Background interest o Prolonged periods of low mood o

Background

v  History

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o  
Adaptive; contingency of survival

o  
Resource conservation

§  Decrease
appetite

§  Low
energy level

§  Low
motivation

o  
Social competition

§  View
depression as a way to defeat

o  
Attachment

§  Loss
of interpersonal relationships

§  Signaling
for help

o  
Some argue that it is “neither a syndrome
or adaptive” (nature of clinical depression, page 7)

v  basics  

o  
7.6% people above 12 have depression

§  Pretty
high rate

o  
Most common illness

o  
Leading cause of disability

o  
In the world, 350 million affected

o  
More common among women

o  
Types

§  Unipolar

·        
One mood

§  Bipolar

·        
Two moods alternating

§  Postpartum

·        
After delivering baby

§  Seasonal
pattern

·        
Reduced daylight leads to depression

o  
Countries with longer winters affected
more

v  Characteristics/symptoms

o  
Lack of joy

o  
Reduced interest

o  
Prolonged periods of low mood

o  
Feeling of sadness

o  
Loss of interest

o  
Unintentional weight loss/ low appetite

o  
Insomnia/ hypersomnia

o  
Fatigue/loss of energy

o  
Unable to think or concentrate

v  Diagnosis

o  
Starts with a consultation with a doctor

§  Safe
and accurate diagnosis

o  
Questions help them see severity of
depression

§  Hamilton
depression rating scale

o  
Individual screening instead of general

o  
Two item patient health questionnaire

v  Causes

o  
Genetics

§  Having
parents with depression

§  Three
to four times greater chance

o  
Biological (brain)

§  After
puberty

§  Hormonal
changes when maturing

§  Changes
to neuroendocrine system

§  Brain
changes

·        
Neural circuits and modulatory systems
linked to depression

·        
Both circuits mature with age

·        
Both have sex differences

·        
First circuit

o  
Amygdala to hippocampus and to prefrontal
cortex

§  Linked
to hypothalamic pituitary adrenal axis

o  
Increased activity

o  
High concentrations of sex steroid
receptors

§  Women
at higher risk

·        
Second circuit

o  
Striatum to PFC and to ventral
dopamine-based systems

o  
Reduced activity

o  
Environmental

§  Child
trauma

§  Past
head injury

o  
Psychosocial

§  Personality

§  Stressful
life events

·        
Parents’ divorce

·        
War

·        
Abuse/torture

·        
orphan hood

v  Treatment

o  
Support

§  Parents

§  Counselors

§  Teachers

§  Psychiatrist

o  
Psychotherapy- usually first option; can
be used with other treatments

§  Cognitive-behavioral
therapy

·        
Individual or group sessions

·        
Over telephone or face-to-face

·        
Can also be given over computer

§  Interpersonal
therapy

·        
Figure out emotional problems that alter
their relationships and communication

o  
How they affect mood

§  Problem-solving

o  
Drugs

§  Antidepressants-
with prescription

·        
Selective serotonin reuptake inhibitors

·        
Monoamine oxidase inhibitors

·        
Tricyclic antidepressants

·        
Atypical depressants

·        
Selective serotonin and norepinephrine reuptake
inhibitors

§  Affects
different neurotransmitters

§  Used
as prescribed even if symptoms go away

§  Can
increase suicidal feelings in some people

o  
Other

§  Exercise

·        
Raises endorphin levels

·        
Stimulates neurotransmitter

o  
Related to mood

§  Brain
stimulation therapies

·        
Electro conclusive therapy

o  
Used when drugs don’t work

o  
Effective for psychotic depression

·        
Magnetic pulses to brain

o  
May or may not work