Abnormal Ch. 8

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					Abnormal Psychology

       Chapter 8
Mood Disorders and Suicide
            Mood Disorders
• Characterized by emotional extremes
  – Unusually severe or prolonged
  – Impairs one’s ability to function
    Major Depressive Disorder
• 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
      Major Depressive Disorder
• Symptoms:
  –   Poor appetite
  –   Insomnia/sleep much of the time
  –   Lethargy
  –   Feelings of worthlessness
  –   Loss of interest in family, friends and activities
    Major Depressive Disorder
• 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
    Major Depressive Disorder
• 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
    Major Depressive Disorder
• 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
    Major Depressive Disorder
• More facts:
  – Some people experience a single major
    depressive episode; most experience multiple
  – 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.
    Theoretical Perspectives in
      Depressive Disorders
• Stress
  – Stressful situations  depression
     • Loss of job, relationship, financial difficulties, etc.
• Psychodynamic – self-focusing model
  – In times of loss, some people become self-
     • Focusing only on one’s loss  depression
    Theoretical Perspectives in
      Depressive 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
    Theoretical Perspectives in
      Depressive 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
    Theoretical Perspectives in
      Depressive Disorders
• Biological
  – Depression may be caused by abnormalities
     • In metabolism
     • In the release and/or transmission of serotonin or
   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
   Seasonal Affective Disorder
• Behavioral characteristics:
  –   Fatigue/lethargic
  –   Excessive sleeping
  –   Craving carbohydrates
  –   Weight gain
   Seasonal Affective Disorder
• 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
  Postpartum Depression (PPD)
• Onset of mood changes after the birth of a
  – 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)
         Postpartum Depression
• Behavioral characteristics of PPD:
  –   Low self-esteem
  –   Poor appetite
  –   Sleep disturbances
  –   Difficulty concentrating/getting motivated
       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
         Postpartum Depression
• Risk factors:
  –   Financial concerns
  –   Troubled marriage
  –   Lack of social support (esp. from father)
  –   Unwanted/sickly baby
  –   Previous history of depression
          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)
         Dysthymic Disorder
• Differs from MDD in that:
  – The onset usually occurs during childhood or
  – Onset occurs gradually; usually chronic with
    episodes lasting for years
  – Less severe; usually doesn’t interfere with
    normal functioning
           Dysthymic Disorder
• Behavioral symptoms:
  –   Poor appetite/overeating
  –   Insomnia/excessive sleeping
  –   Lethargy
  –   Low self-esteem
  –   Poor concentration/difficulty making decisions
  –   Feelings of hopelessness
  –   Irritable/cranky (children only)
           Bipolar Disorder
• Mood disorder in which a person alternates
  – 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
               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
            Bipolar Disorder
• 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
         Bipolar Disorder
– Show fewer sexual inhibitions
– Demonstrate grandiose optimism/self-esteem
– Demonstrate poor judgment/decision making
     Cycling Through Bipolar
• 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)
       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
    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
        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
     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
  – When one monozygotic twin has a mood
    disorder there is a 70% chance the twin will too
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
           (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
           (myths continued)
• The motives for suicide are easily
  – We really don’t know why people commit
• A tendency to commit suicide is inherited
  – It does tend to run in families
     • But it may be a learned behavior
          (myths continued)
• Women kill themselves more often then
  – Women attempt suicide 3x as frequently as men
  – Men kill themselves almost 4x as often as
• When a suicidal person has been depressed
  and suddenly snaps out of it they are less
  likely to commit suicide
   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
   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
   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
     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
       Questions About Suicide
• What factors put one at risk of committing
  –   Mental illness
  –   Impulsive/aggressive tendencies
  –   Substance abuse
  –   Family history of suicide/suicide attempts
  –   Previous suicide attempts
  –   Having been sexually abused
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!
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
   • 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.
       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-
     • The above is the crisis number for PATH, a service
       available to anyone.
     • Website address:

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