inability to experience any pleasure

MODULE 6| MOOD DISORDERS from life, including interactions with

family or friends or accomplishments at
I. UNDERSTANDING AND DEFINING MOOD
work or at school
DISORDERS

A. MOOD vs. AFFECT vs. EMOTIONS  The most central indicators of a full
major depressive episode are physical
➢ MOOD changes (sometimes called somatic or
vegetative symptoms), along with the
 A short-lived emotional state, usually of behavioral and emotional “shutdown”,
low intensity. as reflected by low behavioral
 A disposition to respond emotionally in activation.
a particular way that may last for hours,
days, or even weeks, perhaps at a low  ANHEDONIA (loss of energy and inability
level without the person knowing what to engage in pleasurable activities or
prompted the state. have any “fun”) is more characteristic
of these severe episodes of depression
➢ AFFECT than are, for example, reports of
sadness or distress.
 A term that encompasses a broad o Reflects that these episodes
range of feelings that people can represent a state of low positive
experience. affect and not just high negative
 It embodies both mood and emotions. affect.

➢ EMOTIONS  The duration of a major depressive

episode, untreated, is approximately 4
 An intense feeling that is short-term and to 9 months
is typically directed at a source.
 Emotions often have indicative facial ➢ MANIC EPISODE
expressions and body language as well.
 Begins abruptly, gathering force within
B. AN OVERVIEW OF DEPRESSION AND days.
MANIA  Hallmark feature: Increased activity or
energy level, the person seems to be on
➢ MAJOR DEPRESSIVE EPISODE overdrive and have boundless energy.
 The person experiences a sudden
 An extremely depressed mood state elevation or expansion of mood and
that lasts at least 2 weeks and includes feels unusually cheerful, euphoric, or
cognitive symptoms (such as feelings of optimistic.
worthlessness and indecisiveness) and  They may become extremely sociable
disturbing physical functions (such as to the point of becoming overly
altered sleeping patterns, significant demanding and overbearing towards
changes in appetite and weight, or a others.
notable loss of energy) to the point that  Others recognize the sudden shift in
even the slightest activity or movement mood to be excessive in light of the
requires an overwhelming effort. person’s life situation.
 Exhibit poor judgment and become
 The episode is accompanied by a argumentative.
general loss of interest in things and an
 Some become extremely generous, o HOSPITALIZATION occurs if the
have inflated self-esteem (extreme self- individual is engaging in a self-
confidence to delusions of grandeur). destructive buying spree, charging
 Tend to speak very rapidly with thousands of his money in the
pressured speech. expectation of making more the
 Highly distractible, attention could be next day.
easily diverted by irrelevant stimuli.
 They take on multiple tasks, more than ➢ HYPOMANIC EPISODE
they can handle: Become disorganized
and are incapable of completing their  A less severe version of a manic
projects. episode that does not cause marked
 Unable to sit still and have a decreased impairment in social or occupational
need for sleep: functioning and needs to last only 4
o Wake up early yet feel well-rested days rather than a full week.
and full of energy  Not in itself necessarily problematic, but
o Sometimes go for days without sleep its presence does contribute to the
but without feeling tired. definition of several mood disorders.
 Though they have abundant stores of  Less severe than manic episodes and
energy, they are unable to organize not accompanied by the extreme
their efforts constructively: Elation social or occupational problems
impairs the ability to work and maintain associated with full-blown mania.
normal relationships.  A person might feel unusually charged
 Severe cases: experience delusions with energy, show a heightened level of
(“having a special relationship with activity, and inflated self-esteem.
God”) and hallucinations.  More alert, irritable, and restless than
 Fail to weigh the consequences of their usual.
actions and get into trouble due to:  Work for long hours with little fatigue or
o Lavish spending need for sleep.
o Reckless driving
o Sexual escapades C. THE STRUCTURE OF MOOD DISORDERS
 Some attempt suicide “on the way
➢ UNIPOLAR MOOD DISORDER
down” from a manic phase.
 Individuals find extreme pleasure in
 Diagnosis is made on individuals who
every activity.
experience either depression or mania
 Some are extraordinarily active
because their mood remains at one
(hyperactive), require little sleep, may
“pole” of the usual depression-mania
develop grandiose plans, believing they
continuum.
can accomplish everything they desire.
 Mania (UNIPOLAR MANIA), by itself,
 Observed persistent increased goal-
probably does occur but seems to be
directed activity or energy.
rare, because most people with a
 Speech is typically rapid and may
unipolar mood disorder eventually
become incoherent because the
develop depression.
individual is attempting to express so
many exciting ideas at once referred to
➢ BIPOLAR MOOD DISORDER
as FLIGHT OF IDEAS.
 Duration: 1 week, less if the episode is
 Alternating between depression and
severe enough to require
mania, traveling from one “pole” of the
hospitalization.
 depression-elation continuum to the  Patients may have:
other and back again.
 SOMATIC (PHYSICAL) DELUSIONS:
➢ MIXED FEATURES Believing for example that their bodies
are rotting internally and deteriorating
 Episode characterized by experiences into nothingness.
of manic symptoms but feel somewhat
depressed or anxious at the same time  AUDITORY HALLUCINATIONS: Hearing
or be depressed with few symptoms of voices telling them how evil and sinful
mania. they are.

