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Neurological Disorders

Neurological Disorders. Psychological Disorders. 10 million people suffer from depression. Mood Disorders. Unipolar Disorder (2 wks to 9 mos) Major Depressive Disorder, Single Episode (MDDSE) rare Major Depressive Disorder, Recurrent (MDDR) family history is common

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Neurological Disorders

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  1. Neurological Disorders

  2. Psychological Disorders 10 million people suffer from depression

  3. Mood Disorders

  4. Unipolar Disorder (2 wks to 9 mos) • Major Depressive Disorder, Single Episode (MDDSE) • rare • Major Depressive Disorder, Recurrent (MDDR) • family history is common • Dysthymic Disorder (DD) • milder symptoms • chronic occurrence (2-30yrs) • Double Depression • combination or MDDR and DD • Bipolar Disorder (2 wks to 9 mos) • Bipolar I Disorder • Bipolar II Disorder (hypomania) • Dysphoric Mania • manic episodes with simultaneous depression • Cyclothymic Disorder (mild bipolar) Mood Disorders

  5. Major Depressive Episode Characteristics • Onset is in early to mid 20’s • but not age specific • Onset age has been dropping • 16% of population experience • MDD in their lifetime • 2:1 women to men ratio • 41% occurs just before or just • after menstruation

  6. Depression: Etiology Biological Influence genetic predispostion neurochemical imbalance stress hormones Psychological/Behavioral Influence learned helplessness/hopelessness depressive attributional style disturbed sleep habits Social Influence stressful events serve as triggers

  7. Mood Disorders among Twins

  8. Depression and Neurochemistry

  9. Depression and Stress Hormones

  10. Depression and Sleep Phase advanced body temperature rhythms Enter REM sleep earlier in the night Spend little time in SWS

  11. Depression: Treatment Medical Chemical Electroconvulsive Shock Therapy Psychotherapy Cognitive Behavioral Therapy Interpersonal Therapy

  12. Chemical Treatment • Tricyclic Antidepressants • imipramine (Tofranil) • prevents monoamine reuptake • 64% respond well • many side effects • Monoamine Oxidase Inhibitors • phenelzine (Nardil) • blocks MAO enzyme • which breaks down monoamines • <64% respond well • several lethal side effects • Selective Serotonin Reuptake Inhibitors (SSRIs) • fluoxetine (Prozac) • blocks reuptake of serotonin • minor side effects

  13. (ECT) Electroconvulsive Shock Therapy • for patients where drugs are ineffective or that can’t wait for • drugs to take effect • electric shock to the cortex for less than 1 second • creates seizure and mild convulsions • takes about 6-10 sessions every other day • some short term memory loss • 50-70% beneficial • 60% relapse rate

  14. Cognitive Behavioral Therapy • make patient examine thought process and recognize errors • arbitrary interference • overgeneralization • try to correct cognitive errors • concentrate on less depressive thoughts - be more realistic • target negative cognitive schemes • use journals to identify faulty thinking • do hypothesis testing • put fun back into the patients life • increase exercise • takes about 10-20 sessions

  15. Interpersonal Therapy • resolve problems in existing relationships • identify life stressors • work on interpersonal disputes • role disputes • loss of a relationship • acquiring new relationships • identifying and correcting deficits in social skills • takes about 15-20 sessions

  16. Depressions Vicious Cycle • Must control brain chemistry • e.g., Prozac • Must reshape the negative thought processes • e.g., CBT

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