Unipolar Mood

Disorders
Abirami - E21PC002
 Definition
Unipolar disorder is a persistent or pervasive depression that
does not involve a manic episode, a hypomanic episode, or a
mixed episode. The term is sometimes used synonymously with
major depressive disorder. Also called unipolar depression.

Unipolar Mania is a disorder in which only excitement,

overactivity, and similar euphoric symptoms are seen. This is a
rare condition, as such manic episodes tend eventually to be
followed by one or more major depressive episodes.
 01. Loss & the grieving
process
▪︎Psychological process one goes through
following the death of a loved one.

Other forms ▪︎More difficult for men than for women.

▪︎Four phases of normal response:
(1) Numbing and disbelief, (2) yearning and
searching, (3) disorganization and despair

of (accepts the loss as permanent), and (4)

some reorganization - gradually begins to

depression rebuild his or her life.

▪︎Cause of concern - person
was not fully processing the loss, at least at
a psychological level
 02. Post - partum
▪︎ Occurs in“Blues”
new mothers (and occasionally fathers)
▪︎Symptoms of postpartum blues typically include
changeable mood, crying easily, sadness, and irritability,

Other forms often liberally intermixed with happy feelings.

▪︎A greater likelihood of developing major depression
after the postpartum blues—especially if they are severe.
▪︎ Lack of social support or has difficulty in adjusting to her
of new identity and responsibilities, or if the woman has a

depression
personal or family history of depression that leads to
heightened sensitivity to the stress of childbirth.
▪︎Major depression in women occurs more frequently
expected in women of the same age and socioeconomic
status who have not just given birth than women with Post
Partum Blues.
 03. Dysthymic Disorder
▪︎Persistent depressive disorder.
▪︎Mild to moderate intensity, but its
primary hallmark is its chronicity
Other forms ▪︎Persistently depressed mood most of
the day, for more days than not, or at
least 2 years (1 year for children and
adolescents).
of ▪︎Periods of normal mood may occur

depression
briefly, but they usually last for only a
few days to a few weeks.
Major
Depressive
Disorder
Never have had a manic, hypomanic, or mixed
episode.

An aff ected person must experience either

markedly depressed moods or marked loss of
interest in pleasurable activities most of every
day, nearly every day, for at least two consecutive
weeks.

High levels of comorbidity between depressive and

anxiety disorders.
 Clinical Picture
Five (or more) of the following symptoms have been present during the same 2-week
period

01 02 03 04
Depressed mood most of the day,
Markedly diminished Significant
nearly every day, as indicated by Insomnia or
interest or pleasure weight loss when
either subjective report (e.g., hypersomnia nearly
in all, or almost all, not dieting or
feels sad, empty, or hopeless) or every day.
activities most of weight gain or
observation made by others (e.g.,
the day, nearly decrease or
appears tearful). ( note: In
every day. increase in
children and adolescents, can be
appetite nearly
irritable mood.)
every
 Clinical Picture
Five (or more) of the following symptoms have been present during the same 2-week
period

05 06 07 08 09
Recurrent thoughts of death Feelings of Diminished Psychomotor
(not just fear of dying), Fatigue or loss of
worthlessness or ability to think or agitation or
recurrent suicidal ideation energy nearly eve
excessive or concentrate, or retardation nearly
without a specific plan, or a day.
inappropriate guilt indecisiveness, every day
suicide attempt or a specific (which may be nearly every day
plan for committing suicide. delusional) nearly
every day
Depression as a Recurrent
Disorder
▪︎Depressive episodes are usually time limited; the
average duration of an untreated episode is about 6 to 9
months.

▪︎Most depressive episodes remit (which is not said to

occur until symptoms have largely been gone for at least
2 months)

▪︎Time period before a recurrence occurs is highly

variable.

▪︎Probability of recurrence increases with the number of

prior episodes and also when the person has comorbid
Depression Throughout the
Life Cycle
▪︎ Onset - late adolescence up to middle adulthood.
▪︎ About 1 to 3 percent of school-age children. As in adults,
recurrence rates are high in children.
▪︎ Infants may experience a form of depression (formerly
known as anaclitic depression or despair).
▪︎ Major depression that occurs in adolescence is very likely to
recur in adulthood.
▪︎ Major depression and dysthymia in older adults are still
considered a major public health problem today.
▪︎ Rates of depression among physically ill residents of nursing
homes or residential care facilities are substantially higher than
among older adults living at home.
Specifiers for Major Depressive Episodes
Specifiers for Major Depressive Episodes
Causal Factors
 01. Genetic Influences

▪︎Moderate genetic contribution.

