are also called affective disorders Are pervasive alteration in emotions that are manifested by depression, mania, or both

They interfere with persons life, plaguing him or her with drastic and long-term sadness, agitation, or elation This is also the most common type psychiatric diagnosis associated with suicide; depression is one of the most important risk factor for it

Biologic theories
Genetic theories Neurochemical theories Imbalance on serotonin and norepinephrine serotonin= depression norepinephrine= depression norepinephrine= mania Neuroendochrine influences Hormonal fluctuations

Psychodynamic Theories
Freud Self reproach to anger turned inward related to either a real or percieved loss Feeling abandoned by this loss, people became angry while both loving and hating the lost object Bibring Ones ego (or self) aspired to be ideal and that to be loved and worthy, one must achieve theses high standard

Psychodynamic
Jacobson Ego is a powerless, helpless child victimized by the superego Manic episodes is a defense against underlying

depression, with the id taking over the ego and acting as undisciplined hedonistic being (child) Meyer
Depression is a reaction to a distressing life experience

Psychodynamic
Horney Rejection or unloving parents

Beck
Depression is a result from specific cognitive

distortions in susceptible people. Early/past experiences shaped distorted ways of thinking about ones self

 MAJOR DEPRESSIVE DISORDER BIPOLAR DISORDER (MANIC-

DEPRESSIVE ILLNESS)

Major depressive episode lasts at least 2 weeks, during which the person experiences a depressed mood or loss of pleasure in nearly all activities

Changes in appetite or weight, sleep or psychomotor activity Difficulty in thinking, concentrating or making decisions Recurrent thoughts of death or suicidal ideation, plans, or attempts Decreased energy

 Psychopharmacology

Antidepressants MAOIs SSRIs Cyclic antidepressants Atypical antidepressants

Electroconvulsive Therapy (ECT)

Application of electrodes to the

head of the client to deliver an electrical impulse to the brain; this causes a seizure. It is believed that shock stimulates brain chemistry to correct the chemical imbalance of depression

Psychotherapy Goals:
remission Psychosocial restoration Prevention of relapse or recurrence Reduce secondary consequences such as marital

discord or occupational difficulties Increasing treatment and compliance

Interpersonal Therapy Behavior therapy Cognitive therapy

Investigational Treatments

Transcranial magnetic stimulation (TMS) Magnetic seizure therapy Deep brain stimulation Novel brain-stimulation technique

Ensure that clients feel safe and do not experience uncontrollable urges to commit suicide

Involves extreme mood swings from episodes of mania to episodes of depression. Mean age for first manic episode is the early 20s

Involves extreme mood swings from episodes of mania to episodes of depression. It last for 1 week Symptoms:

Exaggerated/Inflated self-esteem Decreased need for sleep Pressured speech Distractibility Increased involvement in goal-directed activity or psychomotor agitation Excessive involvement in pleasure-seeking activity with a high potential for painful consequences Some may exhibit delusions and hallucinations

Is a period of abnormally and persistently elevated, expansive, or irritable mood lasting 4 days and including 3 or 4 symptoms of mania Difference bet. Mania and hypomania is that hypomanic episodes do not impair the persons ability to function, and there are no psychotic features like delusions and hallucinations

Bipolar I disorder one or more manic or mixed episodes usually accompanied by major depressive episodes Bipolar II disorder one or more depressive episodes accompanied by at least one hypomanic episodes

People with bipolar disorder may experience euthymic or normal mood and affect between extreme episodes, or they may have a depressed mood swing after a manic episode before returning to a euthymic mood.

Psychopharmacology
Lifetime regimen of medications: Antimanic agent (Lithium) Anticonvulsants as mood stabilizers
Carbamazepine Gabapentin

Psychotherapy
Useful in mildly depressive or normal portion of the

bipolar cycle. psychotherapy+ medication = reduced risk for suicide and injury

Dysthymic disorder characterized by at least 2 years of depressed mood for more days than not with some additional, less severe symptoms that do not meet the criteria for a major depressive episode

Cyclothymic disorder is characterized by 2 years of numerous periods of both hypomanic symptoms that do not meet the criteria for bipolar disorder

Substance-induced mood disorder characterized by a prominent and persistent disturbance in mood that is judged to be a direct physiologic consequence of ingested substances such as alcohol, other drugs, or toxins

Mood disorder due to a general medical condition characterized by a prominent and persistent disturbance in mood that is judged to be a direct physiologic consequence of a medical condition such as degenerative neurologic conditions, cerebrovascular disease, metabolic or endocrine conditions, autoimmune disorders, human immunodeficiency virus HIV infections, or certain cancers

Seasonal affective disorder (SAD)

Two types: Winter Depression or fall onset SAD

People experience increased sleep, appetite and

carbohydrates cravings, weight gain Interpersonal conflict Irritability Heaviness in the extremities beginning in late autumn and abating in spring and summer.

 Spring- onset SAD Symptoms of insomnia Weight loss Poor appetite lasting from late spring or early

summer until early fall

SAD is often treated with light therapy

Frequent normal experience after delivery Characterized by:

Labile mood and affect Crying spells Sadness Insomnia Anxiety

Symptoms:
Begin approximately 1 day after delivery, usually peak

in 3 to 7 days, Subside rapidly with no medical treatment

Meets all the criteria for a major depressive episode, with onset within 4 weeks of delivery

Is a psychotic episode developing within 3 weeks of delivery and beginning with fatigue sadness, emotional lability, poor memory and confusion
progressing to delusions, hallucination, poor insight and judgement, and loss of contact with reality.