D. DEPRESSIVE DISORDERS  MOOD CONGRUENT HALLUCINATIONS

AND DELUSIONS
 These disorders differ from one another
in the frequency and severity with  DELUSIONS OF GRANDEUR: Believing
which depressive symptoms occur and that they are supernatural or supremely
the course of the symptoms (CHRONIC gifted that do not seem consistent with
– meaning almost continuous – or NON- the depressed mood.
CHRONIC)
 MOOD-INCONGRUENT HALLUCINATION
1. MAJOR DEPRESSIVE DISORDER AND DELUSION

 Defined by the presence of depression  Associated with a poor response to

and the absence of manic, or treatment, greater impairment, and
hypomanic episodes, before or during fewer weeks with minimal symptoms,
the disorder. compared with nonpsychotic
depressed patients over a 10-year
 An occurrence of just one isolated period.
depressive episode in a lifetime is now
known to be relatively rare. ANXIOUS DISTRESS SPECIFIER

 RECURRENT:  The presence and severity of

o If two or more major depressive accompanying anxiety, whether in the
disorders occurred and were form of comorbid anxiety disorders
separated by at least 2 months (anxiety symptoms meeting the full
during which the individual was not criteria for an anxiety disorder) or
depressed. anxiety symptoms that do not meet all
the criteria for disorders
➢ ADDITIONAL DEFINING CRITERIA FOR
DEPRESSIVE DISORDERS  For all depressive and bipolar disorders,
the presence of anxiety indicates a
PSYCHOTIC FEATURES SPECIFIERS more severe condition, makes suicidal
thoughts and completed suicide more
 Some individuals in the midst of a major likely, and predicts a poorer outcome
depressive (or manic) episode may from treatment.
experience psychotic symptoms
specifically HALLUCINATIONS and
DELUSIONS.
MIXED FEATURES SPECIFIER ATYPICAL FEATURES SPECIFIER

 Predominantly depressive episodes that  Applies to both depressive episodes,

have several (at least three) symptoms whether in the context of persistent
of mania as described above would depressive disorder or not.
meet this specifier, which applies to
major depressive episodes both within  Individuals with this specifier consistently
major depressive disorder and persistent oversleep and overeat during their
depressive disorder. depression and therefore gain weight,
leading to a higher incidence of
MELANCHOLIC FEATURES SPECIFIER diabetes

 This specifier applies only if the full  Although they have considerable
criteria for a major depressive episode anxiety, they can react with interest or
have been met, whether in the context pleasure to some things, unlike most
of a persistent depressive disorder or depressed individuals.
not.
 Has more symptoms, more severe
 Include some of the more severe symptoms, more suicide attempts, and
somatic (physical) symptoms, such as higher rates of comorbid disorders
early-morning awakenings, weight loss, including alcohol abuse.
loss of libido (sex drive), excessive or
inappropriate guilt, and anhedonia PERIPARTUM ONSET SPECIFIER
(diminished interest or pleasure in
activities).  PERIPARTUM: The period of time just
before and just after the birth of a child.
CATATONIC FEATURES SPECIFIER
 Can apply to both major depressive
 This specifier can be applied to major and manic episodes.
depressive episodes whether they
occur in the context of a persistent  New mothers have difficulty
depressive disorder or not, and even to understanding why she is depressed
manic episodes, although it is rare – because they assume this is a joyous
and rarer still in mania. time.

