The earlier the onset the more likely the recurrence

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The earlier the onset, the more likely the recurrence. “With Mixed Features” when coexists with at least three manic symptoms Persistent Depressive Disorder (formerly: Dysthymia) Depressed affect but does not meet other criteria for depression. Mood is chronic and continual (over two years). Postpartum onset - within 6 months of childbirth. Postpartum Postpartum onset - within 6 months of childbirth. Postpartum depression affects ~13% of women (Breese-McCoy, 2011); may depression affects ~13% of women (Breese-McCoy, 2011); may involve biological vulnerability. involve biological vulnerability. Depressive Disorders Depressive Disorders
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Bipolar Disorders Bipolar Disorders One or more manic or hypomanic episodes Mania for one week (Bipolar I); depression for 2 weeks and hypomania for at least four days (Bipolar II) Cyclothymic disorder -- chronic mood swings but less than hypomania or depression, continual in nature with depressed and manic moods that do not meet criteria for major depression. It lasts more than two months and is continual for ≥ 2 years.
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Bipolar more genetically based Bipolar much less common – 1-2% vs. 8-19% of general population has experienced BP vs. UP Onset of bipolar earlier (late teens/early twenties) than unipolar (late twenties) Bipolar displays psychomotor retardation and more suicide ideation and attempts. Bipolar responds to Lithium Comparison Between Depressive Comparison Between Depressive and Bipolar Disorders and Bipolar Disorders
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Behavioral Explanations: Reduced reinforcement due to loss reduces availability of reinforcers and activity. Sympathy reinforces depression (secondary gain) Individual drives others away and loses social reinforcements Lewinsohn’s model: Number of reinforcing events, availability of reinforcers, low social skills, and stress – factors that can reduce rate and availability of reinforcers. In bipolar disorder, biogenic factors dominant but rewards for euphoria continue until negative reactions caused by decreasing tolerance of manic behavior bring on depression.
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Cognitive Explanations: Primary disturbance in depression is negative thinking and low self-esteem. Beck -- schema (cognitive set) predisposes one for major depression. Distortions of thought processes – Beck has focused on types of maladaptive or faulty thinking invoked by schemas or cognitive sets that influence how one interprets and responds to events. Arbitrary inference Selective abstraction Overgeneralization Magnification/minimization
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Learned Helplessness and Attributional Style Learned Helplessness and Attributional Style Depression results from learned helplessness: Depression results from learned helplessness: Belief that no relationship between behavior Belief that no relationship between behavior and consequences; earliest research induced and consequences; earliest research induced depression in rats with uncontrollable shock.
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