Mood Disorders: Major Depression

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Mood Disorders Major Depression
02-28-05
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Mood disorders involve the extremes of mood,
ranging from depression (deep sadness) to mania
(wild elation). Depression is 10 times more
prevalent than mania.
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Depression involves symptoms in 4 major
psychological domains

• Affective (i.e., emotions)
• Cognitive (i.e., thoughts/perceptions)
• Behavioral
• Physiological

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Affective Symptoms of Depression

• Sadness
• Feelings of worthlessness
• Feelings of apathy/hopelessness
• Anhedonia (i.e., loss of pleasure or interest in
  activities or things)

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Cognitive Symptoms of Depression

• Pessimism
• Trouble concentrating
• Thoughts/feelings of guilt/self-blame
• Loss of motivation/disinterest
• Recurrent thoughts of death/suicide

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Behavioral Symptoms of Depression

• Lack of energy fatigue
• Social withdrawal
• Neglect of personal appearance
• Psychomotor retardation (i.e., lethargy slowing
  of movements, responses, speech) or psychomotor
  agitation (i.e., restlessness)
• Crying

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Physiological Symptoms of Depression

• Decreased or increased appetite/weight loss or
  gain
• Sleep disturbance Insomnia (trouble sleeping) or
  hypersomnia (excessive sleeping)
• Disruption of menstrual cycle in women
• Decline in sexual desire

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Classifications of Mood Disorders

• UNIPOLAR DISORDERS (depressed mood only)
  Major
  Depression Dysthymic
  Disorder
• BIPOLAR DISORDERS (depressed and manic/hypomanic
  mood) Bipolar I Disorder
  Bipolar II Disorder
  Cyclothymic Disorder

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Major Depression (MDD)

• Symptoms of depression are present for at least 2
  weeks, represent a significant change in
  functioning
• At least one of the following 1) depressed mood,
  2) anhedonia (loss of interest or pleasure)
• Classified as Single Episode or Recurrent Episodes

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Dysthymic Disorder

• Chronic, continual, and less severe symptoms of
  depression that are present for at least 2 years
• Individuals may have double depression major
  depressive episode during the course of dysthymic
  disorder

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Etiology of Mood Disorders
The Tragedy, Picasso 1903
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Psychodynamic Theory

• Separation and Anger
• Separation may be real or symbolic loss
• Depressed people are overly dependent because
  they are fixated in the oral stage (Freud, 1917)
• Anger turned against the self

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Cognitive-BehavioralTheories of Depression

• Lewinsohns Behavioral Theory
• Becks Cognitive Theory
• Seligmans Learned Helplessness / Attributional
  Style

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Lewinsohns Behavioral Theory of Depression

• Depression is linked with low rates of, or a loss
  of, positive reinforcement
• Access to positive reinforcement is linked to
  three primary factors (see next slide)

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Lewinsohns Behavioral Theory Potentially
reinforcing events

• The number, range, or intensity of accessible
  events or activities that are potentially
  reinforcing to the person may be limited by a
  multitude of factors (e.g., age, gender, physical
  and personality characteristics)

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Lewinsohns Behavioral TheoryAvailability of
reinforcement in the environment

• Access to positive reinforcement might be limited
  in harsh or isolated environments
• Access might decrease after the death of a loved
  one or another change in ones social network

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Lewinsohns Behavioral TheoryInstrumental
behavior of the individual

• Social skills and behaviors are important in
  eliciting positive reinforcement. Typical
  behaviors of depressed individuals may limit
  and/or decrease positive reinforcement (e.g.,
  social isolation, pessimistic talk, preoccupation
  with self, lethargy).

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Becks Cognitive Theoryof Depression

• The schema of a depressed person is characterized
  by a negative cognitive triad far-reaching
  pessimistic views of the SELF, the WORLD, and the
  FUTURE
• Cognitive biases/distortions include Arbitrary
  inference, Selective abstraction,
  Overgeneralization, and Magnification/minimization
  

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Cognitive BiasArbitrary Inference

• Drawing conclusions on the basis of insufficient
  evidence or the lack of any evidence at all
• Example A man concludes that he is worthless
  because it is raining the day he is hosting an
  outdoor party.

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Cognitive BiasSelective Abstraction

• Drawing conclusions on the basis of one minor
  and/or trivial aspect of a situation, which may
  be interpreted out of context, and ignoring the
  bigger picture.
• Example A worker feels worthless when a product
  fails to function, even thought she is only one
  of many people who contributed to its production.

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Cognitive BiasOvergeneralization

• Drawing an overall, sweeping conclusion on the
  basis of a single event.
• Example A student regards his poor performance
  in a single class on one particular day as final
  proof of his worthlessness and stupidity.

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Cognitive BiasMagnification/Minimization

• Exaggerations in evaluating performance
  overestimating weaknesses and playing down
  strengths.
• Example A man, believing that he has completely
  ruined his car (magnification) when he sees that
  there is a slight scratch on the rear fender,
  regards himself as good-for-nothing. A woman
  believes herself worthless (minimization) in
  spite of a succession of praiseworthy
  achievements.

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Seligmans Learned Helplessness Theory of
Depression

• A persons susceptibility to depression depends
  on her past experiences with controlling the
  environment
• If a person sees that her actions continually
  have very little effect on the environment, this
  expectation may be reinforced and depression may
  develop
• Learned helplessness an acquired belief that
  one is unable to affect the outcomes in ones
  life

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Attribution Style (Abramson)

• People who feel helpless make causal attributions
  about why they are helpless attributions may be
  internal or external, stable or unstable, and
  global or specific
• Individuals who make INTERNAL, STABLE, and GLOBAL
  attributions about their helplessness are more
  likely to be depressed

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