 Involves the absence of movement (a  Women with a history of peripartum

stuporous state) or CATALEPSY, in which depression meeting full criteria for an
the muscles are waxy and semirigid, so episode of major depression may be
a patient’s arms or legs remain in any affected differently by the rapid
position in which they are placed. decline in reproductive hormones that
occurs after delivery or may have
 Involve excessive but random or elevated corticotrophin-releasing
purposeless movement. hormone in the placenta and these
factors may contribute to peripartum
 This response may be a common “end depression.
state” reaction to feelings of imminent
doom and is found in many animals
about to be attacked by a predator
POSTPARTUM DEPRESSION  In bipolar disorder, individuals may
become depressed during the winter
 Women experience a major depressive and manic during the summer.
episode within 4 weeks of delivery.  These episodes must have occurred for
 In some cases, the depressive episode at least two years with no evidence of
begins before delivery and continues nonseasonal major depressive episodes
into the postpartum period. occurring during that period of time.
 Usually last for a few days but may
persist for months or even a year or SEASONAL AFFECTIVE DISORDER
more.
 Maybe a normal response to hormonal  Seasonal changes in light may alter the
changes associated with childbirth. body’s underlying biological rhythms
 Accompanied by disturbances in that regulate processes such as body
appetite and sleep, low self-esteem, temperature and sleep-wake cycles.
and difficulties in maintaining  Seasonal changes might affect the
concentration or attention. availability of Serotonin.
 Risk Factors:  May be related to daily and seasonal
o History of mood disorders or changes in the production
depressive episodes during of MELATONIN, a hormone secreted by
pregnancy the pineal gland.
o Being a single or first-time mother  Because exposure to light suppresses
o Financial problems or a troubled melatonin production, it is produced
marriage only at night. Melatonin production
o Domestic violence tends to increase in winter when there is
o Lacking social support from partners less sunlight.
and family members  Increased production of melatonin
o Having unwanted, sick, or might trigger depression in vulnerable
temperamentally difficult infants people.
o Genetic factors
PHASE SHIFT HYPOTHESIS
 PPD is distinct from POSTPARTUM
PSYCHOSIS (a form of Brief Delusional  SAD is a result of phase-delayed
Disorder): circadian misalignment, meaning that
o Mother loses touch with reality the patient’s circadian rhythm is
o Experiences delusions, misaligned with the environmental day-
hallucinations, and irrational night cycle.
thinking.
 Women with SAD reported more
SEASONAL PATTERN SPECIFIER autonomous negative thoughts
throughout the year and greater
 Applies to recurrent major depressive emotional reactivity to light in the
disorder (and also to bipolar disorders). laboratory, with low light associated
 Accompanies episodes that occur with lower mood.
during certain seasons.
 The most usual pattern is a depressive TREATMENT
episode that begins late fall and ends  PHOTOTHERAPY:
with the beginning of spring. o Most patients are exposed to 2 hours
of bright light immediately on
awakening.
 o If the light exposure is effective, the  Diagnosis applied to women who
patient begins to notice a lifting of experience a range of significant
mood within 3-4 days and a psychological symptoms in the week
remission of winter depression in 1-2 before menses.
weeks.
 Symptoms of PMDD:
2. PERSISTENT DEPRESSIVE DISORDER  Mood swings
(DYSTHYMIA)  Sudden tearfulness or feelings of
sadness
 Shares many of the symptoms of the  Depressed mood
major depressive disorder but differs in  Feelings of hopelessness
its course.  Irritability or anger
 Depressed mood that continues at least  Feelings of anxiety, tension, or feeling
2 years, during which the patient on the edge
cannot be symptom-free for more than  Greater sensitivity to cues of rejection
2 months at a time even though they  Negative thoughts about oneself
may not experience all of the symptoms
of a major depressive episode. ➢ ETIOLOGY:
 Differs from a major depressive disorder
in the number of symptoms required,  Biological: Interaction of hormones and
but mostly it is in chronicity. neurotransmitters
 Considered more severe, since patients  Psychological: Attitude towards
with persistent depression present with menstruation
higher rates of comorbidity with other
mental disorders, are less responsive to 2. DISRUPTIVE MOOD DYSREGULATION
treatment, and show a lower rate of DISORDER
improvement over time.
 In children: characterized by irritability
➢ DOUBLE DEPRESSION and increasingly difficult to get along
with at home, engage in intense
 22% of people suffering from persistent arguments at the slightest provocation.
depression with fewer symptoms
(specified as “with pure dysthymic  Adults with a history of disruptive mood
syndrome”) eventually experience a dysregulation are at increased risk for
major depressive episode (Klein et al., developing mood and anxiety disorders
2006). as well as many other adverse health
 MAJOR DEPRESSIVE EPISODES + outcomes.
PERSISTENT DEPRESSION WITH FEWER
SYMPTOMS F. BIPOLAR DISORDER

