and hanging Women: firearms and self-poisoning

40. Questions About Suicide What factors put one at risk of committing suicide? Mental illness Impulsive/aggressive tendencies Substance abuse Family history of suicide/suicide attempts Previous suicide attempts Having been sexually abused

41. What You Should Do If You Suspect Someone Is Suicidal Act on your suspicions; err on side of caution Try to get them to open up to you. Stay with them if you feel they are suicidal Get them to promise not to attempt suicide for 24 hours Call a hotline, take to a walk-in clinic Alert family/friends But only after asking the person who they would like you to call�don�t call without asking first!

42. What You Should Do If You Suspect Someone Is Suicidal Do not tell them that you understand or that everything will be alright You don�t understand how they feel and they know that You don�t know that things will be alright, and they know that too Make them aware of the things they have to live for Marriage, having children, fulfilling dreams, etc.

43. Per the PATH Website If you or someone you know is in a crisis and need help right away: Call this toll-free number, available 24 hours a day, every day: 1-800-570-7284�OR 309-827-4005 The above is the crisis number for PATH, a service available to anyone. Website address: http://pathcrisis.org/page/14am2/Contact_Us.html