Biological ▪︎It seems very probable that there is a
genetic contribution to dysthymia because
Causal of its strong link to elevated levels of the
personality trait neuroticism, which is
Factors moderately heritable.
▪︎Serotonin-transporter gene
 02. Neurochemical Factors

Biological ▪︎Depression was at least sometimes due to

an absolute or relative depletion of
Causal monoamine
serotonin.
class—norepinephrine and

Factors ▪︎Dopamine dysfunction.

 03. Abnormalities of
Hormonal Regulatory and
Immune
▪︎ Systems
Hypothalamic-pituitary-adrenal (HPA) axis

Biological - failure of feedback mechanisms.

- Dexamethasone either fails entirely to

Causal suppress cortisol or fails to sustain its

suppression.

Factors
- cognitive problems may
be related to other findings showing that
prolonged elevations

in cortisol.
▪︎ Low thyroid levels (hypothyroidism) often
become depressed.
▪︎ Dysregulation of the immune system:
 04. Neurophysiological and
Neuroanatomical Influences
▪︎Damage to the left, but not the right, "anterior
prefrontal cortex".

Biological
▪︎ Relatively low activity in the left hemisphere &
relatively high activity in the right hemisphere.
▪︎ Increased right-side activity - increased anxiety
Causal symptoms & increased negative affect associated with
increased vigilance for threatening information.

Factors DECREASED VOLUME

☆ Orbital Prefrontal Cortex: reward
☆ Dorsolateral Prefrontal Cortex: cognitive control
☆ Hippocampus
☆ Anterior Cingulate Cortex: selective attention
INCREASED ACTIVATION
☆Amygdala: perception of threat and in directing
attention.
 05. Sleep and Other Biological
Rhythms

Biological ▪︎Reduced latency to enter REM(15 to 20

minutes

Causal sooner)sleep and the decreased amount of

deep sleep.

Factors ▪︎Size or magnitude of the circadian rhythms is

blunted and may be desynchronized.
▪︎ A majority become depressed in the fall and
winter and normalize in the spring and
summer.
 c a 01. Stressful Life Events
g i
l o
o
▪︎Severely stressful life events often serve as

h a l precipitating factors for unipolar depression.

y c s s
▪︎ Dependent life

u
events play an even stronger role in the onset

s
P C toa r of major depression than do independent life
events.

l ac
▪︎ Minor events - onset of recurrent episodes
than in the initial episode.

F ▪︎Chronic stress - increased risk for the onset,

maintenance, and recurrence of major
depression.
 a l 02. Different Types of Vulnerabilities
i c for Unipolar Depression
o g
l
▪︎Personality and Cognitive Diatheses:

o
Neuroticism, high levels of Introversion &

c h l
negative patterns of thinking.

a
▪︎Early environmental adversities may be

s y s r s mediated by both

P a tou biological variables and psychological variables.

▪︎Individuals who have undergone early

C ac adversity remain resilient, and if the exposure

F
to early adversity is moderate rather than
severe a form of stress inoculation may occur
that makes the individual less susceptible to
the effects of later stress.
 a l 03. Psychodynamic Theories
i c
o g Depression could also occur in response to

o l death of loved one and even due to imagined or

symbolic losses.

c h l
y s a s 04. Behavioral Theories
s
P a tou r
C ac
Either when their responses no longer produce
positive reinforcement or when their rate of

F negative experiences increases.

 Psychological Causal Factors

05. Beck’s Cognitive Theory

▪︎Negative cognitive triad:

(1) The self; (2) One’s

experiences & the surrounding
world; (3) One’s future.
▪︎Negative cognitive biases:
Dichotomous or all-or-none
reasoning, Selective
abstraction & Arbitrary
inference
 a l 06. The Helplessness
i c
o g Pessimistic attributional style (internal, stable, and
global one) have a vulnerability or diathesis for

o l depression when faced with uncontrollable negative

h
life events.

c a l 07. The Hopelessness

s y s r s
u
Perception that one had no control over what was

P a to going to happen and by the absolute certainty that an

C ac
important bad outcome was going to occur.

08.The Ruminative Response Styles

F They tend to focus intently on how they feel and why
they feel that way—a process called rumination.
Thank you!
Byeeeèee