E. OTHER DEPRESSIVE DISORDERS  Characterized by extreme mood swings

and changes in energy and activity
1. PREMENSTRUAL DYSPHORIC DISORDER levels.
 Mood swings shift between heights of
 The problem of mood swings is elation and depths of depression.
associated with the premenstrual  Some experience mixed states
period. characterized by both mania and
 A more severe form of Premenstrual depression.
Syndrome (PMS).
 MIXED STATES: Rapid shift between energy and rapid stream of thoughts
mania and depression. associated with mania into creative
 Develops around the age of 20 in both expressions.
men and women and tends to become
a chronic, recurring condition requiring C. CYCLOTHYMIC DISORDER
long-term treatment. (CYCLOTHYMIA)

➢ RAPID CYCLING:  Derived from the Greek

word, kylos (“circle”)
 Experience of 2 or more full cycles of and thymos (“spirit”).
mania and depression within a year  A chronic cyclical pattern of mood
without intervening normal periods. disturbance characterized by mild
 Occurs more often in women than in mood swings lasting at least two years
men (one year for children and
 Limited to a year or less adolescents).
 Associated with a more severe form of  Begins in late adolescence or early
the disorder and with more serious adulthood and persists for years.
suicide attempts.  Few, if any, periods of normal mood last
for more than a month or two.
A. BIPOLAR I DISORDER  Periods of elevated or depressed mood
are not severe enough to warrant a
 Applies to people who have at least diagnosis of bipolar disorder.
one fully manic episode.  Most common of the bipolar disorders.
 Involves extreme mood swings between  Milder than bipolar disorder but can
manic episodes and major depression significantly impair a person’s daily
with intervening periods of normal functioning.
mood.  Boundaries with bipolar disorder are not
 It may be applied to a person who clearly established
does not have a history of a major  FEATURES:
depressive episode, major depression  Numerous episodes of hypomanic
may have been overlooked in the past symptoms are not severe enough to
or will develop in the future. meet the criteria for a hypomanic
 Onset in men: begins with a manic episode.
episode  Numerous periods of mild depressive
 Onset in women: begins with a major symptoms do not measure up to a
depressive episode depressive episode.
 Fluctuates between periods of mildly
B. BIPOLAR II DISORDER high “highs” and mildly low “lows”
 When they are “UP”: elevated activity
 Hypomanic episode + 1 major levels are directed at accomplishing
depressive episode various personal or professional
projects.
** BIPOLAR DISORDER AND CREATIVITY **  Mildly depressed state:
o Unfinished projects
 Many distinguished writers, composers, o Feel lethargic and depressed but
and artists seem to have suffered from not to the extent typical of a major
major depression or bipolar disorder. depressive episode.
 Perhaps in some cases, creative people
channel their seemingly boundless
 Shifting moods may strain social B. PSYCHODYNAMIC THEORIES
relationships, work may suffer, sexual
interest waxes and wanes with the 1. PSYCHOANALYSIS AND DEPRESSION
person’s moods
 According to Freud, depression is anger
II. ETIOLOGY: MAJOR DEPRESSIVE DISORDER directed inward rather than against
significant others following either the
A. BIOLOGICAL FACTORS actual or threatened loss of significant
others.
1. GENETIC FACTORS
PATHOLOGICAL MOURNING:
 Interactions of genetic and
environmental factors in major  Fosters lingering depression.
depression and other mood disorders.  Occur in people who hold powerful
 High genetic risk: greater effect of life ambivalent feelings (love and anger or
stressors on the development of hostility) toward the departed or whose
depression. departure is feared.
 Two people may share the same
genetic risk factor but may develop INTROJECTION
very different disorders depending on
their particular life experiences or other  Loss or fear of losing a person whom
factors. one feels ambivalent about, anger turns
into rage triggers guilt.
2. BIOCHEMICAL FACTORS & BRAIN  A form of preservation of psychological
ABNORMALITIES connection to the lost object/ person
brings inward the mental representation
 Irregularities in how serotonin is used in of the object.
the brain  Anger is then turned inward, against the
 Antidepressants: part of the self which is the mental
o Relieve depression by altering the
representation of the person.
number or density of these receptors  Self-hate leads to depression
or their sensitivity to
neurotransmitters. 2. PSYCHOANALYSIS AND BIPOLAR
DISORDER
3. BIPOLAR DISORDER
 Bipolar disorder represents the shifting of
 Cognitive deficits in recognizing facial dominance between the ego and the
cues of emotions in others. superego.
 Abnormality in the prefrontal cortex and
limbic system.  Depressive phase:
 Genetic factors: play an even stronger o Superego dominant
role in bipolar disorder than it does in o Exaggerated notions of wrongdoings
major depressive disorder o Flooding the individual with feelings
of guilt and worthlessness

