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Mood Disorders

This lesson explores mood disorders, focusing on unipolar depression, mania, and bipolar disorder. Unipolar depression is characterized by extreme sadness, with a prevalence of 9-26% in females and 5-12% in males. Symptoms include disrupted sleep and eating, impaired concentration, and feelings of worthlessness. Treatment options range from psychotherapy to medication, including SSRIs and MAOIs. The lesson also covers the nature of mania in bipolar disorder, characterized by high energy and risk-taking behavior, along with treatment approaches like lithium-based therapies.

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Mood Disorders

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  1. Mood Disorders Lesson 25

  2. Mood Disorders • Unipolar depression • Mania • Bipolar disorder • Seasonal Affective Disorder (SAD) ~

  3. Unipolar Depression • Extreme sadness & despair • extent & duration important • Prevalence • females 9-26% • males 5-12% • 2:1 females ~

  4. Unipolar Depression • endogenous vs. reactive • Genetic component • DZ twins  25% concordance • MZ twins  70% concordance

  5. Diagnosis & Symptoms • Disrupted eating & sleeping • increased or decreased • Impaired concentration • Changes in activity • increased or decreased • Feelings of guilt / worthlessness • Preoccupation w/ death or suicide ~

  6. Diagnosis & Symptoms • NOT • uncomplicated bereavement • organic • Diagnosis • 5 of 9 symptoms • not complete list • duration > 2 weeks ~

  7. Treatment • Psychotherapy • Drug Therapy • Electroconvulsive-shock Therapy • Sleep Deprivation • Light Therapy ~

  8. Etiology • Catecholamine hypothesis • DA & NE • deficiency • Evidence from drug side effects • Produce depression • reserpine – monoamines • propranalol - NE antagonist ~

  9. Monoamine Hypothesis • Fluoxetine (Prozac) • therapeutic effects • blocks 5-HT reuptake • 5-HT modulates other NTs? • usually more than one NT involved ~

  10. Drug Treatment • Monoamine oxidase inhibitors – MAOIs • NT not degraded • more NT in synapse • Cheese effect • foods with tyramine • metabolism  amphetamine-like • risk of cerebral hemorrhage ~

  11. Tricyclic Antidepressants • Indirect agonists • block monoamine reuptake • imipramine, desipramine • Side effects • Sympathetic arousal • Possible overdose ~

  12. SSRIs • Selective serotonin reuptake inhibitors • Prozac (fluoxetine) • Zoloft (sertraline) • Paxil (paroxetine) • Luvox (fluvoxamine) • blocks 5-HT reuptake • Less effect on NE & DA ~

  13. SSRIs vs Tricyclics • Fewer side effects • less danger of overdose • As effective as tricyclics • Neither addictive • Animals don’t self-administer • negative reinforcement ~

  14. Criticisms • Immediate effects on NT level • Therapeutic effects  2-4 weeks • Explanation? • Compensatory responses • Autoreceptor desensitization • Tetracyclic Antidepressants • Block reuptake & autoreceptors • Faster therapeutic effects • but still a delay ~

  15. Other Selective Reuptake Inhibitors • Norepinephrine Dopamine Reuptake Inhibitor (NDRI) • bupropion (Welbutrin) • Also tx bipolar & Smoking cessation (Zyban) • Selective Serotonin Norepinephrine Reuptake Inhibitor (SNRI) • Serotonin-2 Antagonists/Reuptake Inhibitors (SARI) • Off-label use of antidepressants • wide variety of disorders ~

  16. Mania & Bipolar • Mania Symptoms • Euphoria • grandiose plans • reduced need for sleep • high risk activities • Bipolar Disorder • Cycling between mania & depression ~

  17. Etiology • Induced by drugs • Monoamine agonists • cocaine, amphetamine, antidepressants • Mostly NE & DA ~

  18. Treatment: Mania & Bipolar • Lithium most common • Dangerous, but thresholds well known • Mechanism unknown • affects almost all NTs • Also • Anticonvulsants • atypical neuroleptics ~

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