This is an informative chapter about mood disorders (Bipolar Disorder and Cyclothymic Disorder). None of this information in here or other chapters can be used to diagnose people. Only psychiatry professions are obligated to diagnose. Psychopathology chapters are review and summary of Textbook “David H. Barlow, V. Mark Durand (2014) Abnormal Psychology: An Integrative Approach” and lecture notes.
Bipolar Disorder and Cyclothymic Disorder
Swings of mood between mania and depression. Separate into 2 categories.
Type I: Depression and mania (Bipolar Disorder).
Type II: Depression and hypomania (Cyclothymic Disorder).
Symptoms of Mania
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Bipolar Disorder Diagnostic Criteria
- Presence/history of mania.
- Presence/history of the major depressive episode.
- Mood episodes are not secondary.
Mania: (Three or more of the following);
- Inflated self-esteem, grandiosity.
- Decreased need for sleep.
- More talkative / pressure to keep talking.
- Flight of ideas.
- Distractibility.
- Psychomotor agitation.
- Excessive involvement in pleasurable activities with high potential of painful consequences.
Hypomania:
Same criteria as for mania but less serious social and occupational consequences. Hypomania is a mild form of mania.
Cyclothymic Disorder Diagnostic Criteria
- At least two years had periods of hypomania or depressive symptoms.
- No period of symptom-free for more than 2 months.
Cycles:
A great variability in cycle time rapid cycling. Four or more cycles per year.
Demographic Information
Gender;
Equally in men and women.
Socioeconomic factors;
Equally across classes.
Explanations
Psychodynamic Explanations:
- Manic flight from depression;
Escape the depression with manic behavior - Stress;
It is not a cause itself but triggers the episodes in individuals who are predisposed.
Physiological Explanations:
1.Instability in synaptic transmission and brain activity.
- Mania: High levels of brain activity.
- Depression: Low levels of brain activity.
What causes these changes in brain activity?
- High levels of neurotransmitters.
- High sensitivity to stimulation of the postsynaptic neurons.
What causes these changes in neurotransmitter levels?
- Genetic factors
- Stress
To sum up; Genetic factors establish a predisposition to instability in synaptic transmission, stress may trigger a cycle of instability, changes in synaptic transmission causes changes in the levels of brain activity, changes in brain activity lead to changes in mood.
2.Structural problems in the brain.
- Larger amygdala (in the midbrain).
- Larger nerve tracts related to emotion.
3.Genetic factors.
- First degree relatives 10% higher risk.
- Concordance rate in MZ twins: 60%, DZ twins: 20%
- Biologic/Adaptive parents: 31% / 2%
- The heritability of bipolar disorder: 80%
Treatments
- Lithium.
- Anticonvulsants, antipsychotics, antidepressives.
- ECT.
- Psychoeducation.
You can find academic articles for treatments and guidelines at the links below;
Table of Contents
1.Introduction and Historical Issues
Normality and Abnormality in Clinical Psychopathology
2.Diagnostic Systems and Techniques
Interviews, Observations and Tests
3.Anxiety Disorders I
Symptoms of Anxiety, Phobic Disorders, Generalized Anxiety Disorders, Panic Disorder
4.Anxiety Disorders II
Obsessive-Compulsive Disorders, Post-Traumatic and Acute Stress Disorders.
5.Mood Disorders I
Major Depressive Disorder and Dysthymia.
6.Mood Disorders II
Bipolar Disorder and Cyclothymic Disorder.
7.Schizophrenia I
Symptoms and Issues.
8.Schizophrenia II
Explanations and Treatments.
9.Disruptive Behavior Disorders-I
Attention Deficit/Hyperactivity Disorder.
10.Disruptive Behavior Disorders-II
Conduct Disorder and Oppositional Defiant Disorder.
11.Pervasive Development Disorders
Autistic Disorder, Asberger`s and other Developmental Disorders.
12.Elimination Disorders and Tic Disorder.
13.Mental Retardation.
14.Cognitive Disorders
Amnesia Disorders, Dementia Disorders, Delirium Disorders.
15.Suicide.
16.Substance-related disorders.
17.Sexual Dysfunctions.