 Manic phase:
o Ego rebounds and assumes
supremacy
 o Feelings of elation and self- ➢ RISK FACTORS
confidence
o Excessive display of ego triggers guilt  Gene-environment interactions: genetic
that once again plunges an susceptibility to develop depression with
individual into depression. a history of very stressful life events
 Lack of secure attachments to parents
3. SELF-FOCUS MODEL during infancy or childhood
 Adverse experiences in early life:
 Focus on the individual’s self-esteem parental divorce or physical abuse.
and sense of self-worth.  Insufficient marital supportive
relationships
 Considers how people allocate their
attentional processes after a loss. ➢ BIPOLAR DISORDER

 Depressed people have difficulty  Stressful life changes and underlying

thinking about anything other than biological influences may interact with
themselves and the loss they a genetic predisposition to increase a
experienced. person’s vulnerability to bipolar disorder.
 Stressful life events can trigger mood
C. DIATHESIS-STRESS MODEL episodes in people with bipolar
disorder.
 Stressful life events: INCREASE THE RISK  Negative life events may precede
FOR MOOD DISORDERS depressive episodes, whereas both
negative and positive life events may
 SOURCES OF LIFE STRESSES: precede a hypomanic or manic
episode.
o Loss of a loved one  PSYCHOSOCIAL FACTORS
o The breakup of a romantic relationship
o Prolonged unemployment and  Social support from family members or
economic hardship friends can enhance the level of
o Serious physical illness functioning of bipolar patients by
o Marital or relationship problems providing them with a buffer against
o Separation or divorce the negative effects of stress.
o Exposure to racism and discrimination  Availability of social support: play a role
o Living in unsafe, distressed in helping speed recovery from mood
neighborhoods episodes and reducing the likelihood of
recurrent episodes.
 Stressful life events can contribute to
depression whereas depressive D. BEHAVIORAL THEORIES
symptoms can be stressful in themselves
or lead to other sources of stress 1. ROLE OF REINFORCEMENTS (P.
Lewinsohn, 1974)
➢ PROTECTIVE FACTORS AGAINST
DEPRESSION:  Depression is the result of an imbalance
between behavior and reinforcements.
 Coping skills  Low levels of positive reinforcements
 Genetic endowment lead to:
 Availability of social support o Reduced motivation
 Strong marital relationships o Induce feelings of depression
 o Exacerbate withdrawal cycle of rejection and more
profound depression.
 Secondary Reinforcement: Low rate of o May feel guilty about causing
activity of depressed individuals distress in the family which can
o Sympathy: releases depressed exacerbate their negative feelings
individuals from their responsibilities about themselves.
and maintains depressed behavior o Family members may find it stressful
to adjust to the depressed person’s
 Reinforcement reduction: behavior (withdrawal, lethargy,
o Recovery from serious physical illness despair, and constant demand for
o Loss of loved ones reassurance)
o Changes in life circumstance o Unresponsive, uninvolved, and even
impolite when they interact with
 INTERVENTION: others
o Encourage participation in o Dwell on negative feelings while
rewarding activities and goal- interacting with strangers.
oriented behaviors
o Encourage regular physical activities  Depressed individuals’ excessive need
for reassurance leads to rejection by
2. INTERACTIONAL THEORY (J. COYNE, the very people from whom they seek
1976) reassurance and support due to their
lack of social skills
 The adjustment to living with a
depressed person can become so  Partners who fail to meet each other’s
stressful that the partner or family psychological needs or are critical or
member becomes progressively less hurtful toward each other can affect
reinforcing. each other’s emotional well-being.

