Depression slides

Depression slides - Depression terminology Depression...

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Unformatted text preview: Depression terminology Depression terminology • Symptom—feeling sad, blue or down; common, but temporary • Syndrome—more than a sad mood; group of symptoms that cluster together; affects multiple areas of functioning Affected areas of functioning: Mood Affected areas of functioning: Mood • • • • • More exaggerated and persistent Sadness Irritability Shame Guilt Affected areas of functioning: Affected areas of functioning: Behavior • • • • • • Restlessness and agitation Reduced activity Slowed speech Less frequent social contact Less interest in enjoyable activities Destructive behavior Affected areas of functioning: Affected areas of functioning: Changes in attitude • Feelings of worthlessness and low self­ • • • • • esteem Poorer attitudes towards school Dread of the future Helplessness Hopelessness Increases in suicidal thoughts and behaviors Affected areas of functioning: Affected areas of functioning: Thinking • • • • • • Preoccupation with thoughts and tensions Self­critical and self­conscious Thought patterns are slowed Reasoning is distorted Pessimism Difficulty concentrating, making decisions, remembering Affected areas of functioning: Affected areas of functioning: Physical changes • • • • • Disruptions in eating and sleeping Fatigue Stomachaches, nausea Persistent aches and pains Loss of usual energy Depression terminology cont. Depression terminology cont. • Disorder—syndrome defined using the DSM­IV criteria (Major Depressive Disorder) – Minimum number of symptoms (5) – Minimum duration of 2 weeks – Change from previous functioning – Associated with impairment Development: Development: • Depression expressed differently at different stages of development • Debate over whether depression in childhood same as in adults • Infants—non­responsive, clingy, eating or sleeping disturbances • Preschoolers—withdrawn, somber, irritable, physical complains Development: Development: • School­aged children—more irritability, disruptive behavior, temper tantrums, combativeness, sad appearance, peer and academic problems, suicide threats • Preteens—self­blame, low self­esteem, feelings of sadness, social isolation, disturbances in eating and body image Prevalence: Prevalence: • Between 2­8% of children ages 4­18; rarer during childhood, but increases in adolescence • Many youth may have significant symptoms, but not meet full criteria • Frequently co­occurs with anxiety, conduct disorders Prevalence: Prevalence: • Onset can be gradual or sudden; usually between 13­15 • Average episode is 8 months; usually recover, but usually relapse • More common in females starting in adolescence Causes of depression: Genetic risk Causes of depression: Genetic risk • Moderate genetic influences • Children with parent who had depression as a child 14 times more likely to become depressed • Children of parents with depression have 2­3 times the risk of becoming depressed • Prevalence of MDD in mothers of children with MDD is high (50­75%) Causes: Neurobiological Causes: Neurobiological • Abnormalities in structure and function of several brain regions – Regions associated with attention and sensory processes less active – Regions associated with recognizing and regulating emotions more active – Disturbance in memory areas – HPA­axis—more sensitivity to stress • Less evidence for neurotransmitters Causes: Family influences Causes: Family influences • Families of depressed children display more critical and punitive behaviors to that child • More anger and conflict, greateruse of control, poorer communication, more overinvolvement, less warmth and support, high levels of stress, disorganization, marital discord • Strong link between childhood depression and family dysfunction Causes: Stressful life events Causes: Stressful life events • Major stressful events, and non­major stressful events (daily hassles) can lead to depression • Triggers for depression often involve interpersonal stress or actual or perceived loss (death, break­up, rejection) Causes: Emotion regulation Causes: Emotion regulation • Children show wide differences in ability to regulate mood states • Children with depression may show deficits in one or more skills needed to regulate emotions – Recognizing changes in emotions – Setting goals to change mood – Implementing coping responses Bipolar disorder: Bipolar disorder: • Recently has become a topic of interest in children, with increasing rates of diagnosis • Very difficult to diagnose in children; very rare; symptoms are similar to ADHD • Increases after puberty • Prevalence in children and adolescents is .4 to 1.2% Bipolar disorder: Bipolar disorder: • Striking period of abnormally and persistently elevated or irritable mood accompanied by periods of MDD • Manic episodes must last 1 week, but often shorter in children/adolescents • Intense irritability and rage • Silly, giddy, overexcited, overtalkative; expansive, grandiose beliefs Bipolar disorder: Bipolar disorder: • • • • Actual belief that one is all­powerful Restlessness, agitation, sleeplessness Disinhibited behavior Unrealistic surges in self­esteem; surges of energy • Intense focus, but distractible ...
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