For between 10-30% of new mothers, the weeks and months after
childbirth bring clinical depression
• Postpartum depression
- Symptoms typically begin within 4 weeks and may last up to a year and
include extreme sadness, despair, tearfulness, insomnia, anxiety, intrusive
thoughts, compulsions, panic attacks, feelings of inability to cope, and
- Hormonal changes accompanying childbirth
- Psychological and sociological changes
- Self-help support group; antidepressants, cognitive therapy, interpersonal
psychotherapy, or combinations of these
• Impairment in functioning for most of the
day, and nearly every day, for two weeks
• Not persistent (more than 2yrs+)
- Depressed mood, sadness, or emptiness
- Loss of pleasure in previously enjoyed activities
- At least four additional changes in functioning:
• Alteration in weight, atypical sleep patterns,
restlessness, low energy, feelings of worthlessness,
difficulty concentrating, or preoccupation with death or
1.) What is the difference between depressive disorders and bipolar disorders?
People with depressive disorders suffer only from depression while people with bipolar disorders alternate between periods of depression and of mania.
2.) What are the key symptoms of depression?
Symptoms can vary from person to person, but symptoms usually include feeling extremely sad or miserable, losing one's sense of humor, getting little to no pleasure out of anything, being less active, being less productive, social withdrawal, and feeling unmotivated, pessimistic, and hopeless. Physical symptoms: headaches, indigestion, constipation, dizzy spells, general pain, loss of appetite, insomnia, and fatigue can occur too. In some cases, overeating and excessive sleeping can occur.
What are the key symptoms of mania?
3.) Feelings of euphoric joy, exaggerated optimism, heightened self-esteem, heightened energy, hyper activity, increased talkativeness, rapidly shifting ideas, attention pulled in many directions, exaggerated ambitions, dressing flamboyantly, acting boldlyDes poor judgment, poor planning, and increase in risky behavior.
3.) Describe the role of norepinephrine and serotonin in unipolar depression.
Low activity of norepinephrine and serotonin have been linked to unipolar depression.
4.) Explain Freud and Abraham's psychodynamic theory of depression and research that supports it:
Freud proposed the concept of symbolic, or imagined loss in which a person equates other kinds of events with the loss of a loved one. Studies have offered general support for the psychodynamic idea that major losses, especially ones suffered early in life, may set the stage for depression. At the same time, research also indicates that loss is not always the root of depression. In conclusion, research into the loss-depression link has produced inconsistent findings.
5.) How do behaviorists describe rewards in the role
In a number of studies, behaviorists found a correlation between number of rewards received and presence or absence of depression. Depressed participants typically report getting fewer positive rewards, and when their rewards have increased, their mood improved as well. Social rewards have proven to be particularly important.
6.) How might learned helplessness be related to human depression?
People become depressed when they 1.) Think they no longer have control over the reinforcements (rewards and punishments) in their lives and 2.) Think that they are responsible for this helpless state. One may learn that they have no control over the unpleasant circumstances or events in their life and feel helpless, and therefore depressed, and unmotivated, even if the situation changes and they do have control.
7.) What kinds of negative thinking may lead to mood problems?
The Cognitive Triad—when individuals repeatedly interpret their experiences, themselves, and their future in negative ways. They draw illogical inferences and negative conclusions that are unfounded. This causes depression.
8.) How do sociocultural theorists account for unipolar depression?
Sociocultural theorists attribute depression to decline in social rewards and insufficient social support. They also believe that gender and cultural background/ethnicity impact diagnosis.
9.) What roles do biological and genetic factors seem to play in bipolar disorders?
Overactivity of norepinephrine + Low levels of serotonin = Mania
Low activity of norepinephrine + Low levels of serotonin = Depression
Endocrine system may play a role—High levels of cortisol or High levels of melatonin.
Brain circuit related to depression may include: prefrontal cortex, the hippocampus, the amygdala, and Brodmann Area 25.
10.) Discuss the leading treatments for unipolar depression and bipolar disorders. How effective are these various approaches?
Leading treatments for unipoloar depression are:
Antidepressant drugs - very effective- 1st generation: Monoamine Oxidase (MAO) inhibitors and tricyclics.
MAO inhibitors slow body's production of the enzyme monoamine oxidase, which normally degrades norepinephrine. Thus causing levels of norepinephrine to rise and depression to lift.
Tricyclics all have a three-ring molecular structure. Reduce depression by acting on neurotransmitter "reuptake" mechanisms. This means delaying reabsorption of neurotransmitters that may be being reabsorbed by neurons too quickly.
2nd generation: selective serotonin reuptake inhibitors (SSRIs), selective norepineprhine reuptake inhibitors, and serotonin-norepinephrine reuptake inhibitors
SSRIs - increases serotonin activity specifically without affecting other neurotransmitters.
Behavioral activation-Adding pleasurable activities to a person's life to increase number of rewards and ensuring that their behaviors are reinforced properly, and training clients in effective social skills.
Cognitive-Behavioral Therapy-Adding pleasurable activities to a person's schedule, challenging the client's irrational assumptions, identifying negative thinking and biases, changing maladaptive attitudes.
Interpersonal Psychotherapy-addressing interpersonal loss, interpersonal role disputes, interpersonal role transitions, and interpersonal deficits to resolve issues.
CBT + Drug therapy = Most effective treatment, however others are modestly effective independently.
Electroconvulsive therapy (ECT) - Two electrodes are attached to the patient's head and 65-140 volts of electricity are passed through the brain for half a second or less. This results in a brain seizure that lasts from 25 secs. to a few minutes. After 6-12 treatments take place over the course of 2-4 weeks, most patients feel less depressed. Strong muscle relaxants are given beforehand to minimize convulsions and reduce risk of injury. Can cause loss of memory from immediately before or after treatment, or in rare cases, more distant memory loss. Clearly effective in treating unipolar depression, but unclear how it works.
Vagus Nerve Stimulation-electrically stimulating the vagus nerve with a pulse generator that is inserted under the skin of the chest and wired up to the vagus nerve. As many as 40% improve significantly with it.
Transcranial Magnetic Stimulation (TMS) - Electromagnetic coil is placed on or above the patient's head. The coil sends a current of electricity into the prefrontal cortex. Very effective.
Deep Brain Stimulation-Electrodes implanted into Area 25 of brain and a battery/"pacemaker" is implanted into chest or stomach to power the electrodes. Promising findings using this technique.
13th EditionLori Watson, Patrick J. Hurley