 RECIPROCAL INTERACTION E. COGNITIVE THEORIES

o Our behavior influences how other
people respond to us and how they 1. COGNITIVE TRIAD OF DEPRESSION (A.
respond to us influences how we in BECK, 1979)
turn respond to them.
 Negative concepts of the self and the
 Depression-prone people react to stress world as mental templates are adopted
by seeking or demanding reassurance in childhood on the basis of early
and support from their partners and learning experiences.
significant others.
2. COGNITIVE DISTORTIONS (D. BURNS,
 Persistent demands for emotional 1980)
support may begin to elicit more anger
and annoyance than expression of  Tend to occur automatically.
support.  Automatic Thoughts: likely to be
accepted as statements of facts rather
 Depressed people: than as opinions or habitual ways of
o May react to cues of rejection with interpreting events.
deeper feelings of depression and
by making greater demands for
reassurance, triggering a vicious
a. ALL-OR-NOTHING THINKING like or respect him or her, as in
interpreting a friend’s not calling for a
 Seeing events as either all good or all while as rejection.
bad, or either as white or black with no  FORTUNE TELLER ERROR: the prediction
shades of gray that something bad is always about to
 e.g.: Perfectionism is connected with an happen; the person believes the
increased vulnerability to depression as prediction of calamity is factually
well as poor treatment outcomes. based, even though there is no
evidence to support it.
b. OVERGENERALIZATION
f. MAGNIFICATION AND MINIMIZATION
 Believing that if a negative event
occurs, it is likely to occur again in  Tendency to make mountains out of
similar situations in the future. molehills.
 One may interpret a single negative  CATASTROPHIZING: Exaggeration of the
event as foreshadowing an endless importance of negative events,
series of negative events. personal flaws, fears, or mistakes.
 MINIMIZATION: Minimizes or
c. MENTAL FILTER underestimates one’s good points.

 Focusing only on negative details of g. EMOTIONAL REASONING

events, thereby rejecting the positive
features of one’s experiences.  Interprets feelings and events on the
 Selective Abstraction: an individual basis of emotions rather than on fair
selectively abstracts the negative consideration of the evidence.
details from events and ignores the
events’ positive features. h. “SHOULD” STATEMENTS
 Bases one’s self-esteem on perceived
weaknesses and failures, rather than  Creating personal imperatives or self-
one positive feature or on a balance of commandments “shoulds” or “musts”
accomplishments and shortcomings.  Creating unrealistic expectations

d. DISQUALIFYING THE POSITIVE i. LABELING AND MISLABELING

 The tendency to snatch defeat from  Explaining behavior by attaching

the jaws of victory by neutralizing or negative labels to oneself and others.
denying one’s accomplishments.  Labeling: “stupid” or “insensitive” can
 Taking credit where credit is due may engender hostility towards the person.
help people overcome depression by  Mislabeling: use of emotionally charged
increasing their belief that they can labels and inaccurate, calling oneself
make changes that will lead to a as a “pig” due to a minor deviation
positive future. from one’s diet.

e. JUMPING TO CONCLUSIONS j. PERSONALIZATION

 Forming a negative interpretation of  Assuming that one is responsible for

events, despite a lack of evidence. other people’s problems and behavior.
 MIND READING: a person arbitrarily
jumps to conclusion that others do not
3. COGNITIVE-SPECIFICITY HYPOTHESIS  Outcomes are beyond one’s ability to
control
 Proposes that different disorders are  ATTRIBUTIONAL STYLE:
characterized by different types of o A personal style of explanation
automatic thoughts. o Disappointments or failures:
 People with diagnosable depression  Internal Attribution: Blame
more often reported automatic ourselves.
thoughts concerning themes of loss,  External Attribution: Blame
self-deprecation, and pessimism. circumstances we face
 People with anxiety disorders more  Stable Attribution: Bad
often reported automatic thoughts experiences as typical events
concerning physical danger and other  Unstable Attribution: Isolated
threats. events
 Global Attribution: Evidence of
F. HUMANISTIC THEORIES broader problems
 Specific Attribution: Evidence of
 Depression: caused by an inability to precise and limited shortcomings
imbue a person’s existence with
meaning and make authentic choices ➢ THREE TYPES OF ATTRIBUTION MOST
that lead to self-fulfillment. VULNERABLE TO DEPRESSION:
 Focus on the loss of self-esteem that
can occur when people lose friends or  INTERNAL FACTORS: beliefs that failures
family members or suffer occupational reflect their personal inadequacies,
setbacks. rather than external factors, or beliefs
 Sense of self-worth and self-esteem is that failures are caused by
associated with social and environmental factors.
occupational roles, loss of these
identities could facilitate depression.  GLOBAL FACTORS: beliefs that failures
reflect sweeping flaws in personality
G. LEARNED HELPLESSNESS (ATTRIBUTIONAL) rather than specific factors, or beliefs
THEORY (M. SELIGMAN, 1973, 1975) that failures reflect limited areas of
functioning.
 People may become depressed
because they learn to view themselves  STABLE FACTORS: beliefs that failures
as helpless to change their lives for the reflect fixed personality factors rather
better. than unstable factors, or beliefs that the
 Situational factors foster attitudes that factors leading to failures are
lead to depression. changeable.
 Learned helplessness effect:
 Failing to learn to escape when escape III. TREATMENT AND INTERVENTION FOR
became possible. MOOD DISORDERS
 Showed behaviors similar to those of
depressed people including lethargy, A. BIOMEDICAL APPROACH
lack of motivation and difficulty 1. DEPRESSION
acquiring new skills.
 Some forms of depression in humans a. ANTIDEPRESSANT DRUGS
might result from exposure to
apparently uncontrollable situations.  Increase the availability of
neurotransmitters
 TRICYCLICS:  Dramatic effects on relieving suicidal
o Imipramine (Tofranil), Amitriptyline ideation
(Elavil), Desipramine (Norpramin),
and Doxepin (Sineqan) 2. BIPOLAR DISORDER
o Increase brain levels of
a. LITHIUM AND MOOD STABILIZERS
neurotransmitters norepinephrine
and serotonin by interfering with the
 Lithium Carbonate
process of the reuptake of these
 Helps reduce mania and stabilize
chemical messengers.
moods in bipolar patients and reduces
the risk of relapse
 MONOAMINE OXIDASE (MAO)
 Some patients may fail to respond to
INHIBITORS:
the drug or cannot tolerate it
o Phenelzine (Nardil)
 May lead to mild memory problems
o Increase availability of
 Side Effects:
neurotransmitters by inhibiting MAO
o Weight gain
o Less widely used due to possible
o Lethargy and grogginess
interactions to food and alcoholic
o General slowing down of motor
beverages.
functioning
o Long-term use: gastrointestinal
 SELECTIVE SEROTONIN-REUPTAKE
INHIBITORS (SSRI) distress and lead to liver problems
o Fluoxetine (Prozac) & Sertraline
b. ANTICONVULSANT DRUGS
(Zoloft)
o Interfere with serotonin reuptake
 Carbamazepine (Tegretrol), Divalproex
(Depakote) and Lamotrigine (Lamictal)
 SELECTIVE NOREPINEPHRINE-REUPTAKE
 Help reduce manic symptoms and
INHIBITORS (SNRI)
stabilize moods in people with bipolar
o Venlafaxine (Effexor)
disorder
o Selectively reuptake of both
 Help people with bipolar disorder who
norepinephrine and serotonin
fail to respond to lithium or cannot
increases levels of the same
tolerate its side effects
neurotransmitters in the brain.
B. PSYCHODYNAMIC APPROACH
b. ELECTROCONVULSIVE THERAPY (ECT)
 Help depressed people understand
 Safe and effective treatment for severe
underlying ambivalent feelings toward
depression and shows it can help
important people in their lives whom
relieve major depression even in cases
they have lost or whose loss was
in which drug treatments have failed.
threatened.
 An electrical current of 70 – 130 volts is
 Focus on unconscious conflicts but are
applied to the head to induce
more direct, relatively brief, and focus
convulsions.
on the present as well as past
 Administered in a series of 6-12
conflicted relationships.
treatments given three times per week
 Some use behavioral methods to
over several weeks.
acquire the social skills needed to
 Given to a majority of people with
develop a broader social network.
major depression who had failed to
respond to antidepressant medication.
➢ INTERPERSONAL PSYCHOTHERAPY  Greater protection against relapse than
antidepressant medication
 Relatively brief therapy that emphasizes
the role of interpersonal issues in IV. SUICIDE IN ADULTS
depression and helps clients make
healthy changes in their relationships. o Often a feature or symptom of an
 Focus on the client’s current underlying psychological disorder.
relationships rather than on unconscious o Older adults: higher suicide rates aged
internal conflicts of childhood origin. 65 and above.
 Helps client deal with unresolved or o Gender: more women attempt but
delayed grief reactions following the more men succeed.
death of a loved one as well as with o Reasons behind suicide:
role conflicts in present relationships. o Higher among people with severe
 Effective treatment for major depression mood disorders, greater risk for
and shows promise in treating other repeated episodes of major depression.
psychological disorders as well o Associated with other psychological
including dysthymia, bulimia, and disorders: alcoholism and drug
posttraumatic stress disorder. dependence, anxiety disorders,
anorexia, schizophrenia, panic disorder,
C. BEHAVIORAL APPROACH personality disorders, posttraumatic
stress disorder, and borderline
 Focus on helping depressed patients personality disorder.
develop more effective social or o Past suicide attempts.
interpersonal skills. o “Rational Suicide”: belief that they are
 Increasing their participation in based on a rational decision that life is
pleasurable or rewarding activities. no longer worth living in light of
continual suffering.
BEHAVIORAL ACTIVATION
 Motivated by the desire to escape from
 Encourages patients to increase the unbearable emotional pain.
frequency of rewarding or enjoyable
activities  Prevented if people with suicidal
 Produce substantial effects in treating feelings received treatment for
depression underlying disorders, including
depression, bipolar disorder,
D. COGNITIVE-BEHAVIORAL THERAPY schizophrenia, and alcohol and
substance abuse.
 Believe that distorted thinking plays a
key role in the development of A. THEORETICAL PERSPECTIVES ON SUICIDE
depression.
 Focus on helping people recognize and 1. BIOLOGICAL FACTORS
correct dysfunctional thought patterns.
 Genetics
 Help clients identify and change
 Neurotransmitter
dysfunctional thoughts and develop
imbalance: SEROTONIN
more adaptive behaviors.
o Decreased serotonin levels lead to
 Brief lasting for 14 – 16 weekly sessions.
disinhibition or release of impulsive
 Produce impressive results in treating
behavior that takes the form of a
major depression and reducing risks of
suicidal act in vulnerable individuals
recurrent episodes.
2. CLASSIC PSYCHODYNAMIC MODEL

 Inward-directed anger that turns

murderous.
 Vent their rage against the internalized
representation of the love object,
destroy themselves in the process

3. SOCIOLOGICAL PERSPECTIVE

 ANOMIE (E. DURKHEIM, 1897/ 1958)

o Feeling lost, without identity, rootless

 Social isolation
 Family support is available but not
helpful

4. BEHAVIORAL THEORIES

 Lack of problem-solving skills for

handling significant life stress
 Schneidman (1985):
o Those who attempt suicide wish to
escape unbearable psychological
pain and may perceive no other
way out.

 People who threaten or attempt suicide

may receive sympathy and support
from loved ones and others perhaps
making future and more lethal attempts
more likely.

5. SOCIAL-COGNITIVE THEORY

 Suicide may be motivated by personal

expectancies, such as beliefs that one
will be missed by others or that survivors
feel guilty for having mistreated the
person
 Suicide will solve one’s own problems or
even other people’s problems
 Potential modeling effects of observing
suicidal behavior in others
 Social Contagion